Orthopedic Surgery Flashcards Preview

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Flashcards in Orthopedic Surgery Deck (252):
1

What is ORIF?

Open Reduction Internal Fixation

2

What is ROM?

Range Of Motion

3

What is FROM?

Free Range Of Motion

4

What is ACL?

Anterior Cruciate Ligament

5

What is PCL?

Posterior Cruciate Ligament

6

What is MCL?

Medial Collateral Ligament

7

What is PWB?

Partial Weight Bearing

8

What is FWB?

Full Weight Bearing

9

What is WBAT?

Weight Bearing As Tolerated

10

What is THA?

Total Hip Arthroplasty

11

What is TKA?

Total Knee Arthroplasty

12

What is THR?

Total Hip Replacement

13

What is TKR?

Total Knee Replacement

14

What is PROM?

Passive Range Of Motion

15

What is AROM?

Active Range Of Motion

16

What is AFO?

Ankle Foot Orthotic

17

What is AVN?

AVascular Necrosis

18

What is supination?

Palm up

19

What is pronation?

Palm down

20

What is plantarflexion?

Foot down at ankle joint

21

What is foot dorsiflexion?

Foot up at ankle joint

22

What is adduction?

Movement toward the body

23

What is abduction?

Movement away from the body

24

What is inversion?

Foot sole faces midline

25

What is eversion?

Foot sole faces laterally

26

What is volarflexion?

Hand flexes at wrist joint toward flexor tendons

27

What is wrist dorsiflexion?

Hand flexes at wrist joint toward extensor tendons

28

What is allograft bone?

Bone from human donor other than patient

29

What is a reduction?

Maneuver to restore proper alignment to fracture or joint

30

What is a closed reduction?

Reduction done without surgery (e.g. casts, splints)

31

What is an open reduction?

Surgical reduction

32

What is a fixation?

Stabilization of a fracture after reduction by means of surgical placement of hardware that can be external or internal (e.g. pins, plates, screws)

33

What is a tibial pin?

Pin placed in the tibia for treating femur or pelvic fractures by applying skeletal traction

34

What is an unstable fracture or dislocation?

Fracture or dislocation in which further deformation will occur if reduction is not performed

35

What is varus?

Extremity abnormality with apex of defect pointed away from midline

36

What is valgus?

Extremity abnormality with apex of defect pointed towards midline

37

What is a dislocation?

Total loss of congruity and contact between articular surfaces of a joint

38

What is a subluxation?

Loss of congruity between articular surfaces of a joint, though articular contact still remains

39

What is arthroplasty?

Total joint replacement (most last 10-15 years)

40

What is arthrodesis?

Joint fusion with removal of articular surfaces

41

What is osteotomy?

Cutting bone (usually wedge resection) to help realigning of joint surfaces

42

What is non-union?

Failure of fractured bone ends to fuse

43

What is the diaphysis of a bone?

Main shaft of long bone

44

What is the metaphysis of a bone?

Flared end of long bone

45

What is the physis of a bone?

Growth plate, found only in immature bone

46

How should fractured extremities be examined?

1. Observe entire extremity (e.g. open, angulation, joint disruption)
2. Neurologic (sensation, movement)
3. Vascular (e.g. pulses, cap refill)

47

Which x-rays should be obtained for a fractured extremity?

Two views (also joint above and below fracture)

48

How are fractures described?

1. Skin status (open or closed)
2. Bone (by thirds: proximal/middle/distal)
3. Pattern of fracture (e.g. comminuted)
4. Alignment (displacement, angulation, rotation)

49

How do you define the degree of angulation, displacement, or both?

Define lateral/medial/anterior/posterior displacement and angulation of the distal fragment(s) in relation to the proximal bone

50

What is a closed fracture?

Intact skin over fracture/hematoma

51

What is an open fracture?

Wound overlying fracture, through which fracture fragments are in continuity with outside environment.
High risk of infection.

52

What is a simple fracture?

