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CMPP > ORTHO > Flashcards

ORTHO Flashcards

1
Q

fractures of the shaft of radius or ulna tx

A

surgical tx
ORIF in adults
conservatively –> ages 12-14

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2
Q

what’s the biggest concern in a radius or ulna fx

A

nerve injury

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3
Q

Fracture of distal radial shaft with dislocation of distal radio-ulnar joint

A

galeazzi

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4
Q

prominenece of ulnar head and lack of pronation/supination

A

Galeazzi

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5
Q

galeazzi fx tx

A

ORIF

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6
Q

fracture of the proximal ulnar shaft with radial head dislocation

A

monteggia fx

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7
Q

monteggia fx tx

A

ORIF

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8
Q

distal radius fx AKA

A

colles fx tisk tisk

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9
Q

FOOSH areas of concern

A

scaphoid
distal radius
radial head
proximal humerus

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10
Q

3 varieties of FOOSH fx

A

palmar/dorsal displacement
extra/intra-articular
radial styloid

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11
Q

distal radius fx, non-displaced w/o comminution tx

A

longarm cast to immobilize –> short arm cast

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12
Q

what is an outcome predictor for distal radius fx

A

more disrupted the angle, worse prognosis

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13
Q

extra-articular distal radius fx tx

A

closed

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14
Q

intra-articular distal radius fx tx

A

anatomic reduction to resolve to same length (open reduction)

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15
Q

complications of distal radius fx

A

compression of median nerve
malunion –> limit of wrist ROM
joint degeneration in intra-articular fx

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16
Q

a cause of acute carpal tunnell radius fx

A

distal radius fx

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17
Q

what may you see on initial xray of a scaphoid fx

A

nothing?… repeat in 10-14 days

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18
Q

FOOSH, pain in anatomical snuffbox

A

scaphoid fx

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19
Q

XRAYs needed to assess scaphoid

A

AP
Lateral
AP in ulnar deviation
Clenched fist view

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20
Q

how to treat scaphoid fx if non-displaced and acute

A

thumb spica

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21
Q

how long to keep hand in thumb spica for scaphoid fx

A

12 weeks!

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22
Q

can you treat scaphoid fx with surgery?

A

yes, if want recovery in

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23
Q

scaphoid fx complications

A

AVN

non-union

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24
Q

where does blood supply innervate the scaphoid?

A

distally

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25
Q

tx of non-union scaphoid fx

A

ORIF and bone graft

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26
Q

complication of non-union scaphoid fx

A

arthritis

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27
Q

chronic tendinitis of 1st dorsal compartment of wrist

A

dequervain’s stenosing tenosynovitis

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28
Q

2 tendons in 1st dorsal compartment of wrist

A

abductor pollicis and extensor pollicis brevis

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29
Q

pain radially with use of wrist, 1st dorsal compartment sore, + finkelstein’s

A

dequervain’s stenosing tenosynovitis

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30
Q

tx for dequervain’s?

A 
rest, ice, NSAIDs
consider thumb spica
steroid injection useful for dx and tx
US and PT therapy
surgery if persistent
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31
Q

saturday night palsy deficit

A

radial nerve –> wrist drop

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32
Q

neuropraxia

A

bruise of the nerve

inhibits conduction but doesn’t destroy nerve fiber

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33
Q

how long for neuropraxia to resolve?

A

2 weeks after removal of compression

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34
Q

damage severe enough to kill axon but myelin sheath intact

A

axonotmesis

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35
Q

severing both nerve axon and myelin sheath, usually by physical disruption of nerve (laceration)

A

neurotmesis

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36
Q

does reconnecting the two pieces of nerve together repair the nerve fiber?

A

no, it reapirs the myelin sheath which continues to grow inward

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37
Q

how fast do peripheral nerves gro?

A

1 inch/month

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38
Q

when does the growth of peripheral nerves halt?

A

18 months

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39
Q

carpal tunnel syndrome associated with

A 
occupation
pregnancy
thyroid dz
RA
DM
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40
Q

where is the numbness in Carpal tunnel

A

thumb through middle finger

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41
Q

cause of carpal tunnel

A

pressure on median nerve under transverse carpal ligament

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42
Q

3 tests for carpal tunnel

A

Tinel’s
Phalen’s
EMG/NCV

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43
Q

small needle into into the muscle to read the electrical activity

A

EMG

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44
Q

looks at the velocity of the nerve

A

NCV

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45
Q

differentiates between carpal tunnel and other DDXs

A

NCV

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46
Q

only motor innervation of the median nerve

A

to the thenar eminence

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47
Q

thenar eminence motion

A

ADDuction

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48
Q

treatment progression for carpal tunnel

A

Rest, NSAIDs, night splints
PT
steroid injection
surgical release

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49
Q

what is cut in the surgical release of carpal tunnel?

