Orthopedics Flashcards
New mother presenting with wrist pain that is exacerbated by ulnar deviation of the wrist with a flexed thumb suggestive of?
Diagnosis of De Quervain’s tenosynovitis
Valgus stress test.
is the maneuver to evaluate the medial collateral ligament injury.
Pediatric patients with falls on outstreched hands commonly present with?
Supracondylar fractures of the humerus. These fractures can often concur with neurovascular injuries. Specifically, the anterior interosseous nerve, a branch of the median nerve, presents with thump opposition and making the “OK” sign.
Supracondylar fractures of the humerus are often associated with?
They can often concur with neurovascular injuries. Specifically, the anterior interosseous nerve, a branch of the median nerve, can be stretched due to traction and lead to a palsy preventing thump opposition and making the “OK” sign.
The anterior drawer test
Pushes the tibia posteriorly to observe the amount of posterior translation at the lateral aspect of the ankle, assesses the integrity of the Anterior Talofibular Ligament.
The talar tilt test
The examiner inverts the foot while palpating the talus to determine if tilting occurs, assess the laxity of the Calcaneofibular ligament.
Erb Palsy
C5-C6 nerve roots
pronated and medially rotated arm that canoot be abducted.
The most common damaged root during delivery.
Quadriceps tendon tears
age of 40 and history of chronic disease (SLE, diabetes)
cannot fully extend the knee and there may be a palpable defect in the tendon just superior to the patella.
A complete tear requires surgical repair
Morton’s neuroma
Intermetatarsal plantar nerve neuroma, presents with pain between the third and fourth digits of the foot and clicking sensation.
Due to improperly fitted footwear, in particular heels and cowboy boots.
Treatment is rest, proper footwear, surgil excision in severe or refractory cases.
Legg-Calve-Perthes disease
Idiopathic avascular necrosis of the femoral capital epiphysis.
Unilateral subacute hip pain in a male child (often 4-10 years of age), antalgic gait, decreased hip range of motion, and may have thigh muscle atrophy. \
RX: collapse of the ipsilateral femoral head. Is not an inflammatory condition, the ESR/CRP are often normal.
The goal of treatment is to contain and protect the femoral head and hip joint from further injury while allowing healing to take place. It may include observation, bed rest, reduced weight bearing, bracing, or surgical osteotomy.
Tarsal tunnel syndrome
Caused by an entrapped or damaged distal tibial nerve.
Shooting and burning pain on the plantar surface of her foot and a positive Tinel sign (shooting pain elicited by tapping on the tarsal tunnel).
Management: rest and non-steroidal anti-inflammatory drugs, proper fitting shoes, physical therapy); surgery may be indicated in severe cases.
Midshaft humeral fracture nerve damage
Typically occurs after significant trauma and can result in damage to the radial nerve. Weakness of extension of the forearm, wrist, and fingers depending on the location of the injury. It can also present with a loss of sensation over the dorsum of the distal forearm and lateral hand.
Mid-shaft clavicular fracture that is minimally displaced, neovascular examination.
A thorough neurovascular examination must be done to help rule out brachial plexus and subclavian artery injuries.
Pelvic trauma is best managed with?
IV fluids and a pelvic binder to keep the pelvis in place.
If the bleeding does not stop, the next best step in management is Interventional Radiology vessel embolization.
tibial tubercle apophysitis
AKA Osgood-Schlatter’s disease: is an overuse injury which typically presents in the setting of increased activity in young children.
Anterior knee pain that can be increased with palpation along the area of the insertion of the patellar tendon on the tibial tubercle. Due to overuse traction, the insertion site can become a secondary ossification center and lead to pain.
