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MSKJaz > #s > Flashcards

#s Flashcards

1
Q

2ndry bone healing =

gap fills with __ > ___ (__callus)> __(__ callus = ___)

A

granulation tissue
cartilage - soft
bone - hard - enchondral ossification

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2
Q

fractures that heal by primary bone healing

A

fixed, hairline

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3
Q

lateral displacement of distal part of bone = ___ displacement

A

valgus

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4
Q

if high E/ substantial soft tissue swelling +# = avoid ___

wait until it settles and then ___

A

avoid ORIF

nail/externally fixate

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5
Q

if intra/peri articular # and displaced Rx

A

reduce and rigid internally fixate

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6
Q

if intra/ peri art # at risk of AVN/ non union Rx =

A

replace

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7
Q

Open # Rx -

A

Abx, tetanus injection, debride

stabilise Sx

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8
Q

risks of femoral shaft # = ++_

Rx =

A

1l blood loss, fat emboli, ARDs
resusc, analgesia (femoral nerve block), Thomas splint
unstable = IM nail

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9
Q

distal femur # extra articular Rx =

A

unstable so Thomas splint

can nail but if too distal = plate

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10
Q

intra articular distal femur # Rx =

A

reduce and internally fixate with plates and screws

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11
Q

prox tibial # mechanism of injury

Ix =

A

valgus stress => lateral tibial plateau # with articular surface disruption
CT

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12
Q

Rx of proximal tibial # =

A

reduce and rigid fixate

elevation of depressed articular and bone fragments

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13
Q

tibial shaft fracture complication =

A

compartment syndrome

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14
Q

in tibial shaft # tolerate __+__ but not ___

A

5 degree angulation and 50% bony contact

internal rotation

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15
Q

treatment of tibial shaft #

A

16wks to union
plaster cast
possibly IM nail, plate or ext fixate

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16
Q

intra-articular distal tibial fracture =

ass with ++_

A

Pilon #

spinal/ pelvis/calcaneal #s

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17
Q

Pilon # Rx =

A

Sx emergency - externally fixate to settly soft tissues => internally fixate after CT

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18
Q

Rx for isolated distal fibular/minimally displaced medial malleolus # =

A

conservative

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19
Q

if Bimalleolar/distal fibia # => talar shift Rx =

A

ORIF

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20
Q

Rx for prox. humeral #

A

elderly = conservative (arthroplasty for head splitting/3-4 part#)
youth w displacement = internally fixate

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21
Q

humeral shaft # risks ___ in the ___

A

radial nerve in spiral groove (usually neurapraxia)

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22
Q

humeral shaft # can tolerate substantial ___ without __

A

angulation

loss of function

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23
Q

Rx of humeral shaft #

A

conservative

internally fix if non-union, pathological #, open #, high E, not tolerating brace

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24
Q

Rx of distal humeral # =

A

usually intra art

may => ORIF

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25
Q

nightstick # =

Rx =

A

isolated ulnar #

conservative

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26
Q

if ulna and radial # together =

A

ORIF

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27
Q

Rx for Galeazzi and Monteggia #s

A

ORIF

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28
Q

potential consequences of Colles #

A

median nerve compression
EPL rupture
CRPS
lose grip strength

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29
Q

stable minimally displaced/angulated Colles # Rx =

A

POP (cast)

30
Q

displaced simple Colles # Rx =

A

MUA

31
Q

displaced/comminuted Colles # Rx =

A

MUA and K wire, ORIF

32
Q

Smiths # =
mechanism of injury =
Rx =

A

extra articular distal radial #, volarly displaced and angulated
fall on back of hand
ORIF

33
Q

Barton # =

Rx =

A

intra-articular dorsal/volar rim of distal radius # => subluxed carpus
ORIF

34
Q

comminuted intra-art # of distal radius =

A

externally fixate +/- K-wires

35
Q

lasts less than 28 days and is temporary localised conduction block/demyelination

