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Crozer Surgery Keegan Duelfer > Sutures, Rearfoot, and Trauma > Flashcards

Sutures, Rearfoot, and Trauma Flashcards

1
Q

What is a Keith Needle

A

straight needle

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2
Q

What are some common needle point configurations (3) and their uses

A

Taper point- for soft, easily penetrated tissue

Cutting- cutting edge on inner curve

Reverse cutting- cutting edge on outer curve for tough, difficult to penetrate tissue

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3
Q

What is orthofix

A

polyglycolic acid

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4
Q

How long for orthofix to lose strength/absorb

A

Loses strength in 6-12 weeks

Absorbed in 1-3 years

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5
Q

What is orthosorb

A

PDS

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6
Q

How long before PDS loses its strength/ absorb

A

Loses strength in 4-6 weeks

Absorbed in 3-6 months

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7
Q

What are two sutures that are the least reactive to tissue

A

Stainless steel (least of all)

Prolene

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8
Q

How is Vicryl broken down

A

Hydrolysis

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9
Q

How long does it take to absorb Vicryl (in terms of tensile strength)

A

Tensile strength:
-75% at 2 weeks
-50% at 3 weeks
-25% at 4 weeks

absorbed completely in 10 weeks

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10
Q

Should you use Vicryl with an infection

A

avoid it if possible, since Vicryl is too reactive

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11
Q

Describe a Keck and Kelly procedure

A

For Haglund deformity with cavus foot and high calcaneal inclination angle. Remove the wedge from posterior-superior aspect of calcaneus. The posterior superior process is moved anteriorly

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12
Q

What are treatments for equinus (conservative-2)

A

Stretching/exercises and night splints

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13
Q

What are treatments for equinus (2 broad categories- with 10specifics)

A

Gastroc recession
-Strayer
-Vulpius
-Baker
-McGlamary and Fulp

Tendoachilles lengthening
-open/closed Z
-Hauser
-White
-Hoke
-Sgarlato
-Stewart

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14
Q

What is the Murphy Procedure

A

Achilles advancement for spastic equinus

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15
Q

Name transverse surgical procedures for pes planus (3)

A

-Evans
-Kidner
-C-C distraction arthrodesis

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16
Q

Name sagittal procedures for pes planus

A

-Cotton
-Cobb
-Hoke
-Young
-Lowman
-Miller

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17
Q

Name frontal procedures for pes planus

A

-Koutsogiannis
-Dwyer
-Chambers
-Gleich
-Baker-Hill
-Lord

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18
Q

Name surgical procedures for pes cavus (2 broad categories and 7 specifics)

A

Tendon
-Jones
-Hibbs
-STATT
-PT

Bone
-dorsiflexory osteotomy of 1st met
-Cole
-Japas

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19
Q

What is an arthroereisis

A

a surgical procedure to limit joint mobility (MBA implant in sinus tarsi)

Typically want 2-4 degrees of STJ eversion with implant

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20
Q

What is the Valente procedure

A

STJ blocking using a polyethylene plug with screw threads. Will allow 4-5 degrees of STJ pronation

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21
Q

What order do you resect and what order to you fixate the joints in a triple arthrodesis

A

Resection
1)Midtarsal joints (TN&CC)
2) STJ

Fixation
1)STJ
2)Midtarsal joints

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22
Q

What are some types of fixation for a triple arthrodesis

A

6.5-7.0mm interfragmental compression screws

Staples
Plates

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23
Q

What are FDA- approved total ankle implants

A

Two component devices
-Agility
-Eclipse
-INBONE
-Salto Talaris

Three component devices
-STAR

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24
Q

What should always be asked with a break in the skin

A

Tetanus status

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25
Q

Appropriate classification for distal phalangeal/nail

A

Rosenthal

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26
Q

Appropriate classification for 1st MTPJ

A

Jahss

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27
Q

Appropriate classification for 5th metatarsal base

A

Stewart

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28
Q

Appropriate classification for Lisfranc joint (2)

A

Quenu and Kuss, Hardcastle

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29
Q

Appropriate classification for navicular

A

Watson Jones

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30
Q

Appropriate classification for Posterior tibial tendon

A

Conti

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31
Q

Appropriate classification for Talar neck

A

Hawkins

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32
Q

Appropriate classification for Talar body

A

Sneppen

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33
Q

Appropriate classification for Talar dome (2)

A

Berndt-Hardy, Fallot and Wy

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34
Q

Appropriate classification for calcaneus (3)

A

Rowe, Essex Lopresti and Sanders

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35
Q

Appropriate classification for anterior process calcaneal fractures

A

Degan

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36
Q

Appropriate classification for ankle sprains (3)

A

O’Donoghue, Leach, Rasmussen

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37
Q

Appropriate classification for physeal ankle fractures (2)

A

Dias and Tachdjian

38
Q

Appropriate classification for epiphyseal fractures

A

Salter-Harris

39
Q

Appropriate classification for ankle fracture

A

Lauge-Hansen and Danis Weber

40
Q

Appropriate classification for Pilon fracture (2)

A

Ruedi&Allgower, Dias&Tachdjian

41
Q

Appropriate classification for Achilles ruptures

A

Kuwada

42
Q

Appropriate classification for open fractures

A

Gustilo anderson

43
Q

Appropriate classification for non-unions

A

Weber &Cech

44
Q

Appropriate classification for Frostbite (2)

