Orthopedics

Question 1

What is the name of this #?

Proximal 1/3rd Ulnar fracture and radial head dislocation

Answer 1

Monteggia fracture

Needs ORIF

Question 2

What is the name of this #?

Distal 1/3 radial shaft fracture and DRUJ dislocation

Answer 2

Galleazzi fracture

Need ORIF

Question 3

what is the sign associated with Schaphoid lunate dissociation?

Answer 3

Terry Thomas sign

Question 4

What is the Smith #?

Answer 4

Volar angulation of distal radial metaphyseal #

Question 5

How is the Barton’s # different from Colles #?

Answer 5

Bartons # is more distal from the metaphysis.

Bartons is a fx dislocation of radiocarpal joint and is an intra-articular fracture

Question 6

What is a Monteggia #?

Answer 6

proximal 1/3rd ulnar # with radial head dislocation

Question 7

What is the Galleazzi #?

Answer 7

Distal 1/3 radial shaft # with DRUJ dislocation

Question 8

What lies in the popliteal fossa behind the knee? (anatomy)

Answer 8

1) popliteal artery and vein
2) the common peroneal nerve (innervates the peroneus longus, peroneus brevis, and the short head of the biceps femoris muscles.)
3) tibial nerve

Question 9

On a lateral knee xray what does the presence of a lipohemarthrosis suggest?

Answer 9

An intra-articular fracture

Question 10

What other knee injuries are associated with lateral tibial plateau #?

Answer 10

ACL and MCL

Question 11

What other knee injuries are associated with medial tibial plateau #?

Answer 11

PCL and LCL

Question 12

What fracture is associated with ACL tear?

Answer 12

A Segond fracture is an avulsion fracture of the knee which involves the lateral aspect of the tibial plateau, and is very frequently (~75% of cases) associated with disruption of the anterior cruciate ligament

Question 13

What borders the anatomical snuff box?

Answer 13

EPL (extensor pollicis longus)
EPB (extensor pollicis brevis)
APL (abductor pollicis longus)

Answer 14

Radial height = vertical distance from parallel lines ( tip of ulnar styloid across and line from radial styloid) = 12mm

Avg inclination ~23 degrees

Question 15

A transverse process fracture of L5 is pathnomonic for what type of injury?

Answer 15

Vertical shear fracture through the sacrum on that side of the pelvis.

• the iliolumbar ligament attaches to the transverse process of L5
• is an unstable #

Question 16

What specific pelvic # types are predictive or a urethral injury?

Answer 16

• Anterior arch #
• Fracture of inf.medial pubic rami
• Symphysis diastasis

Question 17

How do you measure an ankle brachial index?

Answer 17

Ratio of BP leg/arm

1: Normal

Question 18

What are the average values of:

1. Radial inclination
2. Radial height
3. Volar tilt

Answer 18

Radial inclination: 22 degrees/23
Radial ht: 12mm
Volar tilt: 11 degrees

Question 19

List 5 bones at risk for AVN

Answer 19

o	Scaphoid
o	Lunate
o	Navicular
o	Talus
o	Femur Head

Question 20

What types of injury are commonly associated with calcaneal fractures?

Answer 20

• Bilateral 7%
• 25% lower extremity (tibial plateau)
• 10% Spinal compression fracture (T12-L2)

Question 21

DDx for hindfoot pain (Talus, calcaneus) (5)

Answer 21

1. Calcaneus stress fracture (tender over calcaneus and with squeezing calcaneus)
2. Plantar fasciitis (insidious onset starting with pain in the am or after sitting progressing to persistent pain with gait, usually medial heel pain, plain radiography may show a heel spur)
3. Heel pad syndrome
4. Subcalcaneal bursitis (tender over bursa)
5. Acute rupture of plantar fascia (from push off phase of gait, pain with passive dorsiflexion of the hallux)
6. Os trigonum syndrome (impingment of os trigonum on lateral posterior talar process typically results in pain during plantar flexion..commonly seen in ballet dancers)
7. Nerve compression (posterior tibial nerve, abductor digiti quinti, lateral plantar nerve) – tarsal tunnel syndrome
8. Tendonopathy/tendinitis or tendon rupture (Achilles, tibialis posterior, peroneal)
9. Arthritis (talocalcaneus, calcaneocuboid, talonavicular joints)

Question 22

What is Sever’s disease?

Answer 22

Sever’s Disease, otherwise known as calcaneal apophysitis is an inflammation of the growth plate in the heel of growing children, typically adolescents.

The condition presents as pain in the heel and is caused by repetitive stress to the heel and is thus particularly common in active children. It usually resolves once the bone has completed growth or activity is lessened.

Question 23

What are risk factors for achilles tendon rupture?

Answer 23

1. Flouroquinolones
2. Steroids (IM, PO)
3. SLE
4. Connective tissue disorders
5. Rheumatoid arthritis.