A

transverse carpal ligament

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50
Q

name of canal in which ulnar nerve passes through

A

guyon’s canal

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51
Q

what nerve does saturday night palsy affect

A

radial

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52
Q

complications of saturday night palsy

A

sensory: numbness of radial forearm and dorsum of hand
motor: inability to extend wrist and fingers

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53
Q

neck fracture of the small finger metacarpal, apex dorsal angulation

A

boxer’s fracture

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54
Q

fight injury scenerio

A

boxer’s fracture

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55
Q

up to what angle of a boxer’s fracture is acceptable?

A

40-60 degrees

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56
Q

treatment of a boxer’s fracture

A

ulnar gutter splint or metacarpal splint

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57
Q

clue on xray of a rotational alignment issue from a metacarpal or phalangal fx

A

diameter discrepancy

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58
Q

tx for phalangeal fx

A

pin for 4-5 wks

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59
Q

hyper-extension, jamming injury of finger scenerio

A

volar plate injury at PIP joint

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60
Q

where does one have pain in volar plate injury

A

palmar part of the joint

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61
Q

tx for volar plate injury at PIP

A

buddy tape and early ROM

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62
Q

complications of volar plate injury

A

stiffness if taped for too long –> wont be able to make a fist
permanent knuckle swelling

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63
Q

most common finger to get crush injury

A

middle

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64
Q

how to tx a subungal hematoma if more than 50%

A

remove nail, repair nail bed

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65
Q

threshold for abx usage with subungal hematomas

A

if tx w/in 6H or not grossly contaminated

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66
Q

when do you replace fingertips

A

kids, thumbs, and if it’s the majority of the finger

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67
Q

open oblique fracture at the base of the thumb MC w/ dislocation of radial portion of articular surface

A

bennet fx

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68
Q

tx of bennet fx

A

surgery! pinning!

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69
Q

Y or T shaped fx at the base of the first metacarpal

A

rolando fx

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70
Q

what is the mechanism most likely involved in bennet and rolando fx?

A

hyper-extension

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71
Q

most common place of finger dislocations

A

IP joints

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72
Q

how to tx finger dislocations

A

reduce by pulling on the finger & buddy-taping it

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73
Q

no man’s land

A

area of flexor tendons between the attachment of the FDP to the distal phalanz & the distal carpal tunnel

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74
Q

where does the FDP attach?

A

DIP

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75
Q

where does the FDS attach?

A

PIP

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76
Q

avulsion of the extensor tendon from distal phalanx

A

mallet finger

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77
Q

MOA of mallet finger

A

jamming injury (trying to catch a ball)

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78
Q

does a mallet finger have passive ROM?

A

yes

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79
Q

tx of mallet finger

A

splint for 6-8 wks

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80
Q

when to tx a mallet finger with a pin

A

unreliable

more than 50% of joint involved

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81
Q

rugger jersey finger

A

avulsion of FDP from Distal phalanx

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82
Q

what limit in ROM does rugger jersey finger cause

A

unable to flex but full passive ROM

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83
Q

tx of rugger jersey finger

A

surgery

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84
Q

rupture or attrition of ulnar collateral ligament of MCPJ of thumb

A

gamekeeper’s thumb

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85
Q

pain and instability of thumb in pinch

A

gamekeeper’s thumb

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86
Q

tx for gamekeeper’s thumb

A

surgery if displaced or unstable

closed if non-displaced or no fx

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87
Q

degenerative nodule impinging on A1 pulley

A

trigger finger

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88
Q

who is trigger finger more common in

A

older people, alcoholics, degenerative arthritis

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89
Q

ROM limitation in trigger finger

A

can flex but not extend

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90
Q

tx of trigger finger

A

50% cured with steroid injection

some need surgical release of A1 pulley NOT removal of nodule

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91
Q

what happens if you remove the nodule from a trigger finger

A

tendon rupture

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92
Q

trigger finger more common in M or W

A

Women

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93
Q

idiopathic fibrosis of palmar fascia

A

dupuytren disease

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94
Q

dupuytren dz associated with what other 2 diseases

A

peyronie’s & plantar fibromatosis

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95
Q

who is dupuytren’s most common in

A 
northern europeans
men over 50
epilepsy
DM
pulm dz
alcoholics
vibrational trauma
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96
Q

