Orthopedic Surgery Flashcards
How does LCP disease present?
Avascular necrosis of the femoral head
Present in a kid with limping, hip pain, and limited hip ROM; dx X-ray, Tx cast + crutches
What do you see in congenital hip dysplasia?
Presents as uneven gluteal folds, posterior dislocating hips (with “snapping”) in a newborn; dx U/S since hip isn’t calcified for X-ray
Tx splinting
How does hip dislocation present?
Presents as a chubby kid limping due to groin pain, hip has limited internal rotation; dx X ray, tx pin femoral head back in place
How does a septic hip present?
Presents in toddlers who refuse to move hip following a septic illness; dx hip aspiration under anesthesia, tx perc drain
How does osteomyelitis present in kids?
Presents in kids with severe localized bone pain following a septic illness; dx bone scan since X ray will be false negative, tx antibiotics
What are genu varum and valgus?
genu varum (bowlegs): 3 y/o surgical correction genu valgus (knock knee) : observation
What is Osgood-Schlatter disease?
Presents in teens with persistent pain over the tibial tubercle, aggravated by quad contraction; tx immobilization in cast
How does club foot present?
Presents as bilateral inverted feet in a newborn
tx serial plaster casts on adducted forefoot –> hindfoot varus –> equinus
How do you treat scoliosis?
Laterally curved spine
Common in teenage girls
Tx spine brace until mature, surgery if severe
How does an osteosarcoma present?
Presents as low-grade knee pain in a 10-25 y/o, X ray shows Codman’s triangle and sunburst appearance
How does Ewing sarcoma present?
Presents as low-grade epiphyseal pain in a child, X ray shows onion skinning, due to t(11;22)
How do metastatic bone cancers present?
Usually from breast (lytic) and prostate (blastic), causing bone pain and pathologic fractures
Dx: bone scan
Tx: radiation
How does multiple myeloma present?
Plasma B cell tumor results in CRAB hypercalcemia renal failure anemia bone pain (punched out lesions on Xray) Dx: urinary Bence-Jones protein Tx: chemo
How do you work up fractures?
All require 2 X-rays 90 degrees from each other including joints above and below fractured bone; anticoagulation of choice is fondaparinux + leg compression devices
How do you manage a clavicular fracture?
Typically between mid-to-distal third of clavicle; tx figure of eight device for 4-6 weeks
How does an anterior shoulder dislocation present?
Presents with outward rotated arm + deltoid numbness due to axillary palsy
How does a posterior shoulder dislocation present?
Presents with internally rotated arm held close to body
What is a Colles fracture?
Distal radial fx in osteoporotic women falling on outstretched hand
Tx is reduction + cast
What is a monteggia fracture?
Diaphyseal fx of proximal ulna + radial dislocation, following direct trauma to ulna
What is a Galezzi fracture?
Diaphyseal fracture of distal radius + ulnar dislocation, following direct trauma to radius
How does a scaphoid fracture present?
Presents as wrist pain and tender anatomic snuffbox in a young person falling on outstretched hand; tx thumb spica cast
How does a metacarpal neck fracture present?
Presents as swollen and tender hand after punching a wall; tx splint or plate
How does a hip fracture present?
presents as shortened and externally rotated hip in an osteoporotic woman; tx depends on location of fracture
What is the risk of a femoral neck fracture?
May lead to avascular necrosis of femoral head
Tx prosthetic replacement of head
