Intro Wk: Ortho

Question 1

The general principles of T&O

Answer 1

Trauma: Resus, Reduce, Restrict, Rehabilitate

Ortho: Look, Feel, Move, Special Tests

Question 2

What are the clinical signs of a fracture?

Answer 2

Pain, swelling, crepitus, deformity, adjacent structural injury

Question 3

How would you describe a fracture?

Answer 3

Location, pieces, pattern, displacement, plane

Question 4

Outline translation and angulation

Answer 4

Coronal Plane:

• Medial/Lateral
• Varus/Valgus

Sagittal Plane:

• Anterior/Posterior
• Dorsal/Volar

Axial Plane:

• Proximal/Distal
• Internal/External

Question 5

When is external fixation most commonly used?

Answer 5

Large amount of soft tissue damage inc risk of infection and also as a quick fix to save life

Question 6

Where is Shenton’s line?

Answer 6

Imaginary curved line drawn along the inf border of the superior pubic ramus and inferomedial border of NOF

Question 7

What is the % risk of AVN in a displaced intracapsular #?

Answer 7

25-30%

Question 8

Hemi vs THR

Answer 8

If young, fit, mobile -> THR

If older and less fit -> hemiarthroplasty

Question 9

Why don’t you give everyone a THR?

Answer 9

Lower mobility, multiple comorbidities, risk of dislocation, requires specialist hip surgeons

Question 10

Important points in an OA hx

Answer 10

Pain (exertional, rest, night)

Disability (walking distance, stairs, giving way)

Deformity

Prev hx of trauma or infection

Tx given physio, injections, ops

Other joints affected

Question 11

What is the angle of flexion if the leg is straight?

Answer 11

0°

Question 12

The mx of OA

Answer 12

Conservative: analgesics, physio, walking aids, avoidance of exacerbating activity, infections

Operative: replace, realign, excise, fuse, synovectomy, denervate

Question 13

RA vs OA

Answer 13

RA - inflammatory - worse in the morning

OA - degenerative - worse w activity

Question 14

Look

Answer 14

Scars
Swellings
Deformities
Redness

Question 15

Feel

Answer 15

PET: pain, effusion, temp

Question 16

Move

Answer 16

Active -> Passive

Active ❌ Passive ✅
Think muscle, tendon, neuro

Active ❌ Passive ❌
Think mechanical block

Question 17

Why do osteophytes form?

Answer 17

They’re outgrowths of bone to try spread the SA and dec friction

Question 18

What are the special tests?

Answer 18

Knee - C’s - collaterals, cruciates, cartilages

Hip - T’s - Trendelenburg’s and Thomas’s

Shoulder - I SITS - impingement, supraspinatus, infraspinatus, teres minor, subscapularis

Question 19

What should you always ask for before performing Thomas’s test?

Answer 19

If they have a hip replacement

Question 20

How does a frozen shoulder present?

Answer 20

Extremely painful, global dec ROM, normal xray