A

neurapraxia / 1st degree nerve injury

36
Q

axonotmesis / 2nd degree nerve injury =

A

nerve cell axon dies distally = Wallerian degeneration

endoneural tubes intact

37
Q

axonotmesis regenerates ___ per day and get ___ recovery may lead to chronic ___

A

1mm
8/10
weakness

38
Q

nerve transected =

Rx =

A

neurotmesis / 3rd degree nerve injury

Sx

39
Q

If have a nerve injury due to a # wait ___ and if no function then __ => ____/___

A

4wks
NCS
nerve graft
tendon transfer

40
Q

Volkmann’s ischaemic contracture is especially ass with ____ but can be caused by any ___
+ necrosis => ____ at wrist

A

supracondylar #
upper limb #
fdp + fpl necrosis
flexion contracture

41
Q

most likely sites of AVN =

A

head of humerus, head of femur
scaphoid
talus

42
Q

only ___ of __ bones need xray to confirm union

A

diaphyseal

long

43
Q

clinical features of hip + prox femur #s

A 
shortening
external rotation
trochanteric bruising
no SLR
severe groin pain on rotation
44
Q

muscles ass with the hip

A

gluteus medius and minimus
adductors
pectineus
iliopsoas

45
Q

femoral neck blood supply is from __+__ -> ___ arteries

A

circumflex medial and lateral

retinacular

46
Q

hip capsule = +++

A

iliofemoral, pubofemoral, ischiofemoral ligaments

zona orbicularis

47
Q

diagnostic xray feature of intracapsular prox femur #

A

break in shenton’s line

48
Q

subtrochanteric femur #s are ass with __

Rx =

A

long term biphosphonates
Analgesia +/- Thomas splint
IM nail fixate

49
Q

Rx for pubic rami #

A

conservative

50
Q

greater trochanter # Rx =

A

conservative

51
Q

fragility fracture sites

A 
NOF
neck of humerus
wrist
vertebrae
pelvic
52
Q

all hip #s admitted to ___ ward within __hrs of presentation

A

acute orthopaedic

4hrs

53
Q

all hip #s who are medically fit should have Sx in ___ from admission in normal working hours

A

<=48hrs

54
Q

all hip #s should be assessed and cared for in a way to decrease the risk of getting a _____

A

P ulcer

55
Q

all fragility hip #s should be managed on ___ ward with routine access to ___ support

A

acute ortho

acute orthogeriatric medical support

56
Q

all fragility hip #s should be assessed to see if need ___

A

antiresorptive therapy

57
Q

all fragility hip #s after a fall should be assessed ___ to prevent ___

A

multidisciplinarily

prevent future falls

58
Q

If have clinical suspicion/confirmed hip # before leaving A+E should have big 6 interventions =

A 
analgesia (esp for xrays)
early warning score
pressure area inspection
blood tests
fluid therapy
delirium screening
59
Q

P sores can develop in ___ if on a hard surface

A

30 mins

60
Q

mobilisation within __ of hip Sx

A

1 day

61
Q

Pelvic injuries ooze blood from ___ and can hold __ of circulating volume
Rx of this =

A

venous plexus
1/2
Sam sling - pelvic binder = tamponade

62
Q

in brain haemmorhage get __+__ on same/ opposite side?

A

weakness
pupil dilatation
contralateral side

63
Q

torus fracture =

looks like a __

A

a buckle # (is seen in paeds)

looks like a never ending ring

64
Q

plastic deformity (specific paed #) =

A

that cant be manipulated back into place usually due to splint of adjacent bone

65
Q

how to test for reduced sweating (in nerve damage)

A

can run pen over skin smoothly

66
Q

fingers wrinkling in water only occurs if __

A

nerves intact

67
Q

movements to assess median, radial and ulnar nerve function

A 
median = OK sign
radial = hitchhiker thumb
ulnar = starfish
68
Q

immobilise ___ for diaphyseal #s and ___ for metaphyseal #s

A 
dia = joint above and below
meta = adjacent joint
69
Q

exceptions to conservative management of #s in paeds =

A

displaced intra articular / growth plate #s

open #s

70
Q

usual Rx for paed #s

A

plaster
traction
less invasive fixation

MSKJaz (28 decks)

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