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MSK Year 2 > Pediatric disorders > Flashcards

Pediatric disorders Flashcards

1
Q

Osteogenesis Imperfecta

A
  • “Brittle bone disease”
  • Defect in maturation & organisation of type I collage.
  • Autosomal dominant
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2
Q

Features of Osteogenesis Imperfecta

A
  • Multiple fragility fractures in childhood, short stature, blue sclerae, loss of hearing
  • Osteopenia, thin (gracile) bones.
  • Fractures heal with poor quality callus
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3
Q

What symptoms are associated with skeletal dysplasia?

A

Learning difficulties; spine deformity; limb deformity; internal organ dysfunction; cranio facial abnormalities; skin abnormalities; tumour formation; joint hypermobility; atlanto-axial subluxation; spinal cord compression and intrauterine or premature death

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4
Q

Achondroplasia

A

Autosomal dominant condition with disproportionately short limbs with prominent forehead and widened nose. Lax joints and normal mental development. A form of short-limbed dwarfism

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5
Q

Marfan’s syndrome

A

An inherited disease that affects your body’s connective tissue, which gives strength, support, and elasticity to tendons, cartilage, heart valves, blood vessels, and other vital parts of your body
Mutation of fibrillin gene
- Tall stature and ligamentous laxity, scoliosis, joint instability, pectus excavatun

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6
Q

Ehlers-Danlos Syndrome

A
  • Autosomal dominant condition with abnormal elastin and collagen formation
  • Joint hypermobility, vascular fragility, joint instability and scoliosis
  • risk of bleeding (vascular fragility)
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7
Q

Down syndrome

A
  • Trisomy 21
  • Short stature, joint laxity, recurrent dislocation (patella)
  • Atlanto-axial instability in the c-spine
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8
Q

Spina bifida

A

Congenital neural tube defect in which the two halves of the posterior vertebral arch fail to fuse - baby’s spine does not form normally. As a result, the spinal cord and the nerves that branch out of it may be damaged.

Two main types – spina bifida occulta & spinabifida cystica

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9
Q

Spina bifida occulta

A
  • Mild form. May have no associated syymptoms
  • Tethering of spinal cord and roots causing pes cavus (high arched foot) and clawing of toes. Neurological symptoms at any age
  • Tuft of hair or dimple in skin overlying the defect
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10
Q

Spina bifida cystica

A

More severe form. Contents of vertebral canal herniate through the defect. Can be just meninges (meningocele) or spinal cord/cauda equina (myelomeningocele) itself

Meningocele not associated with neurological symptoms. Myelomenigocele associated with neurological deficit below the lesion.

Associated with hydrocephalus

Degree of disability depends on spinal level affected.

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11
Q

Polio/ poliomyelitis

A

Viral infection affecting motor anterior horn in spinal cord or brainstem resulting in lower motor neurone deficite

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12
Q

Syndactyly

A

Most common. Two digits are fused to failure of separation of skin and soft tissue of adjacent digits. Surgical separation indicated

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13
Q

Polydactyly

A

Extra digit. Amputation

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14
Q

Fibular hemimelia

A

Complete or partial absence of fibular. Leads to shortened limb, bowing of tibia and ankle deformity.

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15
Q

Management of Fibular hemimelia

A

Limb lengthening in mild cases. Amputation and below knee prosthetics in more severe cases

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16
Q

Most common limb deformity

A

Syndactyly

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17
Q

Erb’s palsy

A
  • Injury to C5 & C6
  • Loss of innervation to deltoid, supraspinatus, infraspinatus, biceps and brachialis muscle.
  • Internal rotation of humerus
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18
Q

Klumpke’s palsy

A
  • Injury to C8 & T1 caused by forceful adduction
  • Paralysis of intrinsic muscles of hand, wrist flexors
  • Fingers flexed
  • Poor prognosis
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19
Q

Sits alone, crawls

A

6‐9 months

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20
Q

Child stands

A

8-12 months

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21
Q

Child walks

A

14‐17 months

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22
Q

Child jumps

A

24 months

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23
Q

Child manages stairs independently

A

Age 3

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24
Q

Loss of primitive reflexes (Moro reflex, stepping reflex, rooting, grasp reflex, fencing posture etc)

A

1‐6 months.

