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Orthopaedics and rheumatology > Trauma and orthopaedics > Flashcards

Trauma and orthopaedics Flashcards

1
Q

What is debridement?

A

Surgical removal of dead, damaged or infected tissue

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2
Q

What is a scarf osteotomy?

A

This is a Z shaped surgical division of the 1st metatarsal to correct a bunion (hallux valgus).

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3
Q

Name 3 types of arthroplasty

A

Total joint arthroplasty, hemiarthroplasty, unicompartmental

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4
Q

Define: arthrotomy

A

opening a joint

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5
Q

Define: osteotomy

A

cutting/dividing a bone

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6
Q

Define: osteosynthesis

A

joining bone

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7
Q

Define: arthroplasty

A

Refashioning a joint

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8
Q

Define: exostectomy

A

smoothing a bone

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9
Q

Name the parts of the long bones

A 
Physis= growth plate in children
Epiphysis= joint side of the physis
Metaphysis= widened flare of the bone on the shaft side of the physis
Diaphysis= shaft of the bone
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10
Q

What is a classic cause of an insufficiency fracture?

A

Osteoporosis

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11
Q

What could cause a pathological fracture?

A

Tumour, infection, metabolic

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12
Q

How long should it take for an adult lower limb fracture to heal?

A

12 weeks

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13
Q

How long should it take for an adult upper limb fracture to heal?

A

6 weeks

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14
Q

What are the 3 main stages of fracture management?

A

Reduce, stabilise, rehabilitate

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15
Q

What are the stages of bone healing?

A

Trauma, haematoma, inflammation, callus formation, consolidation, remodelling

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16
Q

Name some early complications of fractures

A

Blisters, swelling, compartment syndrome, complications of treatment, associated other injuries, sepsis from major trauma, thrombo-embolism, fat embolism/ARDS

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17
Q

Name some late complications of fractures

A

Deformity, delayed/mal/non-union, post-traumatic osteoarthritis, avascular necrosis (femoral neck, scaphoid, talus), chronic pain.

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18
Q

How do you treat compartment syndrome?

A

Fasciotomy

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19
Q

How do we classify sprains?

A

Ligaments:
Grades I (minimal tear, fibre stretching),
II (partial tear)
III (complete tear).
Muscles:
Grades I (small tear, minimal bleeding),
II (significant number muscle fibres torn, bleeding),
III (complete tear).

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20
Q

What are the 2 types of referred pain?

A

1) Radicular, from nerve root compression (along dermatomal distribution).
2) Somatic, pain originating elsewhere (hard to localise).

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21
Q

What is the first sign that someone is in shock?

A

Fast respiratory rate

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22
Q

What are the signs of shock?

A

Tachycardia, hypotension, increased RR, low pulse pressure, CNS disturbance/altered mental state, decreased urine output.

23
Q

Where do you put a chest drain?

A

5th intercostal space, mid-axillary line

24
Q

Where do you put a wide bore cannula to drain the pleura in an emergency? (Needle thoracocentesis)

A

2nd intercostal space, mid-clavicular line

25
Q

What is anthalgic gait?

A

Limp- gait caused by pain (minimal time stepping on the painful side to avoid loading weight)

26
Q

What is the definition of a fracture?

A

A soft tissue injury associated with a break in the continuity of the cortex of the underlying bone

27
Q

What would you see on a gout X-ray?

A

Periarticular erosion

28
Q

What are tophi?

A

Deposits of uric acid crystals in joints, cartilage or bones

29
Q

What are the two types of fracture reduction?

A

Open and closed

30
Q

What is a back slab?

A

Plaster along the back of the affected limb held in place with bandages.

31
Q

What are the two types of traction that can be applied to fractures?

A

Skin traction and skeletal traction

32
Q

List possible causes of arthritis

A 
Congenital
Degenerative
Post traumatic
Septic
Inflammatory
Endocrine
Haematological
Neurological
33
Q

What are the four main surgical methods of managing arthritis?

A

Debridement
Osteotomy
Replacement
Ablation

34
Q

Define arthrodesis

A

Fusion of a joint

35
Q

When would you do an arthrodesis?

A

If the joint cannot be replaced. It relieves pain.

36
Q

What sign might you see in ischaemia in the upper limb?

A

Volkmann ischaemic contracture

37
Q

What is a Bankart lesion?

A

Injury to the anterior inferior glenoid labrum due to anterior shoulder dislocation.

38
Q

What is a Hill-Sachs lesion?

A

Fracture of the posterolateral aspect of the humeral head due to impaction against the anterior inferior glenoid during anterior shoulder dislocation.

39
Q

What lesions may occur in posterior dislocation of the shoulder?

A

Reverse Bankart lesion

Reverse Hill-Sachs lesion.

40
Q

What is sail sign (of the elbow)?

A

A radiological sign that suggests an occult fracture. Caused by displacement of the fat pad around the elbow.

41
Q

What is a Monteggia fracture?

A

Fracture of the proximal 1/3 of the ulna and volar dislocation of the proximal radius.

42
Q

What is a Galeazzi fracture?

A

Fracture of the middle or distal 1/3 of the radius with diastasis of the distal radio-ulnar joint (shortening and dislocation of the ulna).

43
Q

What is a Colles’ fracture?

A

Fracture of the distal radius with dorsal angulation of the distal fragment.

44
Q

What is a Smith’s fracture?

A

Fracture of the distal radius with volar angulation of the distal fragment (similar to Colles’, but angulation is volar not distal).

45
Q

What is the Terry Thomas sign/Madonna sign?

A

A radiological feature of scapholunate disloacation. There is an increase in space between the scaphoid and lunate on an AP wrist X-ray (~3 or 4mm minimum). This occurs due to ligamentous injury.
Associated with wrist instabilities.

46
Q

What is Mallet finger, and what causes it?

A

The finger bends down at the DIP join due to disruption of the extensor tendon.

47
Q

What kinds of fractures need urgent treatment?

A

Open fractures
Fracture dislocations
Fractures with vascular or neurological consequences.

48
Q

What is an avulsion fracture?

A

Bony fragment torn off by a tendon or ligament.

49
Q

Which nerve supplies sensation to the dorsum of the foot?

A

Peroneal nerve

50
Q

Which 3 special tests are best for ACL injury?

A

Anterior drawer test, Pivot shift test (for instability) and Lachman’s test (most sensitive).

51
Q

What clinical findings would you notice in an ACL injury?

A

Large haemarthrosis and quadriceps avoidance gait (not actively extending the knee)

52
Q

How would a patient with an ACL tear present?

A

Felt a “pop“, pain deep in knee, immediate swelling (70%) / hemarthrosis

53
Q

How would a patient with quadriceps tendon rupture present?

A

Often report a history of pain leading up to rupture consistent with underlying tendinopathy.

Symptoms= pain, tenderness at site of rupture, palpable defectusually within 2 cm of superior pole of patella, unable to extend knee against resistance.

54
Q

How do we manage an acutely swollen knee (without fracture)?

acronym= RICE

A

Rest
Ice pakcs
Compression/splintage
Elevation

Orthopaedics and rheumatology (5 decks)

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