One fracture line, two bone fragments

53

What is a comminuted fracture?

Results in more than two bone fragments, i.e. fragmentation

54

What is a segmental fracture?

Two complete fractures with a segment in between

55

What is a transverse fracture?

Fracture line perpendicular to long axis of bone

56

What is an oblique fracture?

Fracture line creates an oblique angle with long axis of bone

57

What is a spiral fracture?

Severe oblique fracture in which fracture plane rotates along the long axis of bone.
Caused by twisting injury.

58

What is a longitudinal fracture?

Fracture line parallel to long axis of bone

59

What is an impacted fracture?

Fracture resulting from compressive force.
End of bone is driven into contiguous metaphyseal region without displacement.

60

What is a pathologic fracture?

Fracture through abnormal bone (e.g. tumor-laden or osteoporotic bone)

61

What is a stress fracture?

Fracture in normal bone from cyclic loading on bone

62

What is a greenstick fracture?

Incomplete fracture in which cortex on only one side is disrupted.
Seen in children.

63

What is a torus fracture?

Impaction injury in children in which cortex is buckled but not disrupted

64

What is an avulsion fracture?

Fracture in which tendon is pulled from bone, carrying with it a bone chip

65

What is a periarticular fracture?

Fracture close to but not involving the joint

66

What is an intra-articular fracture?

Fracture through the articular surface of a bone

67

What is Colles' fracture?

Distal radius fracture with dorsal displacement and angulation, usually from falling on an outstretched hand

68

What is Smith's fracture?

Distal radius fracture with volar displacement and angulation, usually from falling on the dorsum of the hand

69

What is Jones' fracture?

Fracture at the base of the 5th metatarsal diaphysis

70

What is Bennett's fracture?

Fracture-dislocation of the base of the 1st metacarpal with disruption of the carpometacarpal joint

71

What is a boxer's fracture?

Fracture of the metacarpal neck, classically of the 5th digit

72

What is a nightstick fracture?

Ulnar fracture

73

What is a clay shoveler's avulsion fracture?

Fracture of spinous process of C6-C7

74

What is a hangman's fracture?

Fracture of the pedicles of C2

75

What is a transcervical fracture?

Fracture through the neck of the femur

76

What is a tibial plateau fracture?

Intra-articular fracture of the proximal tibia (the plateau is the flared proximal end)

77

What is a Monteggia fracture?

Fracture of the proximal third of the ulna with dislocation of the radial head

78

What is a Galeazzi fracture?

Fracture of the radius at the junction of the middle and distal thirds accompanied by disruption of the distal radioulnar joint

79

What is a Pilon fracture?

Distal tibial fracture

80

What is Pott's fracture?

Fracture of distal fibula

81

What is Pott's disease?

Tuberculosis of the spine

82

What are the major orthopedic emergencies?

1. Open fractures or dislocations
2. Vascular injuries
3. Compartment syndrome
4. Neural compromise
5. Osteomyelitis or septic arthritis
6. Hip dislocations
7. Exsanguinating pelvic fracture

83

What is the main risk when dealing with an open fracture?

Infection

84

Which fracture has the highest mortality?

Pelvic fracture (up to 50% if open)

85

What 3 factors determine the extent of injury of a fracture?

1. Age (suggests susceptible point in MS system)
2. Direction of forces
3. Magnitude of forces

86

What are indications for open reduction of a fracture?

NO CAST:
Non-union
Open fracture
Compromise of blood supply
Articular surface malalignment
Salter-Harris grade III-IV fracture
Trauma patients who need early ambulation

87

What is a grade I open fracture?

< 1-cm laceration

88

What is a grade II open fracture?

> 1-cm laceration, minimal soft tissue damage

89

What is a grade IIIa open fracture?

Massive tissue devitalization or loss, contamination

90

What is a grade IIIb open fracture?

Massive tissue devitalization or loss and extensive periosteal stripping, contamination, inadequate tissue coverage

91

What is a grade IV open fracture?