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25
Q

Child gains head control

A

2 months

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26
Q

Child speaks a few words

A

9‐12 months

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27
Q

Child stacks 4 blocks

A

18 months

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28
Q

Child potty trained

A

2‐3 years

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29
Q

Child understands 200 words, learns around 10 words/day

A

18‐20 months

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30
Q

What is Genu varum?

A

Bow legs - Growth disorder of the medial proximal tibial physis.
Other causes include: rickets, tumour, traumatic physeal injury, skeletal dysplasia.

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31
Q

What risk is associated with Genu varum?

A

Risk of early onset medial compartment osteoarthritis

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32
Q

Genu valgum

A

Also known as Knock-knees is associated with rickets, tumour, trauma and neurofibromatosis

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33
Q

In-toeing

A

When walking and standing, feet point toward the midline.

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34
Q

Causes of in-toeing

A
  • Femoral neck anteversion
  • Internal tibial torsion
  • Forefoot adduction
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35
Q

Flat feet

A

Part of normal variation. Some people have it without any functional problem

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36
Q

Jack test

A

To distinguish between mobile or fixed flat feet.

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37
Q

Curly toes

A
  • Minor overlapping of the toes and curling of toes.
  • Fifth toe most frequently affected
  • May cause discomfort in shoes.
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38
Q

Curly toes treatment

A

Persistent cases in adolescence may require surgical correction

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39
Q

Patellar tendonitis

A

Patellar tendinitis )i.e Jumper’s knee) is an injury to the tendon connecting your kneecap (patella) to your shinbone. (Inflammation of the patellar tendon)

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40
Q

Apophysitis

A

Inflammation of a growing tubercle where a tendon attaches.

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41
Q

Osgood-Schlatter’s disease

A

Tibial tubercle apophysis

A condition that causes pain and swelling below the knee joint, where the patellar tendon attaches to the top of the tibia, a spot called the tibial tuberosity.

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42
Q

Patellofemoral dysfunction

A
  • Common in adolescenet GIRLS
  • Due to muscle imbalance, ligamentous laxity, subtle skeletal predisposition (valgum, wide hips, femoral neck anteversion)
  • Chondromalacia patellae may be present
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43
Q

Chondromalacia

A

Condition where the cartilage on the undersurface of the patella (kneecap) deteriorates and softens

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44
Q

Patellar instability

A

Dislocation & subluxation of patella. May be related to trauma and tear in medial patellofemoral ligament

Dislocation may cause osteochondral fracture. Small fragments may be recovered by arthroscopic surgery. Large fragments – fixation

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45
Q

Osteochondritis dissecans (OCD)

A
  1. Fragment of hyaline cartilage with some bone fragments breaks off the surface of the joint
  2. Poorly localised pain, effusion and locking
  3. Predisposes to OA.
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46
Q

Osteochondritis dissecans (OCD) management

A

Loose fragments require removal. Lesions at risk of breaking – fixation

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47
Q

Patellar instability management

A

Many patients stabilise as they grow older. Recurrent dislocation may require surgery

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48
Q

Talipes Equinovarus

A

Clubfoot

Congenital deformity due to in-utero abnormal alignment of the joints between the talus, calcaneus and navicular.

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49
Q

Treatment of Talipes Equinovarus

A
  • Early splintage
  • 80% of children require a tenotomy of the achilles tendon to maintain full correction
  • Surgery indicated in resistant to splintage
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50
Q

Tarsal Coalition

A

Abnormal bridge between the calcaneus and navicular or between talus and calcaneus.

Can lead to painful fixed flat foot deformity in older children

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51
Q

Hallux valgus

A

Also called bunions - grow on side of foot

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52
Q

Spondylolisthesis

A
  • Slippage of one vertebra over another – usually L4/5 or L5/S1,
  • Due to developmental defect or recurrent stress fracture
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53
Q

Waddling gait

A

Spondylolisthesis (vertebrae slippage out of place)

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54
Q

Features of Spondylolisthesis

A

Low back pain and radiculopathy.
• Paradoxical flat back due to spasm
• Waddling gait

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55
Q

Avascular necrosis

A

Loss of blood supply to a bone - temporary or permanent

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56
Q

Trochanteric Bursitis/gluteal cuff syndrome

A

Inflammation of the bursa at the lateral point of the hip known as the greater trochanter

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57
Q

What are the 4 ligaments of the knee?

