Introduction Flashcards
(21 cards)
Chronic o.m : identify + site
Criteria :3
Sequestrum present or not / if present what is its fate
Complications3
Treatment 3
Osteoarthritis criteria
Treatment
Absent space between the acetabulum and the head of femur : decreased or obliterated
Total hip replacement; replace acetabulum and head of femur
Knee osteoarthritis
Treatment
No space
Medical injection [transient]
Total knee replacement both femur part and tibial part
Right DDH
RADIOLOGICAL CRITERIA
Treatment / age
Criteria of unilateral and bilatreal ddh
Mc females
Shallow acetabulum
Epiphesis [head of femur]small and outer upper quadrant
Shenton line : between lesser trochanter and obturator foramen
<6 months : closed reduction anf fixation by pavelik harmes [abduction brace]
6-18months : closed reduction and fixation by hip spica
>18 months ; ORIF +/- pelvic or femoral osteotomy
Perthes disease [coxa plana]left side
Males preschool age 5-6 years
Painless trendlenberg gait
Cause
Stages
Treatment
Deformity [motion restricted]
Avascular necrosis of small growing epiphysis
Unknown
1.necrosis >2.fragmentation >3.re-ossification >4.remodeling
Containment [ containing head of femur inside acetabulum]
Conservative by cast or surgical osteotomy
Limitation of abduction and internal rotation]
Adduction and external rotation
Shortening of limb
Right congenital coxa vara define
Clinical test diagnosis
Treatment
Coxa vara: reduced neck shaft angle less than 120
Trendlenburg. Sign
Trendlenburg gait unilateral
Waddling [bilateral]
Subtrochanteric valgus osteotomy
Right SUFI : slipped upper femur epiphysis
Teenagers [adolesent coxa vara]
Obeise due to endocronial reasons hypo ay 7aga
Most commun complication
Epiphysis seperated from physis [black line]: trauma ,overweight
Painful coxa vara [painful trendlinberg gait ]:
Pain could start at knee site referral to obturator nerve [missed]
Avascular necrosis : cut of blood supply by the slippage itself or manipulation by surgery [long nail]
Chondrolysis = o.a in adults
SUFI treatment according to the degree
Napilion hat
Motion restricted
Kerin line
Mild 1/3: pin : pinning insitu
Moderate 1/2: pin pinning insitu
Severe 1 : pinning after reduction by gentle manipulation
One nail fear of avascular necrosis
TEV left
Components
Cavus:arch in midfoot
equinus ankle joint fixed plantar flexion opposite: calcanius [dorsiflexion]
Varus: inversion subtalar joint
Adductus :forefoot
Normally cubotus elbow: 7 degree valgum
When reversed varus
Osteochondroma at proximal humerus
Causes of pain
Malignancy transformation
Mc 1ry bonne tumor in old age: multiple myeloma
Mc in children :ewing vs osteosarcomna
Erbs palsy waiter deformity:traction injury in upper brachial plexus c5,c6 good hand function
Klumpekes: c8 t1hand malfunction
Deformaties: adduction ,elbow extension
Brachial plexus at the level of root lmnl [lower]
Total : c5,6,7,8 t1
First 3 months: observation and physiotherapy neuropraxia traction bas
> 3 months:exploration by microsurgery if no elbow or biceps flexion
Later: tendon transfer,de -rotation osteotomy externally
Spine: kyphosis الاتب : posterior angulation of the spine
Or deviation of the spine in sagittal plane
Congenital scheueurmann
Mc cause is TB acquired
Scoliosis : coronal view , AP view : lateral curvature of the spine
More commun in females due to ligament laxity and has gardes
Idiopathic
Congenital
5th metatarsal base : pronious brevus ankle sprained
Olecranon triceps
Greater tuberosity : rotator cuff : supra , infra , teres minor
Patella
Tension band +ORIF
Monteggia fracture
Fracture in upper third ulna and dislocation in proximal radio ulnar joint
ORIF plates and scews
Galeazzi fracture
Fracture in lower third radius and dislocation in distal radio ulnar joint ORIF plates and screws
Colle’s fracture diner fork deformity
Broken end of radius : distal forearm
Fallen outstretched hand
Dorsal displacement