painless nodules in palm –> cord –> finger contraction

A

dupuytren dz

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97
Q

most common finger associated with dupuytren’s dz

A

ring finger, then small, then middle

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98
Q

tx of dupuytren dz

A

surgery when over 30 degrees or any contracture of PIP

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99
Q

disruption of central extensor mechanism allowing the PIP to protrude through extensor hood

A

boutonniere deformity

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100
Q

what is flexed and what is extended in boutonniere deformity

A

DIP extended

PIP flexed

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101
Q

causes of boutonniere deformity

A

rupture of central slip (from RA weakening of tendons)

forced flexion

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102
Q

tx of boutonniere deformity

A

acute: splint in extension
chronic: more complicated

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103
Q

when ordering x-rays image what areas

A

joints above and below point of concern

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104
Q

5 types of salter harris fractures

A
  1. through physis
  2. through physis and metaphysis (corner sign)
  3. through physis and epiphysis
  4. through physis, metaphysis, and epiphysis
  5. compression/ crush
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105
Q

salter harris fx open to joint

A

3 and 4

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106
Q

most common salter harris fx

A

2

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107
Q

tx of salter harris fx

A

RICE
splint
pain management
traction (for larger joints)

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108
Q

gustillo classification pertains to…

A

open fractures

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109
Q

explain gustillo classification

A
  1. less than 1 cm
  2. 1-10cm
    3a. >10cm, no periosteal stripping, adequate soft tissue coverage
    3b. >10c, soft tissue loss w/ free tissue flap
    3c. >10c, vascular damage
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110
Q

where does most of the bone healing come from

A

periosteum

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111
Q

tx for uncomplicated open fractures

A

1st gen cephalosporin

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112
Q

tx for contaminated open fx

A

+ aminoglycoside

+ 3rd gen cephalosporin or fluroquinolones

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113
Q

tx for barnyard open fx

A

clostridium, add penicillin

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114
Q

process of bone healing

A

hematoma –> sticky and fibrous after a week

tosft tissue doesn’t image well so won’t see that until 2-3 wks

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115
Q

deformity that remodels the least

A

rotation

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116
Q

where do clavicle fractures take place

A

midshaft

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117
Q

treatment of clavicle fx

A

use sling
ice, avoid elevation,
pain meds

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118
Q

how long should a clavicle take to heal

A

within 6 wks

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119
Q

what does clavicle fx surgery increase the risk of

A

non-union

infxn

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120
Q

where does a proximal humeral fracture usually take place

A

surgical neck

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121
Q

tx for uncomplicated proximal humeral fx

A

sling

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122
Q

where does most growth occur in the humerus

A

proximal epiphysis

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123
Q

MOA for proximal humerus fx in adults

A

FOOSH (tx w/ sling)… careful they don’t get stiff

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124
Q

neer fx classification

A 
based on location and number of fracture fragments
anatomical neck
surgical neck
greater and lesser tuberosity
articular surface involvement
"two part, three part, four part fx"
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125
Q

how to treat proximal humerus fx in elderly people

A

can try with screws but may need joint replacement

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126
Q

tx for humeral shaft fx

A

initially with coaptation splint and sling

more often with surgery

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127
Q

what nerve injury must you worry about with a humeral shaft fx

A

radial

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128
Q

how to test the radial nerve

A

extension of wrist and fingers

sensation of dorsum of the hand

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129
Q

fracture that is a sign of significant, high energy injury that makes you suspicious to examine chest, mediastinum, and aorta

A

first rib or scapula fx

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130
Q

what kind of mechanism are first rib and scapular fx associated with

A

decelaration injuries

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131
Q

tx for scapular fx

A

not much…

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132
Q

how will a shoulder dislocation present

A

painful, won’t move shoulder

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133
Q

what must you examine before reducing a shoulder dislocation

A

neurovascular

134
Q

mechanism of shoulder dislocations

A

falls or arm pull

135
Q

nerve most commonly affected by shoulder dislocation

A

axillary

136
Q

how to test axillary nerve

A

sensory of chevron area

137
Q

second most common nerve associated with shoulder dislocations

A

musculocutaneous

138
Q

innervation of musculocutaneous nerve

A

anteriolateral forearm sensation

biceps

139
Q

XRAY for soulder dislocation?