Major vascular injury requiring repair

92

What are the 5 steps in the initial treatment of an open fracture?

1. Prophylactic antibiotics to include IV gram-positive +/- anaerobic coverage (cefazolin, cefoxitin/gentamicin).
2. Surgical debridement.
3. Inoculation against tetanus.
4. Lavage wound < 6 hours post-incident with high-pressure sterile irrigation.
5. Open reduction of fracture and stabilization.

93

What structures are at risk with a humeral fracture?

Radial nerve, brachial artery

94

What must be done when both forearm bones are broken?

Because precise movements are needed, open reduction and internal fixation are musts

95

How have femoral fractures been repaired traditionally?

Traction for 4-6 weeks

96

What is the newer technique to repair femoral fractures? What are its advantages?

Intramedullary rod placement.
Nearly immediate mobility with decreased morbidity/mortality.

97

What is the chief concern following tibial fractures?

Recognition of associated compartment syndrome

98

What is suggested by pain in the anatomic snuff-box?

Fracture of scaphoid bone

99

What is the most common cause of a pathologic fracture in adults?

Osteoporosis

100

What is acute compartment syndrome?

Increased pressure within a osteofacial compartment that can lead to ischemic necrosis

101

How is compartment syndrome diagnosed?

Clinically, using intracompartmental pressures is also helpful (> 40 mmHg requires fasciotomy)

102

What are the causes of compartment syndrome?

Fractures, vascular compromise, reperfusion injury, compressive dressings.
Can occur after any musculoskeletal injury.

103

What are common causes of forearm compartment syndrome?

Supracondylar humerus fracture, brachial artery injury, radius or ulna fracture, crush injury

104

What is Volkmann's contracture?

Final sequela of forearm compartment syndrome.
Contracture of the forearm flexors from replacement of dead muscle with fibrous tissue.

105

What is the most common site of compartment syndrome?

Calf (4 compartments: anterior, lateral, deep posterior, superficial posterior compartments)

106

What 4 situations should immediately alert one to be on the lookout for a developing compartment syndrome?

1. Suprcondylar elbow fracture in children
2. Proximal or midshaft tibial fracture
3. Electrical burn
4. Arterial or venous disruption

107

What are the symptoms of compartment syndrome?

Pain, paresthesias, paralysis

108

What are the signs of compartment syndrome?

Pain on passive movement (out of proportion to injury), cyanosis or pallor, hypoesthesia (decreased sensation, decreased 2-point discrimination), firm compartment

109

Can a patient have a compartment syndrome with a palpable or Doppler-detectable distal pulse?

Yes

110

What are the possible complications of compartment syndrome?

Muscle necrosis, nerve damage, contracture, myoglobinuria

111

What is the initial treatment of the orthopedic patient developing compartment syndrome?

Bivalve and split casts, remove constricting clothes and dressings, place extremity at heart level

112

What is the definitive treatment for compartment syndrome?

Fasciotomy within 4 hours, if possible

113

What motor and sensation tests are used to assess the radial nerve?

Motor: wrist extension.
Sensation: dorsal web space, between thumb and index finger.

114

What motor and sensation tests are used to assess the ulnar nerve?

Motor: little finger abduction.
Sensation: little finger-distal ulnar aspect

115

What motor and sensation tests are used to assess the median nerve?

Motor: thumb opposition or thumb pinch
Sensation: index finger-distal radial aspect

116

What motor and sensation tests are used to assess the axillary nerve?

Motor: arm abduction
Sensation: deltoid patch on lateral aspect of upper arm

117

What motor and sensation tests are used to assess the musculocutaneous nerve?

Motor: elbow flexion
Sensation: lateral forearm

118

How is a peripheral nerve injury treated?

Controversial, although clean lacerations may be repaired primarily.
Most injuries are followed for 6-8 weeks with EMG.

119

What fracture is associated with a calcaneus fracture?

