LE Orthopedics (Exam #4)

Question 1

What is the most common type of Pelvic Fracture, and what associated injury is often seen?

Answer 1

Posterior fracture

+/- femoral head dislocation

Question 2

With Pelvic Fractures, what non-bone injuries may be seen?

Answer 2

Internal abdominal injuries

Question 3

What is a major complication of Pelvic Fractures, and therefore, what two exams should be performed?

Answer 3

BLEEDING

• Pelvic exam
• Rectal exam

Question 4

What is the gold standard dx test for Pelvic Fractures?

Answer 4

CT

Question 5

What condition involves XR views of Judet views, inlet/outlet views?

Answer 5

Pelvic Fracture

Question 6

What direction of Hip Dislocation is more common?

Answer 6

POSTERIOR

Question 7

What condition involves PAIN, inability to WB; leg appears shorter?

Answer 7

Hip Dislocation

Question 8

What nerve should be checked with a Hip Dislocation?

Answer 8

Sciatic n.

Question 9

How does presentation of a POSTERIOR Hip Dislocation differ from an ANTERIOR Hip Dislocation (2)?

Answer 9

• Posterior = fixed adduction, internal rotation

- Anterior = slight abduction, external rotation

Question 10

What is the recommended tx for a Hip Dislocation, and in what time frame?

Answer 10

EMERGENT reduction within 6 hours

Question 11

What type of fracture is associated with an increased risk of morbidity/mortality in elderly?

Answer 11

Proximal Femoral Fracture

Question 12

What type of fracture are Femoral Neck Fractures?

Answer 12

Intracapsular

Question 13

How does a Proximal Femoral Fracture present?

Answer 13

• Abduction
• External rotation

Opposite of posterior hip dislocation

Question 14

What is a major consideration in the tx of a Proximal Femoral Fracture?

Answer 14

DVT prophylaxis

Question 15

What condition requires severe trauma/force (vs. pathologic or fall in elderly); common in young males?

Answer 15

Femoral Shaft Fracture

Question 16

What type of fracture should you consider abuse if in a non-ambulatory child?

Answer 16

Femoral Shaft Fracture

Question 17

What is a major complication associated with Femoral Shaft Fractures?

Answer 17

Malunion/delayed union/nonunion

Question 18

What type of dislocation is an Ortho EMERGENCY?

Answer 18

Knee Dislocation

Question 19

What two non-bone injuries should be considered with a Knee Dislocation?

Answer 19

• Neuro injury

- Vascular injury

Question 20

What three dx tests should be ordered for a Knee Dislocation?

Answer 20

• XR
• CT
• MRI

Need to evaluate nerves and vascular, not just bone

Question 21

What is the recommended tx for a Knee Dislocation (2)?

Answer 21

• EMERGENT reduction

- Surgery

Question 22

What direction of Patellar Dislocation is more common?

Answer 22

Lateral

- There is less soft tissue to stabilize that side

Question 23

What condition involves knee “gives way”, severe pain?

Answer 23

Patellar Dislocation

Question 24

What is the recommended tx for a Patellar Dislocation? What tx should be considered for more long-term?

Answer 24

• Immediate reduction

- Knee immobilizer in FULL EXTENSION

Question 25

For what three injuries is immobilizer/cast/splint in FULL EXTENSION recommended as tx?

Answer 25

- Patellar Dislocation - Patellar Fracture - Tibial Plateau Fracture

Question 26

What two conditions involves knee fixed in knee flexion, deformity, swelling, hemarthrosis?

Answer 26

- Patellar Dislocation | - Patellar Fracture

Question 27

What type of fracture should be considered with a Tibial Plateau Fracture?

Answer 27

OPEN

Question 28

What is often the recommended tx for a Patellar Fracture?

Answer 28

Cast/splint in FULL EXTENSION

Question 29

What is often the recommended tx for a Tibial Plateau Fracture?

Answer 29

Cast/splint in FULL EXTENSION

Question 30

What are the two most common MOI for Ankle Fractures?

Answer 30

- Inversion injury | - Eversion injury

Question 31

What condition involves the Ottawa Ankle Rules, and what does it involve (__ AND 1+ of (3))?

Answer 31

Ankle Fractures Malleolar tenderness AND 1+ of... - Posterior fibula pain - Posterior distal tibia pain - Inability to WB

Question 32

What are the three types of Malleolar Fractures, and what are two different combinations that you may see?

Answer 32

Medial, Lateral, Posterior - Bimalleolar = Medial + Lateral - Trimalleolar = all three

Question 33

What type of Ankle Fracture is often seen in PEDS; involves joint so emergent?

Answer 33

Tilleaux/Triplane Fractures

Question 34

What is the most common type of Metatarsal Fractures in adults?

Answer 34

5th Metatarsal

Question 35

What type of Metatarsal Fracture is at risk of non-union?

Answer 35

Jones fracture

Question 36

What is often the recommended tx for Metatarsal Fractures?

Answer 36

Conservative (CAM boot or cast)

Question 37

What condition involves fracture AND dislocation of 1st and 2nd TMT?

Answer 37

Lisfranc Injury

Question 38

What is a Lisfranc Injury (2)?

Answer 38

Fracture AND dislocation of 1st and 2nd TMT

Question 39

What condition involves mid foot pain and is dx with an XR WITH WB?

Answer 39

Lisfranc Injury

Question 40

What sxs is seen with a Lisfranc Injury, and what is the recommended dx test?

Answer 40

Mid foot pain | - Dx with XR WITH WB

Question 41

What is often the recommended tx for a Lisfranc Injury?

Answer 41

Surgery

Question 42

What condition involves MOI is high impact (ex. fall from high height)?

Answer 42

Calcaneus Fracture

Question 43

What body part is most commonly affected with Compartment Syndrome, and what specific section?

Answer 43

Lower leg | - Anterior compartment

Question 44

What condition involves the 6 P's and what are they?

Answer 44

Compartment Syndrome - PAIN (out of proportion) - Paresthesias - Pallor - Pulselessness (late) - Poikilothermia (late) - Paralysis (late)

Question 45

What condition involves PAIN OUT OF PROPORTION, often paresthesias and pallor?

Answer 45

Compartment Syndrome

Question 46

What is the dx of Compartment Syndrome?

Answer 46

CLINICAL | - Dx that shit and get treatin

Question 47

What is the recommended tx for Compartment Syndrome, and WHY?

Answer 47

Fasciotomy | - To relieve pressure (at least the answer for this one was actually in the slides :))

Question 48

What tx should be considered for Compartment Syndrome IF late dx (8+ hours)?

Answer 48

Amptutation

Question 49

What condition involves irreversible cartilage destruction?

Answer 49

Septic Arthritis

Question 50

What is the most common joint affected with Septic Arthritis in adults?

Answer 50

Knee

Question 51

What pathogen is most commonly seen with Septic Arthritis? What other pathogen may be seen in conjunction? What pathogen is second most common?

Answer 51

Staphylococcus aureus +/- MRSA | - Strep = 2nd

Question 52

What dx test is gold standard for Septic Arthritis?

Answer 52

PROMPT arthrocentesis

Question 53

With Septic Arthritis in PEDS, which two joints are most often affected?

Answer 53

- Knee | - Hip

Question 54

If the hip is affected by Septic Arthritis in PEDS, what PE finding will be seen?

Answer 54

FABER position

Question 55

What is the most common cause of PEDS hip pain?

Answer 55

Septic Arthritis