Basics and general concepts of trauma

Question 1

Principal mineral of bone

Answer 1

Ca hydroxyapatite

Question 2

Components of bone

Answer 2

Organic: osteoid
Water
Inorganic ca hydroxyapatite

Question 3

Osteoid is composed of

Answer 3

cells and proteins

Question 4

Bone proteins include

Answer 4

Type 1 collagen (main)
Osteocalcin
Osteonectin

Question 5

Cells of bone include

Answer 5

Osteoblast
Osteocyte
Osteoclast

Question 6

Osteoblast is rich in?

Answer 6

ALP

Question 7

Osteoclast is rich in

Answer 7

TRAP and carbonic anhydrase

Question 8

Most abundant cell in bone

Answer 8

Osteocyte

Question 9

Longest life span among bone cells

Answer 9

Osteocyte

Question 10

Type of collagen in
1. Knee meniscus
2. Articular hyaline cartilage

Answer 10

1. Type 1
2. Type 2

Question 11

Formation markers of bone

Answer 11

Pro collagen
Osteonectin
Osteocalcin
ALP (imp)

Question 12

Breakdown markers of bone

Answer 12

Hydroxyproline
Hydroxylysine
N and C telopeptide
TRAP (M. I)

Question 13

What markers rise in osteoporosis?

Answer 13

TRAP

Question 14

Layers of growth plate

Answer 14

Germinal layer (m.i)
Proliferative layer
Hypertrophic layer
Layer of calcification
Layer of ossification

Question 15

Weakest layer of growth plate

Answer 15

Hypertrophic layer

Question 16

MC layer involved in traumatic injury in growth plate

Answer 16

Hypertrophic layer

Question 17

Revise salter and harris classification

Answer 17

f

Question 18

MC type of Salter Harris fractures

Answer 18

Type 2

Question 19

Metaphyseal fragment in Type 2 fracture is called

Answer 19

Thurston Holland fragment

Question 20

Which # in Salter Harris classification has the worst prognosis?

Answer 20

Type V/ Rammed/ Crushed #
(bec late presentation)

Question 21

Most Imp clinical indication of (#

Answer 21

Abnormal motility

Question 22

WHat clinical feature separates pathological # from the other #?

Answer 22

Pain occurs before # d/t preexisting lesion

Question 23

What is Mirel’s criteria used for?

Answer 23

Plan for prophylactic fixation of pathological #

Question 24

AT what score is the need for prophylactic internal fixation decided in Mirel’s criteria?

Answer 24

> 8

Question 25

Multiple stress # requires what investigation?

Answer 25

Bone scan

Question 26

Bones with tendency for AVN

Answer 26

Head of femu\r Prox pole of scaphoid Prox pole of lunate body of talus Distal femoral condyle Head of humerus Capitulum

Question 27

causing most amount of blood loss

Answer 27

Pelvis > femur

Question 28

What are the causes of traumatic AVN?

Answer 28

# waist of scaphoid #neck of femur # neck of talus # waist of scaphoid

Question 29

MCC of non traumatic AVN Other causes of non traumatic AVN

Answer 29

Idiopathic > Steroid use Sickle cell d/s Gaucher's d/s Alcohol abuse Perthes' d/s Caisson d/s

Question 30

Above what score in MESS is indication of amputation?

Answer 30

>/= 7

Question 31

What are the components of MESS

Answer 31

Mangled Extremity Severity Score: V: Velocity of injury/ soft tissue coverage I: Ischemia time (MI) S: Shock A: Age

Question 32

Other Trauma related scores

Answer 32

Ganga score Limb salvage score

Question 33

CHeck out the diagrams of amputation

Answer 33

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Question 34

What prosthesis are available?

Answer 34

Jaipur foot and Solid Ankle Cushion Heel (SACH)

Question 35

MC pathogen involved in open #

Answer 35

S/ aureus

Question 36

Gustilo Anderson classification-- check out

Answer 36

f

Question 37

WHen should wound closure be delayed in open #?

Answer 37

> 6 hr wound New neurovasc injury Edges cannot be approximated

Question 38

Instruments used for external fixation

Answer 38

1. Schantz pin with external rod 2. Illizarov ring fixator 3. Rail fixator/ limb reconstruction system 4. Spanning external fixator Check out the pics

Question 39

Spanning external fixator is used in

Answer 39

Periarticular #

Question 40

Which fixator uses distraction osteogenesis?

Answer 40

Illizarov external fixator It is aka Callotaxis (1mm/d)

Question 41

Primary healing of # is aka? Secondary healing is aka

Answer 41

Primary/ Direct/ intramembranous Secondary/ Indirect/ Endochondral

Question 42

Callus formation is seen in what type of healing?

Answer 42

Secondary

Question 43

What achieves primary healing of #?

Answer 43

Compression plates Lag screws

Question 44

Check out stages of secondary healing

Answer 44

f

Question 45

Types of non union

Answer 45

Hypertrophic and atrophic non union

Question 46

CHeck out hypertrophic vs atrophic non union diff

Answer 46

f

Question 47

Treatment of -- hypertrophic non union Atrophic non union

Answer 47

Immobilisation Autologous bone grafting

Question 48

MC site of bone graft harvesting?

Answer 48

Iliac crest

Question 49

MOA of bone graft incorporation

Answer 49

Creeping substitution

Question 50

Malunion TOC

Answer 50

Osteotomy

Question 51

Bones with increased risk of malunion

Answer 51

Clavicle (MC) SCH # Intertrochanteric extracapsular # femur Colle's

Question 52

Bones with increased risk of nonunion

Answer 52

Lower 1/3 of tibia (mMC) Scaphoid Lat condyle of humerus Neck of femur (intracapsular) Neck of talus

Question 53

Mx of Intraarticular #

Answer 53

ORIF with plates and screws

Question 54

Mx of Extraarticular #

Answer 54

Conservative: POP, cast, slab.. Surgical (definitive): UL-- Plating with screws LL-- Intramedullary rods/ nails with interlocking screws

Question 55

Mx of patella or oleacranon #

Answer 55

Bc they have fragment pulled by attached tendons Tension band wiring with K wires and stainless steel wires (distractive force becomes compressive force)

Question 56

Fractures of necessity:

Answer 56

Intracondylar # Neck of femur # Monteggia/ Galleazi # Lat condylar # humerus