A

ACL
PCL
MCL
LCL

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58
Q

ACL

A

Prevent abnormal internal rotation of the tibia

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59
Q

PCL

A

Prevents knee hyperextension and anterior translation of femur

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60
Q

MCL

A

Resists valgus force

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61
Q

LCL

A

Resists varus force and abnormal external rotation of the tibia

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62
Q

Meniscal injury features

A

Twisting force on a loaded knee (Turning at football, squatting)
• Localized pain to medial or lateral joint line
• Effusion following day
• Catching or locking sensation
• 15 degree springy block to full extension. Difficulty straightening knee to full extension – meniscus full torn, flipping over and getting stuck in joint line)
• Knees may feel about to give way
• Positive steinman’s test

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63
Q

Steinman’s test

A

Test done to diagnose meniscal pathology at the knee joint.

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64
Q

What meniscal injury is most common?

A

Medial more common than lateral

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65
Q

Bucket handle meniscal tear

A

Large meniscal fragment flips out its normal position and displaces anteriorly or into intercondylar notch. Knee locking occurs due to mechanical extension

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66
Q

Degenerative meniscal tears

A
  • Occurs as meniscus weakens with age.
  • Tends to have complex patterns
  • Often first stage of knee osteoarthritis.
  • Steinman negative
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67
Q

Treatment of meniscal tears

A

Poor healing potential as limited blood supply. Healing potential also decreases with age and time from injury

  1. Meniscal repair – suturing meniscus to its bed. 25% fail and require arthroscopic menisectomy
  2. Arthroscopic menisectomy - removal of some or all of the meniscus
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68
Q

Why do meniscal tears require surgery?

A

Poor healing potential as limited blood supply. Healing potential also decreases with age and time from injury

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69
Q

ACL rupture cause

A

High rotational force. Internal rotation of tibia. Turning upper body laterally on a planted foot

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70
Q

Features of ACL rupture

A
  • “pop” heard.
  • Haemarthrosis within an hour of injury
  • Deep pain in knee
  • Rotary instability with knee giving way when turning on a planted foot
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71
Q

Treatment of ACL rupture

A
  • Physiotherapy
  • ACL reconstruction with tendon graft
  • Indicated for sportspersons or those whose knees give way on sedentary activity. Extensive rehabilitation indicated
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72
Q

What tendons are used for ACL rupture repair?

A

Patellar, semitendinosis or gracilis

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73
Q

When is surgery indicated for ACL rupture repair?

A

Indicated for sportspersons or those whose knees give way on sedentary activity. Extensive rehabilitation indicated

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74
Q

PCL rupture

A
  • Unlikely to occur in isolation.
  • if your shinbone is hit hard just below the knee or if you fall on a bent knee. These injuries are most common during: Motor vehicle accidents
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75
Q

MCL tear

A
  • Fairly common.
  • Laxity & pain on valgus stress. Tenderness over origin or insertion of MCL

MCL prevents leg from extending too far inwards

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76
Q

LCL tear

A

Most often occur from a direct blow to the inside of the knee. This can stretch the ligaments on the outside of the near too far and may cause them to tear

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77
Q

MCL tear management

A
  1. Acute – high knee brace

2. Chronic – MCL tightening or reconstruction

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78
Q

LCL tear management

A

Treatment – Surgical with tendon graft

LCL helps to prevent excessive side (lateral) movement of the knee joint.

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79
Q

What nerve is commonly injured in LCL tears?

A

High incidence of common peroneal nerve injury from excessive stretch

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80
Q

Extensor Mechanism ruptures

A

Rupture involving tibial tuberosity, patellar (more common in younger), quadriceps (more common in older) tendon and quadriceps muscles.

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81
Q

Cause of Extensor mechanism ruptures

A

Due to rapid contractile force (after lifting heavy weight or fall or denegenerate tendon)
- trauma, degenerative disease, overuse injuries

82
Q

Predisposing factors for developing extensor mechanism ruptures

A

Tendonitis; steroid use; diabetes, RA & chronic renal failure

83
Q

Patellofemoral dysfunction

A
  • Disorders of patellofemoral articulation resulting in anterior knee pain
  • Due to lateral pull of the patella.
  • More common in females.
84
Q

Valgus stress injury

A
  • Tear medial collateral.

