Orthopedics Flashcards
(46 cards)
Give 3 early complications of a fracture?
DVT/PE
Compartment syndrome
Infection
Neurovascular damage
What is compartment syndrome?
This results from swelling of a muscle or bleeding within its compartment. The inability of the compartment to expand means that vessels are liable to be occluded and nerves impinged.
Can lead to Volkmanns ischaemic contracture
How do you manage compartment syndrome?
Fasciotomy of the compartments involved
Give 5 late complications of fractures?
Mal-union, Nonunion & Delayed union Infection Growth disturbance Avascular necrosis Myositis ossificans
In a neck of femur fracture, how might the leg look?
Shortened and externally rotated
What sign on examination would you expect on posterior dislocation of the femur?
Shortened and internally rotated
In an intracapsular fracture of the head of the femur, which vessel is in danger and where does it arise?
Medial circumflex artery from the femoral artery
What are the treatment options for a NoF fracture? 3 things
Non displaced = Cannulated screw or Dynamic hip screw
Displaced intracapsular =
Hemiarthroplasty (old, less fit, comorbidities) or THR (mobile, medically fit)
Extracapsular = Intra medullary device or DHS or Arthroplasty
Suggest 4 functions of the meniscus and how would you test integrity
Buffer between joint
Shock absorption
Lubrication
Limits flexion and extension
McMurrays test
In knee ligament tears, what investigations might you consider?
MRI
Arthroscopy
In a knee ligament tear/damage, what is the basic treatment and what advice would you give? 6 things
RICE Knee immobiliser Ice NSAIDs Don't fully weight bear Advice about high intensity activities
Give 2 early and 2 late symptoms of an ACL tear?
Early-Pain and swelling
Late-Arthritis and joint instability
What causes an ACL tear?
Hyper extension and inversion of the knee
In ACL damage, name 3 examinations that might show an abnormality?
Anterior draw test
Lachmans test
Pivot shift test
What is the surgical option for an ACL tear?
ACL reconstruction using graft
Give 3 possible complications of Arthroscopy?
DVT Infection Excessive bleeding Damage to cartilage Paraesthesia over knee
Which 2 types of fractures only occur in children?
Green stick fracture
Salter Harris epiphyseal fractures
Give 4 aspects of the management of a fracture?
Resuscitation - A to E assessment & Skeletal survey for other fractures
Reduction - closed, traction or open
Restriction - maintenance of reduction (slings, plaster, external/internal fixing, functional bracing, continuous traction)
Rehabilation - Mobilise with Physio ASAP
In a child, give 3 features that might suggest non accidental injury?
Fractures in immobile kids Inconsistent story Delayed presentation Repeated injuries Withdrawn child Kid appears scared of guardian
How do you test for painful arc syndrome?
Hawkins test
In painful arc syndrome, where will the patient feel pain during your examination?
70-120 degrees during active abduction
Which classification can you use for an open fracture?
Gustillo-Anderson Classification
What is the Abx therapy in an open fracture?
Co-Amoxiclav and Metronidazole
Name 3 complications of a shoulder dislocation?
Neurovascular damage
Bankart Lesion (glenoid labrum avulsion)
Recurrence (100-age=%)
