Classifications

Question 1

Paediatric septic arthritis

Answer 1

Kocher
NWB
ESR >40
Fever >38.5
WBC >12

Probability: 4=99%, 3=93%, 2=40%, 1=3%

Question 2

Perthe’s

Answer 2

Waldenstroms - stage 1-4
Herring (radiographic)
Group A
Group B
Group C

Question 3

SUFE

Answer 3

Loder - unstable vs stable
Southwick slip angle

Question 4

Physeal fractures

Answer 4

Salter-Harris
S - straight
A - above
L - lower
T - through
ER - erosion

Question 5

Supracondylar

Answer 5

Gartland
Type 1 - minimally displaced
Type 2 - displaced, intact cortex
Type 3 - completely displaced

Question 6

Clavicle

Answer 6

Allman
G1 = middle 1/3
G2 = lateral 1/3 (Neer mod)
G3 = medial 1/3

Neer modification - type II and V unstable

Question 7

Types of non-union

Answer 7

Hypertrophic
Atrophic
Oligotrophic
Septic

Question 8

Prox humerus

Answer 8

Neer

Number of parts

Question 9

Humeral head ischaemia

Answer 9

Hertel

Question 10

Shoulder dislocation

Rarer associated injuries

Answer 10

ALPSA
HAGL
SLAP

Question 11

Olecranon

Answer 11

Mayo
Type 1 = undisplaced
Type 2 = dislplaced, stable
Type 3 = displaced, unstable

Question 12

Distal radius

Answer 12

Frykman
Type I-VIII

AO

Even numbers = ulnar styloid fracture

Question 13

XR scaphoid series

Answer 13

PA
Lateral
Oblique
Ulna deviation
PA clenched fist

Question 14

Scaphoid

Answer 14

Herbert (fracture stability)
Russe (direction of fracture pattern)
Mayo (site of fracture)

Question 15

Nec fasc

Score

Answer 15

LRINEC
Hb
WCC
CRP
Na
Cr
Glu

Question 16

Nec fasc

Types

Answer 16

Type 1 = polymicrobial (staph, pseudomonas, coliforms, bacteroids)
Type 2 = monomicrobial (group A haemolytic strep)
Type 3 = gas gangrene (clostridium)

Question 17

Shock

Answer 17

Cardiogenic
Hypovolaemic
Obstructive
Distributive

Question 18

Trauma lethal triad

Answer 18

Hypothermia
Acidosis
Coagulopathy

Question 19

Tranexamic acid

Mechanism

Answer 19

Antifibrinolytic
1. Binds to plasminogen
2. Decreases conversion to plasmin
3. Prevents fibrin degradation

1g IV over 10 minutes

Question 20

Nerve injury

Answer 20

Seddon
Neuropraxia (class I)
Axonotmesis (class II)
Neurotmesis (class III)

Question 21

Bone healing

Answer 21

Haematoma + inflammation
Soft callus
Hard callus
Remodelling (woven to lamellar)

Question 22

Canadian C spine

High risk

Answer 22

• > 65
• Dangerous mechanism
• Paraesthesia in extremities

Question 23

Canadian C spine

Low risk

Answer 23

• Simple rear end RTC
• Sitting position in ED
• Ambulatory at any time
• Delayed onset neck pain
• Abscence of midline C spine tenderness

Question 24

Knee

Terrible triad

Answer 24

ACL
MCL
Med meniscus

Question 25

Mirels'

Answer 25

Site Size Lesion Pain

Question 26

Nottingham Hip Fracture Score

Answer 26

Age Sex AMTS Hb on admission Residence (?instituionalised) Co-morbidities Active malignancy | Predicts 30 day mortality following a hip fracture

Question 27

Extra-capsular #s | Intertrochanteric

Answer 27

**Evans** Type 1-5

Question 28

Extra-capsular #s | Subtrochanteric

Answer 28

**Russel Taylor** Type 1A, 1B, 2A, 2B ## Footnote Based on three factors, involvement of lesser trochanter, extension into piriformis fossa and stability of the medial construct

Question 29

Intracapsular NOF | Displacement

Answer 29

**Garden** 1 - incomplete 2- minimally displaced 3 - partially displaced 4 - completely displaced

Question 30

Intracapsular NOF | Angle

Answer 30

**Pauwel's** Type I less than 30 deg Type II 30-50 deg Type III more than 50 deg

Question 31

Best practice tarrif

Answer 31

1. Surgery within 36h 2. OG assessment 72h 3. AMTS pre op 4. PT assessment D0/1 5. Falls/bone health assessment 6. Nutritional assessment 7. Delirium assessment (4AT) during admission ## Footnote Came into effect in 2010 following Lord Darzi's NHS next stage review report

Question 32

Pelvic fractures

Answer 32

**Young and Burgess** Lateral compression Ant-post compression Vertical shear

Question 33

Periprosthetic fractures

Answer 33

**Vancouver** A - trochanteric B - around stem C - distal to tip of stem

Question 34

TIbial plateau

Answer 34

**Schatzker** 1. Split 2. Split and depression 3. Depression 4. Medial split 5. Bicondylar 6. Diaphyseal/metaphyseal separation

Question 35

Open fracture

Answer 35

Gustillo-Anderson 1 2 3a 3b 3c | Post debridement only

Question 36

Knee dislocation

Answer 36

**Kennedy** Anterior Posterior Medial Lateral Rotatory ## Footnote Also Schenck classification based upon ligamentous injury

Question 37

Ankle fracture

Answer 37

Weber A-C ## Footnote Also - Lauge Hansen

Question 38

Pilon fracture | Classification

Answer 38

**Reudi and Allgower** Type 1 - undisplaced Type 2 - displaced Type 3 comminuted

Question 39

Pilon fracture | Intraarticular fragments

Answer 39

1. Medial 2. Anterolateral (Chaput) 3. Posterolateral (Volkman)

Question 40

Talus fracture

Answer 40

**Hawkins** 1. Nondisplaced 2. Subtalar dislocation 3. Subtalar and tibiotalar dislocation 4. Subtalar + tibiotalar + talonavicular dislocation ## Footnote Predicts risk of AVN

Question 41

Calcaneum fracture | Angles

Answer 41

**Bohler's** 0-30deg Angle of **Gissane**

Question 42

Calcaneum fracture | CT classification

Answer 42

**Sanders Type 1-4** Based on number of fragments on coronal image

Question 43

Calcaneum fracture | Intra-articular classification

Answer 43

**Essex-Lopresti** Tongue-type Depression-type

Question 44

PJI