Orthopaedics Cheat Sheet

Question 1

Mx of proximal femur intertrochanteric # (so extracapsular)

Answer 1

Dynamic hip screw

Question 2

Mx of intracapsular # and elderly/poor mobility?

Answer 2

Hemiarthroplasty

Question 3

Mx of intracapsular # and young/active and displaced?

Answer 3

THR

Question 4

Mx of intracapsular # and young/active and undisplaced?

Answer 4

Internal fixation - dynamic hip screw, cannulated screw

Question 5

Initial Mx of hip and thigh injuries in A&E?

Answer 5

Thomas’ splint

Question 6

Infratrochanteric # of femur Mx?

Answer 6

IM nail

Question 7

Femoral shaft # in child Mx?

Answer 7

Traction (less risk of infection than internal fixation). Conservative Mx used for open #, distal femoral # and in children

Question 8

Femoral shaft # in child under 1 year Mx?

Answer 8

Gallows traction

Question 9

Open # Mx?

Answer 9

Clean wound, excise non-viable tissue, stabilise with external fixator

Question 10

Mx of Obese 32 year old woman tripped on the kerb with eversion of her right foot, displaced fracture of medial malleolus and fracture of the fibula above the level of the tibio-fibular joint?

Answer 10

Open reduction and internal fixation:
 - Both malleoli displaced + fibula # at or above the Tibiofibular lig (syndesmosis)  surgical plating of the fibula.
 - If significant medial malleolar fragment then  fixed with a screw or wire.
 - Displaced stable fractures  closed reduction and plaster.
 - Non-displaced, stable fractures  plaster cast

Question 11

Mx of old man falls at home, # of L inferior and superior pubic rami but intact femur?

Answer 11

Analgesia and active mobilisation - avoid prolonged bed rest

Question 12

Scaphoid # Mx?

Answer 12

Scaphoid plaster + sling (x-ray may be normal until days after the injury), new cast applied and a follow-up appt in 4 weeks time

Question 13

Supracondylar # of humerus of child Mx?

Answer 13

Reduction under anaesthesia, pin fixation and application of collar + cuff with the arm in flexion (caution - brachial artery and median nerve can be damaged), triceps acts as a natural splint in flexion

Question 14

Type of injury in hitting knee on dashboard?

Answer 14

PCL

Question 15

Stabbed in the neck, then shoulder pain, what nerve is affected?

Answer 15

Right axillary nerve damage

Question 16

Elbow replacement followed by tingling in the ring finger and a positive froment’s sign, Dx?

Answer 16

Cubital tunnel syndrome

Question 17

Internal rotation and shortening after hip dislocation - what type of dislocation is it?

Answer 17

Posterior dislocation

Question 18

Treatment of tibial # in middle age?

Answer 18

Conservative - slowest healing #

Question 19

Screening for DDH?

Answer 19

Ortalani - palpable sensation of the femoral head grinding in and out of the acetabular joint
Barlow - Adduction of the hip and push posteriorly

Question 20

Back pain + back giving in after lifting something heavy, Dx?

Answer 20

Slipped disc

Question 21

Displaced knee condylar #, Complication?

Answer 21

Damage to popliteal artery? (Secondary OA also an option)

Question 22

Fever, old man, pain in L3, Dx?

Answer 22

Discitis?

Question 23

80 year old woman with nodules on finger joints, Ix?

Answer 23

X-ray

Question 24

Woman 27, shooting pain down leg and sore back, Ix?

Answer 24

MRI spine

Question 25

Necrotising fasciitis treatment?

Answer 25

Debridement

Question 26

Painful shoulder arc

Answer 26

Impingement of rotator cuff

Question 27

Unable to initiate abduction, muscle injured?

Answer 27

Deltoid

Question 28

Nerve supply of sternocleidomastoid?

Answer 28

CN XI

Question 29

Carpet fitter has swelling and pain in knee, Dx?

Answer 29

Bursitis

Question 30

Body builder (chronic steroid use) + heavy lifting, common tendon injured?

Answer 30

``` <40 = patellar tendon rupture >40 = quadriceps tendon rupture ```

Question 31

Swelling over the posterior aspect of the elbow, associated pain, warmth, and erythema, typically middle aged men, Dx?

Answer 31

Olecranon bursitis

Question 32

Pain + tenderness localized to the medial epicondyle, pain is aggravated by wrist flexion and pronation. Symptoms may be accompanied by numbness/tingling in 4th/5th finger due to ulnar nerve involvement. Dx?

Answer 32

Medial epicondylitis (Golfer's elbow)

Question 33

Pain localized at the lateral epicondyle. Pain worse on resisted wrist extension with the elbow extended or supination of the forearm with the elbow extended. Episodes typically last between 6 months-2 years, patients tend to have acute pain for 6-12 weeks. Dx?

Answer 33

Lateral epicondylitis (Tennis' elbow)

Question 34

Compression of the posterior interosseous branch of the radial nerve; similar to lateral epicondylitis however the pain tends to be around 4-5cm distal to the lateral epicondyle and worse when extending the elbow and pronating the arm. Dx?

Answer 34

Radial tunnel syndrome