A

Orr and Fainer, Washburn

45
Q

What is a clinical test for a fracture

A

point tenderness over fracture site

46
Q

What is the most table fracture pattern

A

transverse

47
Q

What is the weakest region of the physis

A

one of cartilage maturation

48
Q

What is the Vassal principle

A

initial fixation of the primary fracture will assist stabilization of the secondary fractures

49
Q

What are possible complications of fractures (5)

A

-Nonunion
-delayed union
-pseudoarthrodesis
-OA
-AVN

50
Q

What is the most common cause of non-healing for a bone fracture

A

improper immobilization

51
Q

Are dorsal or plantar lisfranc dislocations more common

A

dorsal- the plantar ligaments are much stronger than dorsal

52
Q

What are the Ottowa Ankle Rules

A

1)A series of ankle X-ray films is required only if there is any pain in the malleolar zone and any of the following findings:
-bone tenderness at posterior edge or distal 6cm of lateral malleolus

-bone tenderness at posterior edge or distal 6cm of medial malleolus

-inability to bear weight both immediately and in the ED

A series of foot X-ray films is required only if there is pain in midfoot zone and any of the following findings:
-bone tenderness at base of 5th met

-bone tenderness at navicular
-inability to weight beat both immediately and in ED

53
Q

What stages of Berndt & Hardy are often associated with lateral ankle ligament ruptures

A

II, III, and IV

54
Q

What are the common locations of talar dome lesions and their mechanisms of injury

A

DIAL A PIMP

Anterior lateral portion- dorsiflexion inversion

Posterior medial portion- plantarflextion inversion

55
Q

What is Hawkins sign

A

Presence of subchondral talar dome osteopenia seen 6-8 weeks after talar fracture signifying intact vascularity. Absence of the sign implies AVN

56
Q

What is the Sneppen classification

A

talar body fractures

57
Q

What % of fractures of the talus involve the calcaneus

A

60%

58
Q

What is Mondor sign

A

plantar, rearfoot ecchymosis that is pathognomonic for calcaneal fractures

59
Q

How is Bohler angle affected by a calcaneal fracture

A

decreases with intra-articular calcaneal fracture

60
Q

How is Gissane angle affected by a calcaneal fracture

A

increases with intra-articular calcaneal fracture

61
Q

What fractures are commonly associated with calcaneal fractures (3)

A

-Vertebral fractures (especially L1)

-Femoral neck

-Tibial plateau

62
Q

What is the mechanism of injury for an anterior process fracture

A

inversion with plantarflexion

63
Q

What are tests for ankle ligament pathology (5)

A

-anterior drawer test
-calcaneofibular stress inversion
-abduction stress
-ankle arthrogram
-peroneal tenography

64
Q

What does anterior drawer test

A

ATF
CF
PTF

65
Q

What does the talar tilt test

A

CFL

66
Q

What are the clinical symptoms of an Achilles tendon rupture (5)

A

-Pain with history of pop
-Weakness of loss of function
-Palpable dell in area of ruptured tendon
-Inability to perform single leg rise
-Increased ankle dorsiflextion

67
Q

What is the Thompson test

A

a positive test result when squeezing of the calf muscle does not plantarflex the foot

68
Q

What is the Hoffa sign?

A

increased dorsiflexion compared to the contralateral side along with the inability to perform a single leg rise test

69
Q

What is a radiographic finding of an Achilles tendon rupture

A

disruption of Kagers triangle

70
Q

Where is the most common location for the Achilles tendon to rupture

A

1.5-4cm proximal to the calcaneal insertion

71
Q

Name the fracture:
Pott

A

bimalleolar fracture

72
Q

Name the fracture:
Cotton

A

trimalleolar fracture

73
Q

Name the fracture:
Tillaux-Chaput

A

avulsion fracture of anterior, lateral tibia from AITFL

74
Q

Name the fracture:
Wagstaff

A

avulsion fracture of anterior, medial fibula from AITFL

75
Q

Name the fracture: Volkman

A

posterior tibial malleolar fracture from PITFL

76
Q

Name the fracture:
Cedell

A

Fracture of posterior medial process

77
Q

Name the fracture:
Shepard

A

Fracture of posterior lateral process

78
Q

Name the fracture:
Foster

A

entire posterior process

79
Q

Name the fracture:
Bosworth

A

lateral malleolar fracture with ankle displacement

80
Q

Name the fracture:
Maisonneuve

A

proximal fibular fracture

81
Q

What is the most common mechanism of injury causing an ankle fracture

A

SER

82
Q

What is the MOI causing a transverse lateral malleolar fracture

A

SADI

83
Q

What is the MOI causing a short, oblique medial malleolar fracture

A

SADII

84
Q

What is the MOI causing a short oblique lateral malleolar fracture

A

PAB III

85
Q

What is the MOI causing a spiral lateral malleolar fracture with a posterior spike

A

SERII

86
Q

What is the MOI to the ankle with a high fibular fracture? What is this fracture called

A

PERIII

Maisonneuve fracture

87
Q

When should a posterior malleolar fracture be fixated

A

ORIF when fragment is greater than 25% of the posterior malleolus

88
Q

What direction should transsyndesmotic screws be inserted

A

approximately 30 degress from the sagittal plane from posterior-lateral to anterior medial

89
Q

What type of screw should be inserted as a transsyndesmotic screw

A

Fully threaded cortical screws are placed across both cortices of the fibula and the lateral cortex of the tibia. Goal is stabilization rather than compression

90
Q

What is the Thurston-Holland sign

A

epiphysis is separated from the physis with the fracture extending into the metaphysis resulting in a triangular fracture fragment

Crozer Surgery Keegan Duelfer (16 decks)

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