L-spine fracture (usually from a fall)

120

What are the nerves of the brachial plexus?

A.M. RUM:
Axillary, Median, Radial, Ulnar, Musculocutaneous

121

What are the 2 indications for operative exploration with a peripheral nerve injury?

1. Loss of nerve function after reduction of fracture.
2. No EMG signs of nerve regeneration after 8 weeks (nerve graft).

122

What is the most common type of shoulder dislocation?

95% are anterior (posterior are associated with seizures or electrical shock)

123

Which 2 structures are at risk in a shoulder dislocation?

1. Axillary nerve
2. Axillary artery

124

How is a shoulder dislocation diagnosed?

Indentation of soft tissue beneath acromion

125

What are the 3 treatment steps for a should dislocation?

1. Reduction via gradual traction
2. Immobilization for 3 weeks in internal rotation
3. ROM exercises

126

What is the most common type of elbow dislocation?

Posterior

127

Which 3 structures are at risk in an elbow dislocation?

1. Brachial artery
2. Ulnar nerve
3. Median nerve

128

What is the treatment for an elbow dislocation?

Reduce and splint for 7-10 days

129

When should hip dislocations be reduced?

Immediately, to decrease risk of avascular necrosis

130

What is the most common cause of a hip dislocation?

High velocity trauma

131

What is the most common type of hip dislocation?

Posterior (often involves fracture of posterior lip of acetabulum)

132

Which structures are at risk in a hip dislocation?

1. Sciatic nerve
2. Blood supply to femoral head

133

What is the treatment for a hip dislocation?

Closed or open reduction

134

What are the common types of knee dislocations?

Anterior or posterior

135

Which structures are at risk in a knee dislocation?

1. Popliteal artery and vein
2. Peroneal nerve
3. ACL
4. PCL

136

What is the treatment for a knee dislocation?

Immediate attempt at relocation, arterial repair, ligamentous repair

137

What are the 5 ligaments of the knee?

1. Anterior cruciate ligament
2. Posterior cruciate ligament
3. Medial collateral ligament
4. Lateral collateral ligament
5. Patellar ligament

138

What is the Lachman test for a torn ACL?

Thigh is secured with one hand while the other hand pulls the tibia anteriorly

139

What is the meniscus of the knee?

Cartilage surface of the tibia plateau (lateral and medial meniscus).
Tears are repaired usually by arthroscopy with removal of torn cartilage fragments.

140

What is McMurray's sign?

Medial tenderness of knee with flexion and internal rotation of the knee.
Seen with a medial meniscus tear.

141

What is the unhappy triad?

Lateral knee injury resulting in:
1. ACL tear
2. MCL tear
3. Medial meniscus tear

142

What is a locked knee?

Meniscal tear that displaces and interferes with the knee joint and prevents complete extension

143

What is a bucket-handle tear?

Meniscal tear longitudinally along contour of normal "C" shape of the meniscus

144

In collateral ligament and menisci injuries, which are more common, the medial or the lateral?

Medial

145

What are the signs of an Achilles tendon rupture?

Severe calf pain; bruised swollen calf; two ends of ruptured tendon may be felt; weak plantar flexion from great toe flexors that should be intact

146

What is the test for an intact Achilles tendon?

Thompson's test:
Squeeze of the gastrocnemius muscle results in plantar flexion of the foot.

147

What is the treatment for an Achilles tendon rupture?

Young: surgical repair
Old: Many can be treated with progressive splints

148

What 4 muscles form the rotator cuff?

SITS:
1. Supraspinatus
2. Infraspinatus
3. Teres minor
4. Subscapularis

149

When do rotator cuff tears usually occur?

5th decade

150

What is the usual history for a rotator cuff tear?

Intermittent should pain especially with overhead activity, followed by an episode of acute pain corresponding to a tendon tear.
Weak abduction.

151

What is the treatment for a rotator cuff tear?

Usually symptomatic pain relief.
Later, if poor muscular function persists, surgical repair is indicated.