* Higher forces potential damage ACL and risk of lateral tibial plateau fracture

85
Q

Arthrodesis

A

Surgical stiffening or fusion of a joint in a position of function

Useful in endstage ankle arthritis, wrist arthritis and arthritis of first MTP

86
Q

Osteotomy

A
  • Surgical realignment of a bone

* Useful for correction of deformity or to shift the load on an arthtitic limb

87
Q

Arthroplasty

A

Restores function of a joint - Can be made from stainless steel, cobalt chrome, titanium alloy, polyethylene and ceramic
• Will eventually fail due to loosening or breakage

88
Q

Brodie’s abscess in osteomyelitis

A

bone reacts by walling off abcess with a thin rim of sclerotic bone

89
Q

What organisms cause surgical infections?

A

Usually Staph aureus and gram neg bacilli

Do not give antibiotics until surgical decision has been reached

90
Q

Another name for frozen shoulder

A

Adhesive Capsulitis

91
Q

Adhesive Capsulitis

A

Progressive pain and stiffness of the shoulder in patients between 40 and 60, resolving after 18-24 months due to capsule and glenohumeral ligaments becoming inflamed, thicken and then contract

92
Q

Tears in glenoid labrum

A
  • SLAP lesions
  • Diagnoses using MRI arthrogram
  • Treatment – biceps tenotomy or labral resection
93
Q

Popeye deformity

A

Spontaneous rupture of bicep

94
Q

Ganglion

A

A ganglion cyst is a fluid-filled swelling that usually develops near a joint or tendon - Cause localised pain or irritation

95
Q

Foot drop

A

Common fibular nerve (pernoeal nerve)

96
Q

Positive anterior drawer test

A

Tibia can be pulled forward easily when knee flexed) due to ACL tear/rupture

97
Q

Painful arc (pain on abducting between about 70 and 120 degrees)

A

Shoulder impigement, Damaged supraspinatus tendon, frozen shoulder

98
Q

Locked knee

A

bucket handle meniscal tear

99
Q

Bamboo spine on xray, scoliosis, Question mark posture

A

Ankylosing spondylitis

100
Q

Popcorn calcification on xray

A

chondrosarcoma

101
Q

Sunray calcification on xray

A

Osteosarcoma

102
Q

Onion-peel” sign

A

Ewing’s sarcoma

103
Q

Management of Infection in prosthetic joints

A

o Ideally, remove prosthetics and cement
o Re-implantation of joint after aggressive antibiotics therapy
o Treatment for staph epidermidis is vancomycin

104
Q

Gas gangrene

A

o Bacterial infection that produces gas in tissues with gangrene
o Spores, found in soil
o Treat with urgent debridement

105
Q

Necrotising fasciitis

A

o Severe infection of either the dermis, subcutaneous tissue, fascia or muscle
o Surgical emergency

Necrotising fasciitis is a very serious bacterial infection of the soft tissue and fascia. Quickly spreads

106
Q

Necrotising fasciitis management

A
  1. Debridement
  2. Penicillin (kills bacteria during exponential growth phase)
  3. Clindamycin (switches off bacterial toxin production during stationary phase)
107
Q

What are the normal curves of the spine?

A

o Cervical lordosis
o Thoracic kyphosis
o Lumbar lordosis

108
Q

Paronychia

A

infection within nail field

109
Q

Bursitis

A

Bursitis is where a bursa becomes swollen and inflamed. A bursa is a small, fluid-filled sac that acts like a cushion between tendons and bones.

110
Q

Hallux rigidus

A

stiff great toe

111
Q

Multiple myeloma

A

Multiple myeloma is a cancer of the plasma cells, which accumulate in the bone marrow. It commonly causes bone pain in the ribs and spine, anaemia and renal failure

112
Q

What shoulder dislocation is most common?

A

Anterior shoulder dislocation is much more common than posterior dislocation

113
Q

What dislocation can arise from a seizure?

