ortho

Question 1

what are pathological fractures

Answer 1

This is a fracture caused by trivial injury to a bone already weakened by disease. M

Question 2

describe salter harris and gustillo anderson

Answer 2

u shuda know it

Question 3

with respect to slipped capital femoral epiphysis what state is the limb usually restricted to on inspection

Answer 3

s restriction of flexion, abduction and medial rotation

Question 4

What does a break in “shentons line” mean

Answer 4

In displaced fractures,
there is a break in Shenton’s line, which is an imaginary smooth line drawn from the
inferomedial aspect of the femoral neck to the inferior aspect of the superior pubic ramus.
[This can also suggest developmental dysplasia of the hip in younger pts

Question 5

what are the two classifications of fractures of the hip

Answer 5

Two broad groups of fractures are recognized in the neck of femur
1) Intracapsular fractures
- Subcapital
- Transcervical
2) Extracapsular fractures
- Basal (basicervical) [this is due to how the capsule is form. Anteriorly the
capsule DOES cover the basicervical BUT posteriorly the capsule DOES
NOT cover the basicervical area]
- Intertrochanteric (Most common)
- Subtrochanteric

Question 6

describe garden classification for fractures

Answer 6

shuda knw it

Question 7

which are easier to treat intra capsular or extra capsular fractures

Answer 7

If the fracture is intra-capsular, there is likely to be compromise of the capsule & the
capsular arteries, which may lead to avascular necrosis of the head of the femur (33.3%) also
50% risk of non-union since there are no muscles attached to give blood supply, the fracture site
is bathe by synovial fluid that washes the haematoma away and has constituents that does
not facilitate haematoma formation.
Extra-capsular fractures do not have this problem & are hence easier to treat

Question 8

blood supple of the hip joint

Answer 8

Abdominal aorta  Common iliac  External iliac  femoral  medial and lateral circumflex
 from medial circumflex: superior, inferior metaphyseal & lateral epiphyseal]

Question 9

what is the most common indication for total hip arthroplasty

Answer 9

osteoarthritis (not

Question 10

etiology of full sciatic nerve injury

Answer 10

total hip arthroplasty, hip dislocation, direct trauma, iatrogenic, herniated lumbar disc

Question 11

motor and sensory deficit of full sciatic nerve injuries

Answer 11

hamstring muscle paralysis,
sciatic splits into tibial and common peroneal so may cause motor deficits in muscles supplied by those

sensory:lower leg and foot however medial malleolus and medial border of foot spared as it is innervated by saphenous nerve

Question 12

what is fat embolism syndrome

Answer 12

acute respiratory disorder caused by inflammatory response to embolised fat globules which occurs mainly due to long bone fractures and intramedullary intrumentation

Question 13

major and minor criterias of diagnosis fat embolism syndrome

Answer 13

Major (1)
hypoxemia (PaO2 < 60)
CNS depression (changes in mental status)
petechial rash
pulmonary edema

Minor (4)
tachycardia
pyrexia
retinal emboli
fat in urine or sputum
thrombocytopenia
decreased HCT