A

yes! unless witnessed on field

140
Q

most shoulder dislocations anterior or posterior

A

anterior

141
Q

what kind of sedation do you need for reducing shoulder dislocation

A

IV!…

some people you can just talk them through it and some need the OR

142
Q

hypocratic method

A

reducing shoulder with foot in the axilla and pulling straight out

143
Q

2 other techniques of shoulder reduction

A

put patient in a prone position and weight their arm to create traction
manipulate scapula to put the glenoid on the humeral head

144
Q

after reducing shoulder

A

sling, confirm with xrays (MUST GET LATERAL)

145
Q

who has high risk of recurrent instability in shoulder dislocations

A

young people

146
Q

when should you get elderly people moving after shoulder dislocation

A

4-5 days

147
Q

most common reasons for posterior dislocations

A

seizures or violent muscle contraction

148
Q

grades 1-3 of acromioclavicular dislocation

A

1: no displacement (AC sprain)
2: displacement about 50% but less than 100%
3: more than 100% displacement tear of AC and CC

149
Q

tx of AC dislocation

A

sling, don’t reduce, ice, pain meds

150
Q

tx of residual pain from AC dislocation

A

mumford incision ( take out distal 1-2cm clavicle)

151
Q

most common bursitis in shoulder

A

subacromial bursa

152
Q

older patient, pain out of the blue in the anterolateral arm and shoulder

A

subacromial bursitis

153
Q

tx of bursitis

A

anti-inflammatories, cortisone

154
Q

secondary cause of subacromial bursitis

A

rotator cuff tendonitis

155
Q

4 muscles of rotator cuff

A

supraspinatus
infraspinatus
subscapularis
teres minor

156
Q

spectrum of rotator cuff disease

A

intermittent inflammation
chronic inflammation
tendinosis
tear

157
Q

rotator cuff dz associated with what activity

A

overhead

158
Q

where is the pain in impingement syndrome/rotator cuff dz

A

anterolateral shoulder

159
Q

positive impingement signs (4)

A

neer
hawkins
painful arc
empty can

160
Q

positive impingement test

A

subacromial injection of lido relieves pain

161
Q

any reliable clinical test for full thickness tear

A

drop arm is the closest but not really

162
Q

rotator cuff tx (intermittent inflammation)

A 
rest
avoid overhead activities
NSAIDs
PT
steroid inj
163
Q

if no relief in 6 weeks of intermittent rotator cuff inflammation what is the next step?

