#s

Question 1

2ndry bone healing =

gap fills with __ > ___ (__callus)> __(__ callus = ___)

Answer 1

granulation tissue
cartilage - soft
bone - hard - enchondral ossification

Question 2

fractures that heal by primary bone healing

Answer 2

fixed, hairline

Question 3

lateral displacement of distal part of bone = ___ displacement

Answer 3

valgus

Question 4

if high E/ substantial soft tissue swelling +# = avoid ___

wait until it settles and then ___

Answer 4

avoid ORIF

nail/externally fixate

Question 5

if intra/peri articular # and displaced Rx

Answer 5

reduce and rigid internally fixate

Question 6

if intra/ peri art # at risk of AVN/ non union Rx =

Answer 6

replace

Question 7

Open # Rx -

Answer 7

Abx, tetanus injection, debride

stabilise Sx

Question 8

risks of femoral shaft # = ++_

Rx =

Answer 8

1l blood loss, fat emboli, ARDs
resusc, analgesia (femoral nerve block), Thomas splint
unstable = IM nail

Question 9

distal femur # extra articular Rx =

Answer 9

unstable so Thomas splint

can nail but if too distal = plate

Question 10

intra articular distal femur # Rx =

Answer 10

reduce and internally fixate with plates and screws

Question 11

prox tibial # mechanism of injury

Ix =

Answer 11

valgus stress => lateral tibial plateau # with articular surface disruption
CT

Question 12

Rx of proximal tibial # =

Answer 12

reduce and rigid fixate

elevation of depressed articular and bone fragments

Question 13

tibial shaft fracture complication =

Answer 13

compartment syndrome

Question 14

in tibial shaft # tolerate __+__ but not ___

Answer 14

5 degree angulation and 50% bony contact

internal rotation

Question 15

treatment of tibial shaft #

Answer 15

16wks to union
plaster cast
possibly IM nail, plate or ext fixate

Question 16

intra-articular distal tibial fracture =

ass with ++_

Answer 16

Pilon #

spinal/ pelvis/calcaneal #s

Question 17

Pilon # Rx =

Answer 17

Sx emergency - externally fixate to settly soft tissues => internally fixate after CT

Question 18

Rx for isolated distal fibular/minimally displaced medial malleolus # =

Answer 18

conservative

Question 19

if Bimalleolar/distal fibia # => talar shift Rx =

Answer 19

ORIF

Question 20

Rx for prox. humeral #

Answer 20

elderly = conservative (arthroplasty for head splitting/3-4 part#)
youth w displacement = internally fixate

Question 21

humeral shaft # risks ___ in the ___

Answer 21

radial nerve in spiral groove (usually neurapraxia)

Question 22

humeral shaft # can tolerate substantial ___ without __

Answer 22

angulation

loss of function

Question 23

Rx of humeral shaft #

Answer 23

conservative

internally fix if non-union, pathological #, open #, high E, not tolerating brace

Question 24

Rx of distal humeral # =

Answer 24

usually intra art

may => ORIF

Question 25

nightstick # = | Rx =

Answer 25

isolated ulnar # | conservative

Question 26

if ulna and radial # together =

Answer 26

ORIF

Question 27

Rx for Galeazzi and Monteggia #s

Answer 27

ORIF

Question 28

potential consequences of Colles #

Answer 28

median nerve compression EPL rupture CRPS lose grip strength

Question 29

stable minimally displaced/angulated Colles # Rx =

Answer 29

POP (cast)

Question 30

displaced simple Colles # Rx =

Answer 30

MUA

Question 31

displaced/comminuted Colles # Rx =

Answer 31

MUA and K wire, ORIF

Question 32

Smiths # = mechanism of injury = Rx =

Answer 32

extra articular distal radial #, volarly displaced and angulated fall on back of hand ORIF

Question 33

Barton # = | Rx =

Answer 33

intra-articular dorsal/volar rim of distal radius # => subluxed carpus ORIF

Question 34

comminuted intra-art # of distal radius =

Answer 34

externally fixate +/- K-wires

Question 35

lasts less than 28 days and is temporary localised conduction block/demyelination

