Ortho

Question 1

why is neurovascular status important?

Answer 1

compartment syndrome

Question 2

just bc an xray is neg….

Answer 2

doesnt mean no fx

Question 3

open fx requires

Answer 3

antibiotics, 1st gen cephs

Question 4

what to keep in mind for tendon injuries

Answer 4

• Up to 90% of a tendon can be lacerated with preserved ROM SO TEST AGAINST RESISTANCE
• splint them then send to hand sx

Question 5

PE- DIP joint is flexed at 40 degrees

Answer 5

mallet finger

TX- splint the PIP joint in extension

Question 6

Results from injury at the dorsal surface of the PIP joint

Answer 6

boutonierre deformity

splint PIP in extension

Question 7

M/C involve the fourth and fifth MC neck(boxers fx)

Angulation 20 degrees of the 4th or 40 degrees of the 5th needs to be reduced

Answer 7

metacarpal fx

tx-ulnar gutter

Question 8

MC carpal fx

Answer 8

scaphoid

Fracture of Scaphoid, Lunate, and Capitate can cause AVN

Question 9

colles (fork deformity)

Answer 9

FOOSH

distal radius goes posterior

Question 10

smith

Answer 10

distal radius goes anteriorly

Question 11

how to tx tendon ruptures

Answer 11

includes sling, ice, NSAIDs, and referral to orthopedic specialist OUTPATIENT

Question 12

MC elbow dislocation

Answer 12

posterolateral
An open dislocation, absence of radial pulse before reduction, and presence of systemic injuries are all factors associated with arterial injury and ARE EMERGENCIES

Question 13

how ot tx non-displaced radial head fx

Answer 13

sling

Question 14

fracture of proximal third of the ulna with a radial head dislocation, pain and swelling at the elbow

Answer 14

monteggia (think hit by a bat)

Question 15

a fracture of the distal radius with an associated distal radioulnar joint disloctation, pain and swelling at the wrist

Answer 15

galeazzi

Question 16

how to tx forearm fxs

Answer 16

Nondisplaced- fractures long arm splint, referral to ortho

Displaced- consult(closed reduction for children; ORIF for adults)

Question 17

AC joint injuries

Answer 17

1/2-sling

3-6 sx

Question 18

how to confirm shoulder dislocation

Answer 18

Xray- AP and a scapular “y” view to confirm dislocation

Question 19

how to tx humerus fxs

Answer 19

sling immoblization for nondisplaced fx, ice, analgesics and ortho referral. Humeral shafts get long arm or sugar tong splints and ortho referral. Any displaced or communted fractures get an immediate ortho consult

Question 20

Patients usually present shortened and externally rotated. They usually complain of pain in the groin or knee

Answer 20

hip fx,

Question 21

BEST test for hip fx

Answer 21

MRI is 100% sensitive. You order this when a patient can not bear weight to r/o occult fracture. CT scan may be used also but not as sensitive

Question 22

femoral head/neck and inter/subtrochanteric fxs require

Answer 22

ortho consult

greater/lesser trochanteric do not

Question 23

Patients usually have extremity shortened and INTERNALLY ROTATED

Answer 23

hip dislocation, 90% posterior
True orthopedic emergencies and should be reduced(sedation) within 6 hours because delays in reduction corresponds with high incidence of AVN

Question 24

valgus or varus force combined with axial load that drive the femoral condyle into the tibia

Answer 24

tibial plateau fx, knee immobilizer

Question 25

Ottawa Rules(knee xrays are needed if ANY of the following are present)

Answer 25

``` Age >= 55 years Pain at the head of fibula Isolated patella tenderness Inability to flex knee 90 degrees Inability to walk 4 weightbearing steps ```

Question 26

what to worry about for tibia fxs

Answer 26

compartment syndrome

Question 27

PATIENT WILL NOT BE ABLE TO EXTEND THE KNEE AGAINST RESISTANCE

Answer 27

quad/patellar tendon rupture, | MRI outpt, ortho

Question 28

most sensitive acl test

Answer 28

lachman

Question 29

any ligament tear

Answer 29

outpt MRI and ortho

Question 30

MC ankle sprain

Answer 30

anterior talofibular

Question 31

which type of foot dislocation is MC

Answer 31

posterior, reduce ASAP

Question 32

calcaneal fx

Answer 32

plain films or CT posterior splint intra-articular asap ortho

Question 33

lisfranc fx

Answer 33

CT posterior splint ED ortho consult

Question 34

jones fx

Answer 34

xray posterior splint 24-48 hr f/u

Question 35

Elevated pressures within a confined muscle compartment can lead to functional and circulatory impairment of that limb. M/C are legs(lower) and forearm

Answer 35

compartment syndrome | 5 Ps

Question 36

how to dx compartment syndrome

Answer 36

measure compartment pressures(vascular sx consult)normal compartment pressures at <10 mmhg

Question 37

how to dx osteomyelitis

Answer 37

xray, MRI***, CBC, CRP(elevated), ESR(elevated), cultures

Question 38

septic arthritis fluid analysis

Answer 38

>50k WBC | admit