Blue Boxes: Lower Extremity Flashcards Preview

04. MSK Exam 2 Final > Blue Boxes: Lower Extremity > Flashcards

Flashcards in Blue Boxes: Lower Extremity Deck (15)
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1

What bone would you use for a bone graft?

Why?

Fibula: Nutrient foramen is located in the middle third of the fibula in most cases, this segment of the bone is used for transplanting when the graft must include a blood supply to the medullary cavity as well as to the compact bone of the surface (via the periosteum).

2

What can cause a dislocated epiphysis of the femoral head?

  • Repetitive microtraumas that place increased shearing stress on the epiphysis
    • Especially w/ abduction and lateral rotation of thigh
  • Epiphysis often dislocates, slowly resulting in a progressive coxa vara
  • Symptoms: hip discomfort referred to knee
  • Need radiographic examination to confirm diangosis 

3

What can cause a metatarsal fracture?

Heavy object falls on foot

-Common in dancers

4

Femoral Fractures

Which part of the femur is most frequently fractured?

What are other common fractures?

  • Femoral Neck Fracture
    • Most common
    • Weakest part of the bone
  • Intertrochanteric Fracture
    • Due to indirect trauma (e.g. stepping of curb)
  • Greater Trochanter Fractures
    • Due to direct trauma
  • Spiral Fractures of Femoral Shaft
  • Distal Femur Fractures
    • Separation of condyles 
    • Can compromise blood supply to leg

 

Femur vulnerable to osteoporosis 

5

Tibial Fractures

Where is the most common fracture?

What other common fractures are there?

  • Tibial Shaft Fractures: Most Common
    • Narrowest part
    • Poor blood supply 
    • Anterior surface is subcutaneous (makes it most common site for a compound fracture)
  • Transverse Stress Fractures
    • Distal part of tibia 
    • Common with hikers
  • Diagonal Fracture
    • Middle/Inferior part 
    • Common with skiing

6

How can the sesamoid bone be injured?

Crushing injury

7

What are the most common Fibular Fractures?

  • Distal end of lateral malleolus
    • Most common
  • Also seen in medial malleolus

8

Why are epiphysial plates more prone to injury in adolescents?

What is this type of injury called?

  • Adolescents are still growing and the epiphysial plate are what allows the long bones to grow.
  • During growth spurts, bones can grow faster than muscles.
    • Can result in irritation and injury to the plate and developing bone
  • Also known as ostechondrosis

9

Where do avulsion fractures of the hip tend to occur?

  • Occur at Apophyses: Bony projections that lack secondary ossification centers 
    • ASIS and AIIS
    • Ischial Tuberosities
    • Ischiopubic rami

Remember avulsion fractures occur where muscles or ligaments are attached 

 

10

What is Os Trigonum?

 

  • Secondary ossification center (lateral tubercle of the talus) occasionally fails to unite with the body of the talus.
    • This failure may be caused by applied stress (forceful plantarflexion) during the early teens.
    • Occasionally, a partly or even fully ossified center may fracture and progress to nonunion.
  • Either event may result in a bone (accessory ossicle) known as an os trigonum
    • Increased prevalence among soccer players and ballet dancers

11

Why are tibial fractures serious in adolescents?

  • Primary Ossification center is at superior end of tibia 
    • Epiphysial Plate can be damaged 
  • Osgood-Schlatter Disease

12

What is considered a pelvic and hip fracutre?

Hip Fracture:

  • Femoral Head
  • Femoral Neck
  • Femoral trochanters

Pelvic Fracture: Fractures of hip bone (yes this seems counterintuitive

  • Pubic rami 
  • Bony pelvic ring

13

How can Calcaneal Fractures happen?

What joint is normally involved?

Hard fall on heel (eg falling from ladder)

-Disrupts Subtalar joint

14

What is the difference between Coxa Vara and Coxa Valga?

Coxa Vara and Valga are the angle of inclination between the long axis of the femoral neck and the femoral shaft

  • Coxa Vara: angle of inclination is decreased
  • Coxa Valga: angle of inclination is increased

15

What can cause a fracture of the talar neck?

Severe Dorsiflexion of the ankle

-Body of talus can dislocate posteriorly