Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MSK > Trauma ortho 2 > Flashcards

Trauma ortho 2 Flashcards

1
Q

Hip fractures

X-ray - what would you see [2]

A

Disruption of Shenton’s line

Intracapsular or extracapsular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hip fractures Mx

Immediate management [6]

A 
ABCDE
Analgesia: IV morphine
Fluid resus
Imaging
DVT prophylaxis
Prepare for theatre
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hip fractures Mx
Why would a conservative approach be rare? [2]
Who would this be applicable to? [1]

What is involved in prep for theatre? [6]

A

Why? Takes weeks to heal, leaves patient bedridden for extended periods of time
Those unfit for surgery

Prep for theatre:

  • FBC
  • Clotting, crossmatch 2 units
  • U&E
  • CXR
  • ECG
  • Gain consent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Hip fractures Mx
Surgical management
Intracapsular vs extracapsular

A

Intracapsular - REPLACE

Extracapsular - FIX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Hip fractures Mx

Surgical management of intracapsular # [3]

A

Disrupted blood supply so risk of AVN
Hemiarthroplasty
OR THR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Types of extracapsular fractures [2]

A

Trochanteric

Subtrochanteric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Mx of intracapsular hip fractures: Undisplaced [2]

A
  • internal fixation or

- hemiarthroplasty if unfit.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Mx of intracapsular hip fractures: displaced [2]

A
  • young and fit: reduction and internal fixation

- old and reduced mobility: hemiarthroplasty or THR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Mx of extra capsular hip fractures

Post-operative management of hip fractures in general [3]

A

Dynamic hip screw

SAME DAY MOBILISATION, anti-coagulation, good nutrition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Displaced intracapsular hip fracture: THR between hemiarthroplasty

A

THR: >70 with no co-morbidities
Hemiarthroplasty: >70 with major co-morbidities or immobile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Mx of extra capsular fractures

A

Dynamic hip screw

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When would you use an intramedullary device for extra capsular fracture? [3]

A

Reverse oblique
Transverse
Subtrochanteric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Hip OA
RF [3]
Mx

A
  • post-avascular necrosis of the hip
  • paediatric hip disease
  • BUT NOT increased BMI (unlike knee OA)
    Mx: THR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Hip OA symptoms [4]

A

Poorly localized groin, thigh or buttock pain
Referred pain to knee
Worse on weight bearing
Stiffness on hip flexion eg tying shoelaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Hip OA signs [3]

A 
Antalgic gait
Positive Trendelenburg sign
Reduced ROM (esp internal rotation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Types of THR for Hip OA [2]

A

Conventional (replacement of femoral head and neck)

Simple resurfacing of femoral head (young with preserved femoral neck)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Early complications of THR [6]

A 
VTE
Dislocation
Deep infection
Pathological fracture
Nerve palsy
Limb length discrepancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Causes of hip replacement failure [4]

A

Prostethic loosening*
Dislocation
Periprosthetic fracture
Infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Hip pain in adults differentials [8]

A 
Osteoarthritis
Inflammatory arthritis
Referred lumbar spine pain
Greater trochanteric pain syndrome
Meralgia parenthetic
Avascular necrosis
Pubic symphysis dysfunction
Transient idiopathic osteoporosis
20
Q 
Greater trochanteric pain syndrome
AKA
Cause
Ep
Symptoms
A

AKA Trochanteric bursitis
Due to repeated movement of the fibroelastic iliotibial band
Ep: women, 50-70 years
Pain and tenderness over the lateral side of thigh

21
Q

Avascular necrosis definition
Causes [4]
Investigation [3]

A 
Def: death of bone tissue secondary to loss of blood supply
Causes:
- long term steroid use
- chemotherapy
- alcohol excess
- trauma
Ix:
- x-ray normal initially
- crescent sign means collapse of articular surface
- MRI*
22
Q

Pubic symphysis dysfunction:
Causes
Symptom [2]
Sign

A

Common in pregnancy due to ligament laxity
Pain over the pubic symphysis with radiation to the groins and the medial aspects of the thighs.
A waddling gait may be seen

23
Q

Transient idiopathic osteoporosis
Ep
Clinical features [4]

A 
Third trimester
Groin pain 
Associated with limited ROM at hip
NWB
Elevated ESR
24
Q

Femoral shaft fracture

Management [4]