A

MRI

164
Q

tx of rotator cuff tear

A

surgery if full thickness and symptomatic

165
Q

what is an imitator of a rotator cuff dz

A

subluxation from subtle instability

166
Q

mechanism of a calcaneal fx

A

from a fall or MVA

167
Q

what to inspect with a calcaneal fx from a fall

A

follow the chain -> tibial plateau, hip, lumbar spine

168
Q

presentation of a calcaneal fx

A

unable to walk, huge swelling, ecchymoses

169
Q

tx of calcaneal fx

A

surgery if any displacement

170
Q

bohler’s angle

A

angle between front and back of calcaneous
normal 20-40
less in fx

171
Q

poor prognosis for calcaneal fx

A

persistent foot pain

172
Q

mechanism of talus fx

A

fall or twist

173
Q

why are talar fx hard to dx

A

unseen on plain film

174
Q

complication of talar fx

A

AVN of talar dome
collapse of ankle
ankle arthritis

175
Q

worst place for talar fx

A

neck

176
Q

presentation of talar fx

A

swelling, pain, unable to weight bare

177
Q

best imaging for talar fx

A

CT

178
Q

most common stress fx

A

metatarsal

179
Q

march fx

A

metatarsal stress fx

180
Q

where are metatarsal stress fx most common

A

2nd metatarsal

181
Q

best test for immediate dx of metatarsal stress fx

A

MRI

won’t show up on xray for 10-14 days

182
Q

tx of metatarsal stress fx

A

casting

183
Q

evulsion of the base of 5th metatarsal

A

dancer’s fx

184
Q

transverse fx of 5th metatarsal

A

jones fx

185
Q

difference between jones and dancers fx

A

no ligament involvement in jones

186
Q

oblique fx of the metatarsal due to fall or twist

A

trauma fx

187
Q

metatarsal fx involving the joint

A

neck fx

188
Q

most common MT involved in comminuted fx

A

1st

189
Q

most important toe for ambulation

A

1st

190
Q

high energy injury, minimal xray signs, common in MVAs, compression fx

A

lisfranc dislocation

191
Q

huge swollen foot w/o obvious pathology

A

lisfranc dislocation

192
Q

medial dislocation of 1st metatarsal

A

lisfranc dislocation

193
Q

which xrays do you need for lisfranc dislocation

A

AP
oblique
lateral

194
Q

achilles rupture, occurs to healthy or diseased tendons

A

ones that have had chronic achilles tendonitis

195
Q

comes down from jump, feels like he/she was kicked from behind

A

achilles rupture

196
Q

can pts ambulate after achilles rupture

A

yes, but cant resume play

197
Q

test to confirm achilles rupture

A

thompson sign

198
Q

tx for achilles rupture

A

closed or surgery

199
Q

which achilles tx is prefered for young people, athletes

A

surgical (faster recovery)

200
Q

which tx for achilles has higher chance of re-rupture

A

closed

201
Q

pain in arch and sole of the foot, pain/burning in medial ankle into arch and plantar foot

A

tarsal tunnel syndrome

202
Q

dx of tarsal tunnel syndrome

A

EMG/NCV

203
Q

tx of tarsal tunnel

A

rest, ice, NSAIDs, shoe modification

204
Q

first few steps out of bed are very painful, better with walking around

A

plantar fasciitis

205
Q

where does plantar fascia insert

A

calcaneus

206
Q

tender acutely mid-plantar heel pad

A

plantar fasciitis

207
Q

windlass phenomenoin

A

pain made worse with doriflexion of ankle and toes (plantar fasciitis)

208
Q

tx for plantar fasciitis

A 
shoe modification
rest
ice
taping
stretching
NSAIDs
maybe steroid inj
209
Q

pain over 6 months of plantar fasciitis

A

consider surgery

210
Q

pain in forefoot, expecially with tight foods

A

interdigital neuroma (morton’s)

211
Q

dx of interdigital neuroma

A

squeeze interspace and squeeze metatarsals together

212
Q

where is interdigital neuroma most common

A

2-3 interspace of toes

213
Q

tx of interdigital neuroma

A

metatarsal bar
steroid injection
some warent excision

214
Q

flexion of PIP

A

hammer toes

215
Q

flexion of PIP and DIP

A

claw toes

216
Q

how long must you pin hammer or claw toes for

A

6-8 wks

217
Q

first metatarsal in valgus

A

bunion

218
Q

cause of bunions

A 
tight shoes
adolescent bunions (genetics)
219
Q

ottawa ankle xray rules

A

only xray if..
pain in malleolar zone on either side and any one of the following..
bone tenderness in distal 6cm of tibia or fibula
inability to bear weight both immediately and in the ER for 4 steps

220
Q

foot xray rules

A

pain in midfood zone and any one of the following
bone tenderness at base of 5th metatarsal OR
bone tenderness at navicular OR
inability to bear weight immediately or in ER for 4 steps

221
Q

fracture of distal tibia

A

pilon fx

222
Q

mechanism of pilon fx

A

longitudinal impact

223
Q

tx of pilon fx

A

surgery

224
Q

tx of ankle fx

A

ORIF unless very distal (below mortise and evulsion fx)

225
Q

bimalleolar fx

A

deltoid ligament disruption and distal fibular fx

226
Q

high ankle sprain aka

A

maisonneuve fx

227
Q

maisonneuve fx

A

deltoid injury to medial evulsion to interosseous membrane to proximal fibula fx

228
Q

tx of maisonneuve fx

A

surgery

229
Q

which ligament sprains are most common in ankle

A

90% are lateral
anterior talofibular
calcaneofibular
posterior talofibular

230
Q

degree of ankle ligament sprains

A
  1. injury w/o lengthening
  2. stretching w/o failure
  3. complete rupture
231
Q

