Orthopaedics Flashcards
Patient has pain on medial side of 5th toe and lateral side of 4th toe, what growth might be causing it?
Interdigital neuroma- Morton’s metatarsalgia
Causes of pain in the heel?
Bony: diseases of calcaneum, arthritis of subtalar joint
Tendon: rupture of calcaneal tendon, calcaneal paratendinitis, plantar fasciitis
Soft tissue: tender heel fat pad, postcalcaneal bursitis,
What type of imaging is most specific for osteomyelitis?
MRI
In emergency treatment of an open fracture what order do you reduce it, stop bleeding or clean the wound?
ATLS
Stop bleeding (tourniquets, chemicals, pressure)
Clean wound
Reduce and retain
Tetanus, antibiotics, imaging
How are open fractures classified in Gustilo Anderson classification?
1- clean, 1cm skin wound, simple fracture
2- no flaps or avulsions, skin wound >1cm, simple fracture
3- high energy injury or multifragmented fracture or vascular injury needing repair, severe farmyard contamination
How many compartments are there in the leg?
Anterior, lateral, superficial posterior and deep posterior
Potential regions of compartment syndrome
Which parts of the body are most at risk of compartment syndrome?
Forearm and leg (calf)
If you have a septic joint, what are the three ways bacteria may seed to the joint?
Haematogeous- bacteraemia
Direct inoculation
Contiguous spread from osteomyelitis
Why is septic arthritis an emergency?
Irreversible cartilage destruction by release of proteolytic enzymes, the cartilage replacing the damaged cartilage is of an inferior quality.
How will the patient be holding their leg if they have a septic arthritis?
In flexion, as this maximises the volume of pus the capsule can contain
Which blood test is most useful for determining efficacy of treatment with a septic arthritis?
CRP, should increase within hours of infection, normalising within 1 week of treatment
When does the cauda equina start?
L2 to the coccygeal nerve
Differential causes of cauda equina syndrome?
Lumbar disc herniation (commonest)
Spinal stenosis Tumours Trauma (dislocation or collapse) Epidural hematoma Epidural abscess
Patient has had a bike accident, they have pain out of proportion to the clinical expectation in their forearm, they get pain on passive stretching. What is the possible cause?
Compartment Syndrome
Signs of ischaemia:
Pain, paralysis
Pallor, pulselessness, paraesthesia (late)
After how many hours of ischaemia can a muscle become irreversibly damaged?
6 hours