152

What is Dupuytren's contracture?

Thickening and contracture of palmar fascia.
Incidence increases with age.

153

What is Charcot's joint?

Joint arthritis from peripheral neuropathy

154

What is tennis elbow?

Tendonitis of the lateral epicondyle of the humerus.
Classically seen in tennis players.

155

What is turf toe?

Hyperextension of the great toe (tear of the tendon of the flexor hallucis brevis).
Classically seen in football players.

156

What are shin splints?

Exercise-induced anterior compartment hypertension (compartment syndrome).
Seen in runners.

157

What is a heel spur?

Plantar fasciitis with abnormal bone growth in the plantar fascia.
Classically seen in runners and walkers.

158

What is Kienbock's disease?

Avascular necrosis of the lunate

159

What is traumatic myositis?

Abnormal bone deposit in a muscle after blunt trauma deep muscle contusion

160

How does a cast saw cut the cast but not the underlying skin?

It is an oscillating saw that goes back and forth cutting anything hard while moving the skin back and forth without injuring it

161

What is osteomyelitis?

Inflammation or infection of bone marrow and adjacent bone

162

What are the most likely causative organisms in osteomyelitis?

Neonates: Staph aureus, Strep
Children: Staph aureus, H. flu, Strep
Adults: Staph aureus
Immunocompromised: Staph aureus, gram-negatives
Sickle cell: Salmonella

163

What is the most common organism isolated in osteomyelitis in the general adult population?

Staph aureus

164

What is the most common organism isolated in osteomyelitis in patients with sickle cell disease?

Salmonella

165

What is seen with osteomyelitis on physical exam?

Tenderness, decreased movement, swelling

166

What are the diagnostic steps for osteomyelitis?

H&P, needle aspirate, blood cultures, CBC, ESR, bone scan

167

What are the treatment options for osteomyelitis?

Antibiotics +/- surgical drainage

168

What is a Marjolin's ulcer?

Squamous cell carcinoma that arises in a chronic sinus from osteomyelitis

169

What is septic arthritis?

Inflammation of a joint beginning as synovitis and ending with destruction of articular cartilage if left untreated

170

What are the causative agents with septic arthritis?

Same as osteomyelitis, except that gonococcus is a common agent in the adult population

171

What are the findings on physical exam with septic arthritis?

Joint pain, decreased motion, joint swelling, joint warm to the touch

172

What are the diagnostic steps for septic arthritis?

Needle aspirate, x-ray, blood cultures, ESR

173

What is the treatment for septic arthritis?

Decompression of the joint via needle aspiration and IV antibiotics.
Hip, shoulder, and spine must be surgically incised, debrided, and drained.

174

What is the most common type of orthopedic tumor in adults?

Metastatic

175

What are the common sources of orthopedic tumors?

Breast, lung, prostate, kidney, thyroid, multiple myeloma

176

What is the usual presentation of an orthopedic tumor?

Bone pain or as a pathologic fracture

177

What is the most common primary malignant bone tumor?

Multiple myeloma

178

What is the differential diagnosis of a possible bone tumor?

Metastatic disease; primary bone tumor; metabolic disorder (hyperparathyroidism); infection

179

What are the 8 benign bone tumors?

Osteochondroma; enchondroma; unicameral/aneurysmal bone cyst; osteoid osteoma; chondroblastoma; fibroxanthoma; fibrous dysplasia; non-ossifying fibroma

180

What are the 7 malignant bone tumors?

Multiple myeloma; osteosarcoma; chondrosarcoma; Ewing's sarcoma; giant cell tumor; malignant melanoma; metastatic

181

What is the difference in bone reaction from benign and malignant bone tumors?

Benign: Sclerotic bone reaction
Malignant: Little reaction

182

Are most pediatric bone tumors benign or malignant?

80% are benign

183

Are most adult bone tumors benign or malignant?

66% are malignant

184

What are the 4 diagnostic steps for bone tumors?