ankle sprain pain w/o instability

A

1st degrere

232
Q

ankle sprain instability and echymosis

A

3rd degree

233
Q

when see medial ankle sprain what do you look for

A

maisonneuve fx

234
Q

tx of ankle sprains

A

RICE, NSAIDs, activity as tolerated, PT, brace

235
Q

persistent pain ater sprain

A

talar dome injuries (chondral fx)
AVN of talus
occult fx
tendon injuries

236
Q

best way to evaluate persistent pain after ankle sprain

A

MRI

CT if you suspect fx

237
Q

positive varus stress test

A

calcaneofibular ligament

238
Q

anterior drawer test positive

A

anterior talofibular ligament

239
Q

Brostrom repair

A

chronic instability from ankle sprain, tightens everything up

240
Q

two fx associated with the knee

A

distal femur

tibial plateau

241
Q

tx of tibial plateu and distal femur fx

A

surgery

242
Q

tx of patellar fx

A

fixation

243
Q

ottawa rules for knee

A 
age 55+
tenderness of fibular head
tenderness of patella
inability to flex to 90 degrees
inability to bear weight immediately or in ER
244
Q

most common knee fx

A

lateral tibial plateu fx

245
Q

best imaging to detect tibial plateau

A

CT

lateral xray

246
Q

most common site of open fx of tibia

A

distal 1/3 because poor soft tissue coverage

247
Q

sudden increase in activity point tenderness of tibia

A

stress fracture (most commonly in distal 3rd of tibia)

248
Q

three of 4 major ligaments of the knee are torn

A

dislocation

249
Q

what must you carefully evaluate with knee dislocation

A

vasculature

popliteal artery damage is common

250
Q

where does popliteal artery run

A

along back-side of tibia

251
Q

precaution to take with popliteal artery in a knee dislocation

A

artery may clot off at any time
get a vascular surgeon involved!
arteriogram to rule out intimal tear

252
Q

overuse injury to muscle or bone in leg

A

shin splints

253
Q

are shin splints a diagnosis or symptom

A

symptom

254
Q

cause of most overuse injuries in leg

A

shin splints

255
Q

three causes of shin pain in athletes

A

periostitis
tibial stress fx
chronic exertional compartment syndrome

256
Q

inflammation where muscle attaches to bone

A

periostitis (most common cause of shin pain in athletes)

257
Q

acute swelling anterior to patella and tendon

red, hot, good ROM, pain in full flexion

A

pre-patellar bursitis

258
Q

pre-patellar burisits aka

A

housemaid’s knee

259
Q

tx for housemaid’s knee

A

ice, rest, NSAIDs

may aspirate and inj steroid if resistant

260
Q

medial ligaments of the knee

A

sartorius, gracillus, semitendinosis

261
Q

bursitis caused by running

A

pes anserine

262
Q

where is the pes anserine bursitis

A

medial knee

263
Q

tx of pes anserine bursitis

A

ice, NSAIDS, change training schedule, inj if persistent

264
Q

pain worsened with climbing stairs

A

pes anserine bursitis

265
Q

jumper’s knee aka

A

patellar tendinitis

266
Q

disabling inflammation of patellar tendon at inferior pole of patella

A

patellar tendinitis

267
Q

seen in athletes who perform repetitive jumping, running, or kicking activities

A

patellar tendinitis

268
Q

pain distal to patella exacerbated by deep knee bends or stair climbing

A

patellar tendinitis

269
Q

inferior patellar pain

A

patellar tendinitis

270
Q

tx for patellar tendinitis

A

rest
NSAIDs
PT
strengthen squads and stretch hamstrings

271
Q

steroid injections contraindicated in what knee pathology

A

patellar tendinitis because it may rupture

272
Q

lateral knee pain in runners especially when going downhill

A

iliotibial band syndrome

273
Q

tx for IT band syndrome

A

ice, nsaids, change running schedule, stretch

274
Q

increased pressure laterally on knee and alteral patella rubs on the condyle

A

patellofemoral syndrome

275
Q

who does patellofemoral syndrome occur most in

A

adolescent girls

276
Q

pain, aching wien sitting with knees bent, squatting, going up stairs in an adolescent girl

A

patellofemoral syndrome

277
Q

PE in patellofemoral syndrome

A

negative

278
Q

pain with prolonged sitting with knee bent (theater sign)

A

patellofemoral syndrome

279
Q

XRAY and MRI findings in patellofemoral syndrome

A

negative

280
Q

patellofemoral syndrome tx

A

ice, nsaids, patellar braces or knee straps
quad strengthening
hamstring stretching