Answer 35

neurapraxia / 1st degree nerve injury

Question 36

axonotmesis / 2nd degree nerve injury =

Answer 36

nerve cell axon dies distally = Wallerian degeneration | endoneural tubes intact

Question 37

axonotmesis regenerates ___ per day and get ___ recovery may lead to chronic ___

Answer 37

1mm 8/10 weakness

Question 38

nerve transected = | Rx =

Answer 38

neurotmesis / 3rd degree nerve injury | Sx

Question 39

If have a nerve injury due to a # wait ___ and if no function then __ => ____/___

Answer 39

4wks NCS nerve graft tendon transfer

Question 40

Volkmann's ischaemic contracture is especially ass with ____ but can be caused by any ___ _+_ necrosis => ____ at wrist

Answer 40

supracondylar # upper limb # fdp + fpl necrosis flexion contracture

Question 41

most likely sites of AVN =

Answer 41

head of humerus, head of femur scaphoid talus

Question 42

only ___ of __ bones need xray to confirm union

Answer 42

diaphyseal | long

Question 43

clinical features of hip + prox femur #s

Answer 43

``` shortening external rotation trochanteric bruising no SLR severe groin pain on rotation ```

Question 44

muscles ass with the hip

Answer 44

gluteus medius and minimus adductors pectineus iliopsoas

Question 45

femoral neck blood supply is from __+__ -> ___ arteries

Answer 45

circumflex medial and lateral | retinacular

Question 46

hip capsule = _+_+_+_

Answer 46

iliofemoral, pubofemoral, ischiofemoral ligaments | zona orbicularis

Question 47

diagnostic xray feature of intracapsular prox femur #

Answer 47

break in shenton's line

Question 48

subtrochanteric femur #s are ass with __ | Rx =

Answer 48

long term biphosphonates Analgesia +/- Thomas splint IM nail fixate

Question 49

Rx for pubic rami #

Answer 49

conservative

Question 50

greater trochanter # Rx =

Answer 50

conservative

Question 51

fragility fracture sites

Answer 51

``` NOF neck of humerus wrist vertebrae pelvic ```

Question 52

all hip #s admitted to ___ ward within __hrs of presentation

Answer 52

acute orthopaedic | 4hrs

Question 53

all hip #s who are medically fit should have Sx in ___ from admission in normal working hours

Answer 53

<=48hrs

Question 54

all hip #s should be assessed and cared for in a way to decrease the risk of getting a _____

Answer 54

P ulcer

Question 55

all fragility hip #s should be managed on ___ ward with routine access to ___ support

Answer 55

acute ortho | acute orthogeriatric medical support

Question 56

all fragility hip #s should be assessed to see if need ___

Answer 56

antiresorptive therapy

Question 57

all fragility hip #s after a fall should be assessed ___ to prevent ___

Answer 57

multidisciplinarily | prevent future falls

Question 58

If have clinical suspicion/confirmed hip # before leaving A+E should have big 6 interventions =

Answer 58

``` analgesia (esp for xrays) early warning score pressure area inspection blood tests fluid therapy delirium screening ```

Question 59

P sores can develop in ___ if on a hard surface

Answer 59

30 mins

Question 60

mobilisation within __ of hip Sx

Answer 60

1 day

Question 61

Pelvic injuries ooze blood from ___ and can hold __ of circulating volume Rx of this =

Answer 61

venous plexus 1/2 Sam sling - pelvic binder = tamponade

Question 62

in brain haemmorhage get __+__ on same/ opposite side?

Answer 62

weakness pupil dilatation contralateral side

Question 63

torus fracture = | looks like a __

Answer 63

a buckle # (is seen in paeds) | looks like a never ending ring

Question 64

plastic deformity (specific paed #) =

Answer 64

that cant be manipulated back into place usually due to splint of adjacent bone

Question 65

how to test for reduced sweating (in nerve damage)

Answer 65

can run pen over skin smoothly

Question 66

fingers wrinkling in water only occurs if __

Answer 66

nerves intact

Question 67

movements to assess median, radial and ulnar nerve function

Answer 67

``` median = OK sign radial = hitchhiker thumb ulnar = starfish ```

Question 68

immobilise ___ for diaphyseal #s and ___ for metaphyseal #s

Answer 68

``` dia = joint above and below meta = adjacent joint ```

Question 69

exceptions to conservative management of #s in paeds =

Answer 69

displaced intra articular / growth plate #s | open #s

Question 70

usual Rx for paed #s

Answer 70

plaster traction less invasive fixation