Flashcards in Pot Pourri Deck (69)
What are the 4 AO principles of internal fixation?
1. anatomic reduction
2. stable internal fixation
3. preservation of blood supply
4. early, active, pain-free ROM
Where does the blood supply to the bone cone from?
periosteum- supplies outer 1/3 of cortical bone
endosteal or medullary vessels (nutrient artery)- supply inner 2/3 of cortical bone
which type of healing heals with callus formation?
secondary healing (or indirect healing)
what is primary (or direct) healing?
bypasses callus formation; occurs with absolute stability ; utilizes cutting cones
what are the differences in bone healing between cortical and cancellous bone?
cortical- undergoes secondary healing (w/ callus formation)
cancellous- no significant callus formation due to tremendous angiogenic potential of trabecular bone
What is AO technique- lag screw by technique?
overdrill, underdrill, countersink, measure
Which step of AO technique does lag screw by design take out?
Where is the apex of deformity in metatarsus adductus?
Lisfranc's joint (tarsometatarsal joint)
Describe the levels of deformity in the skewfoot.
transverse plane adduction
frontal plane inversion
What are the stages of Eichenholtz for charcot neuroarthropthy?
stage 0- at risk for Charcot (e.g. neuropathic diabetic w/ acute sprain or fx)
stage 1- development/fragmentation (red, hot swollen foot; xray shows multiple fractures and subluxation)
stage 2- coalescence (absorption of fine debris; sclerosis of bone ends)
stage 3- reconstruction/consolidation (remodeling of bone)
Describe the stages of Brodsky classification.
Type 1 (most common)- Lisfranc's (tarsometatarsal) joint
Type 2- Chopart's/ STJ
Type 3a- ankle
Type 3b- calcaneus
Type 4- multiple regions
Type 5- forefoot
What are the 3 currently FDA approved meds for treating diabetic foot infection?
1. Zyvox (LInezolid)
2. Zosyn (Piperacillin/tazobactam)
3. Invanz (Ertapenem)
Give a verbal description of the types of Achilles rupture repairs.
Kessel- a box
What is Burrow's triangle?
a wedge of skin and subcutaneous fat excised, usually at the end of a closed wound and created by flap transfer or advancement, so that a smooth repair can be obtained.
What is Virchow's triad?
2. endothelial damage
(all are factors predisposing to a thrombus)
trade name for bupivicaine?
Exparel , Marcaine, Sensoricarine
What is Exparel?
is basically a fat-soluble type of lidocaine (liposome injectable suspension)
How are amides cleared? esters?
amides- cleared by the liver
esters- in the blood by cholinesterases
what is the correct order of correction for clubfoot using the Ponsetti casting method?
what are the main causes of graft failure?
*BONUS- how would you prevent these from happening?
fenestration- prevents hematoma/seroma
bolster dressing- helps with graft adhesion and prevents shearing forces
What angles are used to evaluate a Calc fracture? how do they change in a calcaneal fracture?
Bohler's angle (normal 25-40)- decreases w/ a calc fx
Critical angle of gissane (normal- 120-145)- increases w/ a calc fx
What is the max. dose of lidocaine? (w/ epi and w/o)?
w/o epi: 4.5mg/kg or up to 300mg
w/ epi: 7mg/kg or up to 500mg
What is the max. dose of marcaine? (w/ epi and w/o)?
w/o epi: 2.5mg/kg or up to 175 mg
w/ epi: 3.2mg/ kg or up to 225mg
What is a pantalar fusion?
fusion of the tibiotalar, subtalar, talonavicular and calcaneocuboid joints
What is a tibiotalar fusion called?
What is the ankle fusion technique that is indicated in a child to preserve the potential for growth of the distal tibia and fibular physis?
What is the double calcaneal osteotomy?
Evans with a medial calcaneal slide
(indicated for a RF valgus and FF abudction)
What is the order in which the effects of local anesthetics are felt?
1. loss of pain and temp sensation
2. loss of proprioception
3. loss of touch and pressure sensation
4. motor paralysis
What properties are provided by a bone graft?