281
Q

patellofemoral pain syndrome aka

A

chondromalacia patella

282
Q

softening or destruction of cartilage on underside of patella

A

patellofemoral pain syndrome

283
Q

tx for patellofemoral pain syndrome

A

quad strengthening (especially vastus medialis)
knee sleeve
NSAIDs

284
Q

when do pts with patellofemoral pain syndrome need to see ortho

A

persistent symptoms
anatomic abnormalities
jerky painful patellar movements

285
Q

is patellar instability short or long term

A

short term usually

286
Q

how to tx recurrent dislocations of the patella

A

surgical realignment

287
Q

how to dx subluxations of the patella

A

abnormal Q angle

288
Q

Q angle

A

angle between the longitudinal axis of the quads and the patellar tendon

289
Q

anterior knee pain in adolescents worsens with running or squatting

A

osgood schlatter’s

290
Q

tenderness directly over the tibial tubercle, remainder of knee normal

A

osgood- schlatters

291
Q

xray findings for osgood schlatters

A

nonezo

292
Q

traction apophysis

A

…. no idea

293
Q

toddler’s fx

A

sudden twisting of tibia

294
Q

most common fx of toddler’s & preschoolers

A

tibia fx

295
Q

suden refusal to bear weight or walk

swelling and warmth over fx site

A

toddler’s fx

296
Q

tx for toddler’s fx

A

long leg cast 3-4 wks

297
Q

are kids more likely to have a fx or ligament injury

A

fracture

298
Q 
pain
decreased ROM
edema
fever
red, hot, swollen
A

osteomyelitis

299
Q

most common sites of bony malignnacy

A

long bones
distal femur
proximal tibia

300
Q

tx for combined ligament injury

A

surgery for one (usually ACL or PCL)

301
Q

unhappy triad of o’donoghue

A

ACL tear
MCL tear
medial meniscus tear

302
Q

tx for unahppy triad of o’donoghue

A

reconstruct ACL, debride or repair meniscus

303
Q

MCL or LCL more commonto tear

A

MCL

304
Q

force that tears MCL

A

outside force

305
Q

force that tears LCL

A

inside force

306
Q

tx of isolated collateral ligament tears

A

closed, even in 3rd degree

brce with early ROM

307
Q

how soon can one return to play after collateral ligament tear

A

6-8 wks

308
Q

backwards force on knee, dashboard injury, fall on bent knee, extreme hyperextension, falling on bent knee

A

PCL tear

309
Q

does PCL tear cause instability or disability

A

disability

310
Q

exam to dx PCL tear

A

posterior drawer

311
Q

long term complication of PCL tear

A

arthritis

312
Q

ACL’s job

A

stabilizes tibia from coming forward on femur

313
Q

mechanism of ACL

A

non-contact

pivoting

314
Q

can people resume the game after ACL tear

A

no

315
Q

what happens an hour or two after ACL tear

A

huge hemarthrosis

316
Q

other causes of hemarthrosis besides ACL

A

fx
peripheral meniscus tear
capsular tears

317
Q

PE for ACL tear

A

lachman and anterior drawer

318
Q

best test that tells you whether ACL is torn or not

A

lachman

319
Q

best test to tell you if one is ACL dependent or independent

A

pivot shift test

320
Q

is MRI good or bad for ACL

A

okay, but since ACL is in the oblique plain it sometimes misses it

321
Q

ACL tear tx

A

1/3 need surgery (reconstruction)

either autologous or allograft

322
Q

how long does it take to rehab from ACL tear

A

about 6 months

323
Q

who does meniscus tears occur in?

A

young athletes with contact injuries

older people because cartilage stiffens

324
Q

most common torn meniscus

A

medial

325
Q

which meniscus most common to be torn with ACL tear

A

lateral

326
Q

can one go back into the game after a meniscus tear?

A

yes

327
Q

which meniscus is fixed

A

medial

328
Q

where is pain with a meniscus tear

A

posteromedial

with extension and flexion

329
Q

PE tests you can use for meniscus tear

A

McMurrays

apply’s distraction

330
Q

best dx tool for meniscus tear

A

MRI

331
Q

locked knee with tear

A

meniscus from bucket handle tear lflipping to the front of knee

332
Q

when does hemarthrosis occur with mensicus tear

A

next day

CMPP (17 decks)

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