1. Physical and lab tests
2. Radiographs
3. CT, technetium scan
4. Biopsy

185

What are the radiographic signs of malignant bone tumors?

Large size; aggressive bone destruction; poorly defined margins; ineffective bone reaction to tumor; extension to soft tissues

186

What are the radiographic signs of benign bone tumors?

Small size; well-circumscribed; sharp margins; effective bone reaction to the tumor; no extension

187

What are specific radiographic findings with osteosarcoma?

Sunburst pattern

188

What are specific radiographic findings with Ewing's sarcoma?

Onion skinning

189

What are specific radiographic findings with fibrous dysplasia?

Bubbly lytic lesion, ground glass

190

What is the mainstay of treatment for bone tumors?

Surgery (excision and debridement) for both malignant and benign tumors.
XRT and chemotherapy as adjuvant therapy for many malignant tumors.

191

What is the usual age of presentation with osteosarcoma?

10-20 years

192

What is the gender distribution for osteosarcoma?

M > F

193

What is the most common location for osteosarcoma?

66% in the distal femur, proximal tibia

194

What is the radiographic sine qua non for osteosarcoma?

Bone formation somewhere within tumor

195

What is the treatment for osteosarcoma?

Resection (limb sparing if possible) and chemotherapy

196

What is the 5-year survival for osteosarcoma?

70%

197

What is the most common site of metastasis for osteosarcoma?

Lungs

198

What is the most common benign bone tumor?

Osteochondroma

199

What is a chondrosarcoma?

Malignant tumor of cartilaginous origin.
Presents in middle-aged and older patients and is unresponsive to chemotherapy and XRT.

200

What is the usual presentation of Ewing's sarcoma?

Pain, swelling in involved area

201

What is the most common location for Ewing's sarcoma?

Around the knee (distal femur, proximal tibia)

202

What is the usual age of presentation with Ewing's sarcoma?

Evenly spread among those < 20 years

203

What are the associated radiographic findings with Ewing's sarcoma?

Lytic lesions with periosteal reaction termed "onion skinning", which is calcified layering.
Central areas of tumor can undergo liquefaction necrosis, which may be confused with purulent infection.

204

What is the 5-year survival rate for Ewing's sarcoma?

50%

205

How can Ewing's sarcoma mimic the appearance of osteomyelitis?

Bone cysts

206

What is a unicameral bone cyst?

Fluid-filled cyst most commonly found in the proximal humerus in children 5-15 years

207

What is the usual presentation of a unicameral bone cyst?

Asymptomatic until pathologic fracture

208

What is the treatment for a unicameral bone cyst?

Steroid injections

209

What is an aneurysmal bone cyst?

Hemorrhagic lesion that is locally destructive by expansile growth, but does not metastasize

210

What is the usual presentation of an aneurysmal bone cyst?

Pain and swelling.
Pathologic fractures are rare.

211

What is the treatment for an aneurysmal bone cyst?

Curettage and bone grafting

212

Which arthritides are classified as degenerative?

Osteoarthritis, post-traumatic arthritis

213

What signs characterize osteoarthritis?

Heberden's nodes; Bouchard's nodes; symmetric destruction; usually hip, knee, spine

214

What are Bouchard's nodes?

Enlarged PIP joints of the hand from cartilage or bone growth

215

What are Heberden's nodes?

Enlarged DIP joints of the hand from cartilage or bone growth

216

What is post-traumatic arthritis?

Usually involves one joint of past trauma

217

What are the treatment options for degenerative arthritis?

1. NSAIDs for acute flares, not long-term
2. Local corticosteroid injections
3. Surgery

218

What are the characteristics of rheumatoid arthritis?

Autoimmune reaction in which invasive pannus attacks hyaline articular cartilage.
Rheumatoid factor (anti-IgG/IgM) in 80% of patients.

219

What is pannus?

Inflammatory exudate overlying synovial cells inside the joint

220

What are the classic hand findings with rheumatoid arthritis?

