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UCPEX > Orthopaedics > Flashcards

Orthopaedics Flashcards

(43 cards)

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1
Q

Indication to manipulate Colles

A

> 20 degrees angulation
Shortening >5mm
Displacement >2/3 radius

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2
Q

Clavicle MOI and resulting fracture

A

Force through acromion - middle 1/3
Force from above - lateral
Inferior force - comminuted
Posterior force single fracture

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3
Q

Referral for clavicle fracture

A

> 2cm shortening
100% displaced

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4
Q

Shoulder dislocation position

A

Anterior - abduction, external rotation

Posterior - flexion, internal rotation

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5
Q

Most common osteoporotic fractures

A
  1. distal radius
  2. vertebral
  3. proximal humerus
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6
Q

MOI brachial plexus

A

Traction
Compression
Direct blow to supraclavicular fossa

Stretching > neuropraxia
Rupture > full/partial tear - roots still connected to spinal cord
Avulsion > Complete detachment of root from spinal cord

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7
Q

Patterns of brachial plexus injuries

A

Erb’s palsy - C5-6 +/- C7
Klumpke’s palsy C8-T1 +/- C7
Total palsy - C5-T1
Horner’s syndrome - sympathetic chain C8-T1 root avulsion

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8
Q

Bauman’s angle

A

Supracondylar fracture - coronal plain deformity:

Angle between longitudinal humeral shaft and lateral condyle physis
Normal 70-75 deg

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9
Q

Nerve at risk in Monteggia fracture/dislocation

A

Posterior interosseous nerve

Weak finger extension
Weak thumb extension
Wrist extension > radial deviation

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10
Q

Galeazzi fracture - clues to DRUJ injury

A

Widening of DRUJ
Fracture base of ulna styloid
Dislocation/subluxation of ulna on lateral
>5mm shortening of radius compared to ulna

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11
Q

4 stages of carpal disruption: Mayfield classification

A
  1. Scapholunate dissociation
  2. Lunocapitate disruption
  3. Lunotriquetral disruption = perilunate dislocation
  4. Lunate dislocation + median nerve compression
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12
Q

Associated fracture with perilunate dislocation

A

Scaphoid in 61%

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13
Q

Tendons involved in De Quervains tenosynovitis

A

EPB
APL

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14
Q

TFCC articulation

A

Ulna + triquetrum
Radius + lunate

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15
Q

Signs of TFCC injury

A

Pain between ulnar styloid + pisiform/FCU - Ulna fovea sign
Pain on supination lift test
Decreased wrist power, decreased forearm rotation
Prominence of ulna head

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16
Q

Canadian C spine rules

A

> 65, dangerous mechanism, paraesthesia

Low risk factors - sitting, ambulatory, delayed onset pain, no midline tenderness, low speed MVA

Check active rotation 45 deg

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17
Q

Young and Burgess classification of pelvic ring fractures

A

Anteroposterior compression - open book
Lateral compression - windswept pelvis
Vertical shear - Malgaigne fracture, bucket handle fracture
Combination

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18
Q

Avulsion fractures of pelvis, muscles attach:

Iliac crest
ASIS
AIIS
GT
LT
Ischial tuberosity
Pubic symphysis

Study These Flashcards
A

Iliac crest - abdominal wall
ASIS - Sartorius
AIIS - rectus femoris
GT - glute medius and minimus
LT - Iliopsoas
IT - hamstrings
pubic symphysis - adductors

19
Q

Garden classification for intraarticular NOF#

Study These Flashcards
A

I - valgus impacted
II - undisplaced complete fracture
III - partially displaced
IV - fully displaced

20
Q

Risk factors for SUFE

Study These Flashcards
A

Obesity
Adolescents - 10-16
Male
African American, Pasifika, Latino
Prior radiation to area

21
Q

Symptoms and signs of SUFE

Study These Flashcards
A

Groin pain
Knee pain
Limp - trendelenburg/waddling gait

Limited internal rotation
Drehmann sign - external rotation with passive flexion of hip
Thigh atrophy

22
Q

Estimated for closed and open femur and tibia fractures

Study These Flashcards
A

Closed femur 1-1.5L
Open femur 2-3L
Closed tibia - 0.5-1L
Open tibia 1-2L

23
Q

Ottawa knee rule

Study These Flashcards
A

Xray if any of:

Age >55
Isolated patella tenderness
Tenderness at fibula head
Unable to flex to 90 deg
Unable to weight bear >4 steps

24
Q

Associated soft tissue injuries in tibial plateau fracture

Study These Flashcards
A

ACL rupture
Lateral meniscal injury

25
Medial collateral ligament tears are associated with what other ligament tear?
ACL
26
Risk factors for Osgood Schlatter's
Girls 8-12 Boys 12-15 Atheletic - jumping sports/sprinting
27
Oestern + Tscherne classification for soft tissue injury in closed fractures
0 - minimal soft tissue injury 1 - Superficial contusion/abrasion, simple fractures 2 - Deep abrasions, muscle/skin contusions, direct trauma, impending compartment syndrome 3 - Excessive skin contusion, muscle destruction, crushed skin, subcutaneous degloving, acute compartment syndrome, rupture of major blood vessel/nerve
28
Risk factors for Achilles tendon rupture
"Weekend warrior" Steroid injections Fluoroquinolone antibiotics
29
Risks for compartment syndrome
Fractures/crush injuries to limb Circumferential 3rd degree burns Limb reperfusion injury DVT Cast, splints, constrictive dressings Male <35
30
Symptoms of compartment syndrome
6 P's Pain Pallor Pulselessness Poikylothermia Paralysis Paraesthesia
31
Intracompartment reading for compartment syndrome
Normal 0-4mmHg With exertion - up to 10mmHg Acute compartment syndrome: >30mmHg
32
Ottawa ankle rules
Tenderness on: Posterior edge/tip distal 6cm lateral mall Posterior edge/tip distal 6cm medial mall Base of 5th MT Navicular Inability to bear weight >4 steps
33
Ankle injury in pronation + external rotation
Medial malleolar, consider Maisonneuve
34
Ankle injury in inversion and external rotation
Distal fibular
35
Ankle injury in abduction/forced eversion
Deltoid ligament
36
Ankle injury in adduction
LCL tear/tip of fibula avulsion
37
Ankle injury with inversion on plantar flexed foot
Lateral ligament complex sprain
38
Conservative management of calcaneus fractures
<1cm extraarticular fracture, <2mm displacement, intact Achilles Sanders I - non displaced posterior facet Anterior process fracture <25% calcaneocuboid joint Non smoker, non diabetic, no PVD
39
Bohler's angle Gissane's angle
Bohler's - normal 20-40 Reduced = collapse of posterior facet Gissane's angle - normal 120-145 Increased = collapse of posterior facet
40
Snowboarder's fracture
Lateral process of talus Dorsiflexion, inversion
41
42
5th metatarsal fracture mechanisms
Zone 1 Base of 5th metatarsal - inversion with traction avulsion from peroneus brevis WBAT stiff soled shoe Zone 2 Jones fracture - Forefoot adduction Cast NWB Zone 3 Proximal diaphysis - march fractures - repetitive stress Cast NWB
43
Lisfranc injury mechanism
Axial loading on plantar flexed foot Fixed hindfoot, rotational force forefoot Direct trauma

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