Flashcards in Ortho pearls Deck (17):
What are 15 Buckley indications to operate or consult in orthopedics
1. open fracture
2. neurovascular compromise
3. failure to reduce joint/bone
4. failure to maintain reduction/alignment of joint/bone
5. major trauma/polytrauma
6. infection - septic joint, infected hardware
7. intra-articular step >2 mm
8. bilateral fractures
9. pediatric elbow
10. floating joint
11. patients with compliance issues
12. to save a life (or functional life) ie. hip fractures in elderly
13. complex injuries
14. obese patients
15. cosmetic results
What are 4 stages of bone healing
1. inflammatory (hematoma)
2. soft callus
3. hard callus
What is the goal in all ankle fractures
Keep the tibia over and in line with the talus
What are 2 things you must not miss in acute knee injuries
Extensor mechanism disruption
What are ddx considerations in bony pain?
traumatic soft tissue injury
What are 3 routes of infection in osteomyelitis?
What features of the synovial membrane allow for infection?
Lacks a basement membrane which allows for bacteria to easily penetration into articular cartilage, bone, and prosthetic devices
What is the involucrum?
Layer of new bone growth outside the sequestra
What is the sequestra?
In osteomyelitis, decreased blood supply can lead to areas of necrotic bone (hallmark of chronic osteomyelitis)
What are 5 risk factors for osteomyelitis?
sickle cell disease
pre-existing joint disease (trauma, RA, gout)
What is the gold standard for diagnosis of osteomyelitis?
diagnostic in 87% of cases
What are Xray findings of osteomyelitis?
lucent areas of cortical bone destruction
periosteal reaction (children >adults)
findings lag behind clinical picture up to 2 weeks
How do Xray / bone scan / CT / MRI compare for diagnosing osteomyelitis?
Xray: 90% abnormal by 28 days,
Why do babies get septic arthritis with osteo?
Lack of physis separating epiphysis from metaphysis, direct spread
What are 3 complications from vertebral osteomyelitis?
What are the 4 Kochner's criteria for septic arthritis?
Non weight bearing