Wrist: radial deviation
Fingers: ulnar deviation

221

What are the surgical management options for joint or bone diseases?

1. Arthroplasty
2. Arthrodesis
3. Osteotomy

222

What is the major difference between gout and pseudogout?

Gout: caused by urate deposition, negative birefringent, needle crystal.
Pseudogout: caused by calcium pyrophosphate positive birefringent square crystals.

223

What is a Charcot's joint?

Arthritic joint from peripheral neuropathy

224

What are the major differences between pediatric and adult bones?

Children: increased bone flexibility and bone healing, physis is weak point

225

What types of fractures are unique to children?

Greenstick fractures, torus fractures, and fracture through physis

226

What does the Salter-Harris classification system describe?

Fractures in children involving physis

227

What is a Salter I fracture?

Through physeal plate only

228

What is a Salter II fracture?

Involves metaphysis and physis

229

What is a Salter III fracture?

Involves physis and epiphysis

230

What is a Salter IV fracture?

Extends from metaphysics through physis into epiphysis

231

What is a Salter V fracture?

Axial force crushes physeal plate

232

What acronym can help you remember the Salter classification?

SALTR:
Separated
Above
Lower
Through
Ruined

233

Why is the growth plate of concern in childhood fractures?

Growth plate represents the weak link in the child's musculoskeletal system.
Fractures involving the growth plate of long bones may compromise normal growth, so special attention should be given to them.

234

What is the chief concern when oblique or spiral fractures of long bones are seen in children?

Child abuse is a possibility

235

What is usually done during reduction of a femoral fracture?

Small amounts of overlap is allowed because increased vascularity from injury may make the affected limb longer if overlap is not present.
Treatment after reduction is a spica cast.

236

What is unique about ligamentous injury in children?

Most ligamentous injuries are actually fractures involving the growth plate

237

What two fractures have a high incidence of associated compartment syndrome?

1. Tibial fractures
2. Supracondylar fractures of the humerus

238

What is the epidemiology of congenital hip dislocation?

F > M, firstborn children, breech

239

What percentage of congenital hip dislocations are bilateral?

10%

240

How is the diagnosis of congenital hip dislocation made?

Barlow's maneuver, Ortolani's sign, radiographic confirmation is required

241

What is Barlow's maneuver?

Detects unstable hip.
Patient is placed in the supine position and attempt is made to push femurs posteriorly with knees at 90 degrees and hip will dislocate.

242

What is Ortolani's sign?

Clunk produced by relocation of a dislocated femoral head when the examiner abducts the flexed hip and lifts the greater trochanter anteriorly.
Detects a dislocated hip.

243

What is the treatment for congenital hip dislocation?

Pavlik harness (maintains hip reduction with hips flexed at 100-110 degrees)

244

What is scoliosis?

Lateral curvature of a portion of the spine.
Nonstructural: corrects with positional change
Structural: does not correct

245

What are 3 treatment options for scoliosis?

1. Observation
2. Braces (Milwaukee brace)
3. Surgery

246

What are the indications for surgery for scoliosis?

Respiratory compromise; rapid progression; curves > 40 degrees; failure of brace

247

What is Legg-Calve-Perthes disease?

Idiopathic avascular necrosis of femoral head in children

248

What is a slipped capital femoral epiphysis?

Migration of proximal femoral epiphysis on the metaphysis in children.
The proximal femoral epiphysis externally rotates and displaces anteriorly from the capital femoral epiphysis, which stays reduced in the acetabulum.

249

What is Blount's disease?

Idiopathic varus bowing of tibia

250

What is nursemaid's elbow?

Dislocation of radial head (from pulling toddler's arm)

251

What is Little League elbow?

Medial epicondylitis

252

What is Osgood-Schlatter's disease?

Apophysitis of the tibial tubercle resulting from repeated powerful contractions of the quadriceps.
Seen in adolescents with an open physis.