A
  • stabilisation in ED with traction AND
  • Thomas splint
  • followed by locked intramedullary nail introduced proximally with a guide wire
  • to allow early immobilisation
25
What must you always assess for in femoral shaft fractures? [2]
Sciatic nerve injury | Femoral artery injury, blood loss
26
Posterior hip dislocation Most common mechanism of injury Presentation [2] Complications [3]
Ax: front seat passenger when knee strikes dashboard Sy/Si: - femoral head palpable in buttock - leg is flexed, INTERNALLY rotated, adducted and shortened Complications: - sciatic nerve injury - Equinus deformity - AVN
27
Posterior hip dislocation Investigation [2] Mx [2]
Ix: - AP and lateral XR - MRI to assess for sciatic nerve injury Mx: - closed reduction under GA within 4h reduces risk of AVN - followed by traction for 3w to promote joint capsule healing
28
Scaphoid fracture Ax Symptoms [3] Investigations [2]
Ax: FOOSH Sy/Si: - tenderness over anatomical snuff box and scaphoid tubercle - pain on axial compression of the thumb - pain on ulnar deviation of a pronated wrist or supination against resistance Ix: - scaphoid series of XR - MRI or repeat XR in 2w if -ve but highly suspicious of #
29
Scaphoid fracture mx [2] | Complication
Mx: - immobilisation in neutral cast (or Futura splint) or - percutaneous cannulated screw fixation Cx: avascular necrosis (proximal pole relies on interosseous supply from distal part)
30
Ankle ligament strain Classification [3] Symptoms [3]
Inversion injury to anterior tibiofibular part of lateral ligament Eversion injury: medial deltoid ligament Syndesmosis injury Symptoms: - stifness - tenderness over lateral ligament - pain on inversion
31
Management of simple sprains | POLICE
``` Protection from further injury Optimal Loading Ice Compression Elevation + analgesia Aim: allow WB ASAP ```
32
What is a severe sprain? How do we manage severe sprains? Safety net [3]
``` Ligament completely ruptured, NWB Below knee immobilization for 10d Advise to return if: - any NV compromise - pain hindering WB after 24h - Not fully WB by 4d ```
33
ANKLE FRACTURES Management of minimally displaced or stable fractures [3] Management of high velocity or proximal injuries Management of elderly patients
Weight bear Immobilisation the Controlled Ankle Motion boot does both these things Surgical repair: compression plate Elderly: conservative mx as thin bone doesn't hold metalwork well
34
Neck of talus fracture Mechanism Mx
Ax: forced dorsiflexion Mx: ORIF if displaced
35
Calcaneous fracture Mechanism Presentation [3] Mx
Ax: serious manual worker fall e.g. ladder or scaffolding Sy/Si: - often bilateral - swelling, bruising, inability to weight bear * **look for associated spinal injury*** Mx: immobilisation or surgery (cx higher with surgery)
36
Stress/March fracture Ep Ax Mx
Ep: soldiers Ax: excessive walking causes shaft # of 2nd or 3rd metatarsal Sy/Si: pain and excessive walking Ix: XR may be normal or show subtle periosteal changes Mx: rest and analgesia +/- plaster cast
37
Lisfranc fracture Ax Which bones are involved
Ax: polytrauma or awkwardly stepping off kerb Px: - fracture dislocation of a tarsometatarsal joint causes - dislocation of the second metatarsal joint (Lisfranc joint)
38
Lisfranc fracture Presentation [2] Mx [2]
Sy/Si: - pain, tenderness and swelling - causes COMPARTMENT SYNDROME OF MEDIAL FOOT Mx: - ORIF (precise anatomic reduction - with screw fixation across second metatarsal joint (Lisfranc joint))
39
Ankle fractures Ottawa Rules Uses [2]
Can help to clinically ddx between likely sprain and likely fracture Can guide indication for imaging in ED
40
Ankle fractures | Classification [4]
Medial malleolar Lateral malleolar Bimalleolar Trimalleolar (third is the posterior part of tibia)
41
Ankle fractures Weber AO system refers to level of fibular # Describe what a Weber A # is and their likely management [2]
Transverse fractures | below the syndesmosis [1] generally stable fractures (can often be managed non- operatively) [1]
42
Ankle fractures Weber AO system Describe what a Weber B # is and their likely management [3]
at the level of the syndesmosis [1], extending proximally – spiral or short oblique fracture pattern [1]; may be stable or unstable fractures (more likely to require surgical fixation) [1]
43
Ankle fractures Weber AO system Describe what a Weber C # is and their likely management [3]
fracture above the tibial plafond [1], likely to involve a syndesmotic injury [1]; unstable fractures (should always be considered for surgical fixation) [1]
44
Ankle fractures | General mx approach [4]
Assess Reduce Immobilise in backslab Plan definitive mx
45
Ankle fractures | Conservative management is best for which group of patients [2]
Stable, undisplaced fractures [1] with minimal disruption to articular surface [1]
46
Ankle fractures | Conservative management for displaced fractures - descrbe [3]
Manipulation under anaesthesia Moulded casting to hold in place Requires close follow up - X-ray at week 1 then week 2 as re-displacement is common
47
Ankle fractures | Surgical management indications [2]
Unstable # with taller shift or displacement and fragmentation of articular surface Where conservative has failed

MSK (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions