UE Ortho

Question 1

scapula fx tx (2)

Answer 1

sling/immobilizer + rehab for 6-12 mo.

surgery indicated for articular surface displacement

Question 2

neer classification areas (4)

and fracture parts

Answer 2

surgical neck
anatomical neck
greater tuberosity
lesser tuberosity
parts 1-4

Question 3

nerve concern w/ humerus fx & presentation

Answer 3

radial n.

wrist drop

Question 4

sulcus sign

Answer 4

glenohumeral dislocation

Question 5

glenohumeral dislocation tx (2) and complication concerns (2)

Answer 5

immediate reduction
shoulder immobilizer 2-4 weeks

axillary n.- test sensation over deltoid
rotator cuff tear if ROM does not return after reduction

Question 6

Bankart lesion

Answer 6

detachment of anterior inferior labrum from glenoid rim

Question 7

Hill Sachs lesion

Answer 7

cortical depression of the posterolateral humeral head when humeral head is impacted by anterior rim of glenoid

Question 8

axillary nerve damage (2)

Answer 8

decreased sensation to lateral aspect of shoulder

decr. deltoid function

Question 9

nerve concern with supracondylar fx (2)

Answer 9

anterior interosseus nerve: test with OK sign

2 point discrimination to all 5 palmar pads

Question 10

elbow dislocation diagnosis & tx (2)

Answer 10

plain films are diagnostic
immediate reduction if needed
casting/sling with early mobilization

Question 11

tx nursemaids elbow (2)

Answer 11

supination with pressure over radial head

hyperpronation with pressure over radial head

Question 12

Monteggia fx

Answer 12

ulnar (or radial & ulnar) shaft fx w/ dislocation of the radial head

Question 13

cause of Volkmann’s ischemic contracture (2)

Answer 13

crush injury

tight bandage/cast

Question 14

Colles fx (2)

Answer 14

dinner fork deformity

outward fall

Question 15

Smith’s fx

Answer 15

inward fall

Question 16

wrist fx tx

Answer 16

splinting, reduction, casting 4-6 weeks

Question 17

Galeazzi fx & treatment

Answer 17

distal radius fx w/ disruption of distal radius & ulna joint

casting in slight pronation

Question 18

anatomical snuffbox borders

Answer 18

lateral: extensor pollicis brevis + abductor pollicis longus
medial: extensor pollicis longus

Question 19

scaphoid fx diagnosis and treatment (2)

Answer 19

radiographs may be negative, repeat in 2 weeks

thumb spica cast
surgery for displaced

Question 20

what UE fx is at highest risk for AVN

Answer 20

proximal aspect of scaphoid

Question 21

PIP dislocation tx (3)

Answer 21

rule out fracture first w/ plain films
reduction: accentuate deformity first
splinting for 2 weeks

Question 22

when to give abx for a crush injury

Answer 22

with associated distal phalanx fracture

Question 23

subungual hematoma tx

Answer 23

nail trephination

Question 24

jersey finger presentation

most commonly affected

Answer 24

inability to flex DIP joint, pain over volar aspect

ring finger most common

Question 25

jersey finger tx (2)

Answer 25

surgical repair within 10-14 days to prevent tendon shortening
splint x 6 weeks

Question 26

mallet finger presentation & tx

Answer 26

inability to extend the DIP joint

extension splint 6-8 weeks

Question 27

Boutonniere deformity

Answer 27

flexion of PIP

hyperextension at DIP

Question 28

Swan neck deformity

Answer 28

hyperextension of PIP

flexion of DIP

Question 29

Boxer’s fx treatment (2)

Answer 29

ulnar gutter cast

surgery if greater than 30 degrees angulation

Question 30

gamekeeper’s thumb MOI & treatment (2)

Answer 30

injury to MCP joint –> ulnar collateral ligament tear & MCP instability

spica cast
surgery for stener lesion- adductor pollicis interferes with UCL healing

Question 31

clavicle fx (4)
non-displaced and displaced

Answer 31

nondisplaced: figure 8 and sling for 8-12 weeks
displaced: plate & screw
muscle relaxant for pain
refer for F/U