A

Shoulder dislocation

114
Q

Axillary nerve damage signs

A

Principle sign of axillary nerve damage is loss of sensation in regimental badge area

115
Q

Shoulder dislocation management

A

Treat with closed reduction under anaesthetic

116
Q

Olecranon fracture

A

o Occur with fall onto the elbow

o Treat with ORIF

117
Q

Monteggia fracture

A

A fracture of the proximal third of the ulna with dislocation of the proximal head of the radius.

118
Q

Galeazzi fracture

A

fracture of the middle to distal third of the radius associated with dislocation or subluxation of the distal radioulnar joint (DRUJ).

119
Q

Colles fracture

A

Extra-articular fracture of the distal radius with dorsal displacement

Broken wrist - similar to Smith’s but smith does not extend to wrist

Occurs due to a FOOSH - Median nerve compression and carpal tunnel may be a feature

120
Q

Smith’s fracture

A

o Extra-articular fracture of the distal radius with volar displacement
o Occurs due to fall onto the back of a flexed wrist (opposite of a FOOSH)
o Treat with ORIF

121
Q

Barton’s fracture

A

o Intra-articular fracture of the distal radius

o Treat with ORIF

122
Q

Scaphoid fracture

A 
o	Usually occurs after FOOSH
o	Tenderness in the anatomical snuff box
o	Difficult to visualise on xray
o	Treat with plaster cast to immobilise the wrist while healing occurs
o	If displaced, ORIF
123
Q

Baker’s cysts

A

Is a fluid filled swelling at the back of the knee

124
Q

McMurray’s test

A

Used to detect internal tears in the knee joint. It is a procedure by which the knee is systemically rotated to identify where tears in the cartilage (called the meniscus) may have occurred or developed.

125
Q

Rheumatoid factor for RA

A

> 

Sensitivity 50-80%

> Specificity 70-80%

126
Q

Anti-CCP antibodies

A

Better diagnostic marker for RA compared to RF
> Sensitivity 60-70%
> Specificity 90-99%

127
Q

Complications of RA

A

1) Increased cardiovascular risk
2) Osteopenia (reduced bone mass of lesser severity than osteoporosis)
3) osteoporosis

128
Q

DMARDs side effects

A
  • Bone marrow suppression
  • Infection
  • Liver function derangement
  • Pneumonitis
  • Nausea
129
Q

Anti TNF agents

A

Infliximab, Etanercept, Adalimumab, Certolizumab, Golimumab

130
Q

Anti TNF agents adverse effects

A
  • Risk of infection (esp TB)
  • Question over risk of malignancy (esp skin cancer)
  • Contraindicated in certain situations e.g. pulmonary fibrosis, heart failure
131
Q

Osteophytes

A

A bony outgrowth associated with the degeneration of cartilage at joints

132
Q

OA X-ray changes

A
  • Marginal osteophytes.
  • Joint space narrowing.
  • Subchondral sclerosis.
  • Subchondral cysts.
133
Q

Increased urate production

A

o Inherited enzyme defects
o Myeloproliferative/Lymphoproliferative disorders
o Psoriasis
o Haemolytic disorders
o Alcohol (beer, spirits)
o High dietary purine intake (red meat, seafood, corn syrup)

134
Q

Reduced urate excretion

A
  • Chronic renal impairment
  • Volume depletion e.g. heart failure
  • Hypothyroidism
  • Diuretics
  • Cytotoxics e.g. cyclosporin
135
Q

Milwaukee shoulder

A

Hydroxyapatite crystal deposition in or around the joint.
Release of collagenases, serine proteinases and IL-1
> Acute and rapid deterioration.
> Females, 50-60 years

136
Q

Soft tissue rheumatism

A

General term to describe pain that is caused by inflammation/damage to ligaments, tendons, muscles or nerve near a joint rather than either the bone or cartilage
Pain should be confined to a specific site e.g. shoulder, wrist etc.

137
Q

Spondyloarthropathies

A

Family of inflammatory arthritides characterized by involvement of both the spine and joints, principally in genetically predisposed (HLA B27 positive) individuals

138
Q

Enthesitis

A

Inflammation at insertion of tendons into bones

139
Q

Red flag signs in back pain

A 
Age <20 or >50
Thoracic pain – aortic aneurysm 
Previous carcinoma (breast, bronchus, prostate)
Immunocompromise (steroids, HIV)
Feeling unwell
Weight loss
Widespread neurological symptoms
Structural spinal deformity
140
Q

Technetium scan

A

Is a bone scan to show tumours, infection bleeding, using technetium (radioactive substance) as a tracer.

141
Q

Xrays

A

X-ray – shows dense tissues.

Dense materials, such as bone and metal, show up as white on X-rays.

142
Q

MRI scan

A

MRI is a medical imaging modality that creates detailed images of soft tissues.

143
Q

Cellulitis

A

Cellulitis is a bacterial infection of the deeper layers of skin and the underlying tissue.
Best guess antibiotics to cover Staph and Strep - Flucloxacillin and benzylpenicillin.

144
Q

Blount disease

A

Blount disease is a growth disorder of the shin bone characterized by inward turning of the lower leg (bowing) that slowly worsens over time.
Growth arrest of medial tibial physis of unknown aetiology (weight overload)
typical Beak-like protrusion on x-ray

145
Q

Knee dislocation

A

Serious high energy injury with high incidence
Popliteal artery injury
Common peroneal nerve injury
Compartment syndrome
Emergency reduction, recheck neurovascular status.

146
Q

Patellar dislocation

A

Rapid turn or direct blow

Increased incidence in females, adolescents, ligamentous laxity, valgus knee, torsional abnormalities

147
Q

Extensor mechanism rupture - mechanism of injury

A

Fall onto flexed knee with quads contraction 🡪 rupture quads or patellar tendon.

148
Q

Hyaline cartilage

A

Covers the surface of bone in synovial joints.
Decreases friction and distributes load.
Comprised of water, collagen, proteoglycans & chondrocytes.

149
Q

Chondrocytes

A

Produce and regulate the extracellular matrix in joints

No blood vessels - nutrition from synovial fluid and subchondral bone, healing / repair poor.

150
Q

Most common primary bone sarcoma

A

Osteosarcoma

151
Q

Second most common malignant sarcoma in young adults

A

Ewing’s sracoma

152
Q

Chondrosarcoma

A

chondrosarcoma, which remember involves abnormal cartilage forming cells or chondrocytes.

153
Q

Osteoid osteoma

A

Describes a small benign lesion that usually affects the long bones. It has this characteristic ‘o’ appearance on Xray

154
Q

Most common benign bone tumour

A

Osteochondroma

155
Q

2nd most common benign bone tumour

A

Enchondroma

156
Q

Tendon

A

Attach muscle to bone

157
Q

Fibroblast

A

The predominant cell in tendons is the fibroblast which are responsible for the production and maintenance of collagen and other proteins which confer the flexibility and tensile strength of tendons.

158
Q

Achilles tendonitis

A

Achille’s tendon rupture is a common injury and tends to occur after a sudden force such as a forceful push off the foot e.g., while running, jumping etc. It is commoner in patients with Rheumatoid arthritis, those on steroids and patients with tendonitis.
Common, middle aged

159
Q

Achilles tendonitis Diagnosis

A

USS, MRI

160
Q

What medication is responsible for new onset Achilles tendon disorders; tendinitis and tendon rupture

A

Ciprofloxacin

161
Q

Thompson’s test

Simmond’s test

A

Same thing
Examines the integrity of the Achilles tendon by squeezing the calf
If the test is positive, there is no movement of the foot on squeezing the corresponding calf, signifying likely rupture of the Achilles tendon.

162
Q

LOAF

A

Lumbricals IF and MF
Opponens
Abd Pollicis Brevis
Flexor Pollicis Brevis

All innervated by the median nerve

163
Q

Filled with synovial fluid and Fluctuates / trans-illuminates

A

Ganglion

164
Q

A subungual hematoma

A

A subungual hematoma is a collection of blood under your fingernail or toenail.

165
Q

Bursitis

A

Inflammation of the synovium lined sacs that protect bony prominences and joints.
Can become secondarily infected and form an abscess. Bursi are between bones and tendons (cushions)

166
Q

Bursitis management

A

NSAIDs / Analgesia
Antibiotics
Incision and drainage

167
Q

Lipoma

A

Benign neoplastic proliferation of fat

168
Q

Risk factors for Hip fractures

A 
Osteoporosis - 3x more common in females
Smoking
Malnutrition
Excess alcohol
Neurological impairment
Impaired vision
Low BMI
169
Q

Blood supply to femoral head

A

Intramedullary artery of shaft of femur
Medial & lateral circumflex branches of profunda femoris
Artery of ligamentum teres

170
Q

What are the 2 categories of hip fractures?

A

Intracapsular

Extracapsular

171
Q

Types of intracapsular hip fractures

A

Subcapital
Transcervical

Can be undisplaced/displaced

172
Q

Types of extracapsular hip fractures

A

basicervical
intratrochantric
Reverse oblique
subtrochantric

173
Q

Management of intracapsular high function hip fracture

A

Displaced - THR

Undisplaced - CHS

174
Q

Management of intracapsular Low function hip fracture

A

Hemi-arthroplasty

175
Q

Management of extracapsular intratrochantric hip fracture

A

DHS screw

176
Q

Management of extracapsular subtrochantric hip fracture

A

IM nail

177
Q

Classification of ankle fractures

A

Weber - A, B and C

178
Q

Tibial Plateau Fractures

A

Refers to a break or crack in the top of the shin bone, at the knee. It involves the cartilage surface of the knee joint. This joint helps supports your body weight, and when it is fractured, it is unable to absorb shock.

High energy injuries in the young, but low energy injuries in older osteoporotic bone

179
Q

ORIF

A

Open Reduction Internal Fixation

180
Q

Thomas’ Splint

A

Immobilizes limbs with fractures - e.g femoral shaft fracture

181
Q

Young-Burgess Classification

A

Classification of pelvic fractures

182
Q

Humeral shift fracture - nerve injury

A

Radial

183
Q

Proximal Humeral Fractures

A

Common injury, typically low energy of osteoporotic bone from a fall
Usually surgical neck fracture (rather than anatomical neck)

184
Q

Posterior shoulder dislocation

A

Fall with shoulder in internal rotation,
Direct blow to anterior shoulder
Humeral head posterior to the glenoid

Usually due to seizures/electrical shocks

185
Q

Inferior shoulder dislocation

A

Arm held in abduction.
Humeral head inferior to the glenoid
Needs prompt neurovascular assessment and reduction.

186
Q

Different parts of a bone in children

A

Epiphysis
Physis
Metaphysis
Diaphysis

187
Q

Greenstick fracture

A

A greenstick, buckle or torus fracture is a fracture in a young, soft bone in which the bone bends and partially breaks. A person’s bones become harder (calcified) and more brittle with age. Greenstick fractures usually occur most often during infancy and childhood when one’s bones are soft. The name is by analogy with green wood which similarly breaks on the outside when bent.

188
Q

Salter Harris fracture classification

A

Salter Harris fracture classification of displaced growth plate fractures

189
Q

Diaphysis

A

shaft of bone

190
Q

Physis

A

Growth plate

191
Q

Epiphysis

A

The end part of a long bone, initially growing separately from the shaft.

192
Q

Metaphysis

A

The metaphysis is located between the diaphysis and epiphysis.

193
Q

Type I salter harris fracture

A

A complete physeal fracture with or without displacement

194
Q

Type II salter harris fracture

A

A physeal fracture that extends through the metaphysis producing a chip fracture o the metaphysis (may be very small)

195
Q

Type III salter harris fracture

A

A physeal fracture that extends through the epiphysis

196
Q

Type IV salter harris fracture

A

A physeal fracture that extends through the metaphysis and epiphysis

197
Q

Type V salter harris fracture

A

A compression fracture of the growth plate

198
Q

Weber A fracture

A

below the level of the syndesmosis (infrasyndesmotic)
usually transverse
tibiofibular syndesmosis intact

199
Q

Weber B fracture

A

Distal extent at the level of the syndesmosis (trans-syndesmotic); may extend some distance
tibiofibular syndesmosis usually intact, but widening of the distal tibiofibular joint

200
Q

Weber C fracture

A

above the level of the syndesmosis (suprasyndesmotic)

tibiofibular syndesmosis disruption with widening of the distal tibiofibular articulation

MSK Year 2 (3 decks)

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