Orthopaedics Flashcards
(29 cards)
Which structures are likely to be damaged after a fracture of the surgical neck of the humerus?
Axillary nerve
Posterior communicating humeral artery
Name the 4 muscles which make up the rotator cuff and say what movements they produce in the shoulder
Supraspinatus - abduction
Infraspinatus - external rotation
Subscapularis - internal rotation
Teres minor - external rotation
Where is the shoulder most prone to dislocation and why?
Inferiorly as there is much less muscle bulk there.
Wrist drop is a sign of damage to which nerve?
Radial
Where do the heads of triceps muscle insert?
Olecranon
Describe the ligaments in the elbow
Collaterals x2 - radial and ulnar collaterals. These help stabilise the hinge joint of the elbow.
Anular ligament - wraps from the ulnar, round the radius, and back to the ulnar. Allows pronation / supination of the joint.
What is varus deformity of the knee?
Distal ends of the leg are displaced medially leading to a bow-legged appearance
What is valgus deformity of the knee?
Distal to the knee is displaced laterally, leading to a knocked knee appearance
What is the posterior sag test?
Investigates for any damage to the posterior cruciate ligament. With the knee flexed, look from the side. ‘Sagging’ of the joint suggests damage.
What is the anterior drawer test?
Investigates damage to the anterior cruciate ligament. With knee flexed, place hands around the knee joint, with thumbs on the anterior surface of the tibia. Stabilise the lower leg with your forearm, and apply a pulling motion. Excessive movement is suggestive of anterior cruciate ligament damage.
What is compartment syndrome?
Increased pressure in one of the muscle compartments (usually in the leg) often following trauma. Results in pain out of proportion to the injury. Pressure may rise to above the venous drainage / arterial pressure, causing ischaemia.
What is Simmon’s test?
Done in ankle exam - ask patient to knee on chair with feet hanging over edge - squeeze calf muscle. Foot should plantar flex. If not it is a sign of Achilles rupture
What tool is used to help decide if a patient with an ankle injury requires an x-ray?
Use Ottawa rules
How are ankle fractures of the lateral malleolus classified?
Weber Classification
A = Distal to ankle joint
B = At level of ankle joint
C = Proximal to ankle joint
What is the criteria for patients needing an ankle x-ray after ankle injury?
Pain in the malleolar region and any of the following:
- Bone tenderness at the posterior tip or edge of the lateral malleolus
- Bone tenderness at the posterior tip or edge of the medial malleolus
- Inability to take 4 complete steps either immediately or in the emergency department
What is the criteria for patients needing an foot x-ray after foot injury?
Pain in the midfoot zone and any of the following:
- Bone tenderness at the base of the 5th metatarsal
- Bone tenderness at the navicular
- Inability to take 4 complete steps either immediately or in the emergency department
What is the classification system for neck of femur fractures?
Garden classification
What is a Monteggia fracture?
Fracture of the ulnar shaft with dislocation of the head of the humerus at the elbow
What is a Galleazzi fracture?
Fracture of the radial shaft with dislocation of the distal radioulnar joint
What is a Colles fracture?
Fracture of the distal radius with dorsal displacement of the distal fragment. There is usually an associated ulnar styoid fracture.
What is a Smith’s fracture?
Fracture of the distal radius with volar displacement of the distal fragment
Which part of the elbow is affected in tennis elbow?
Lateral epicondyl
Which part of the elbow is affected in golfer’s elbow?
Medial epicondyl
What is the classification system for supracondylar fractures?
Gartland classification
