Flashcards in SAQ 2 Deck (48):
List 5 risk factors for failure of bracing in AIS
Suboptimal correction in-brace
Hypokyphotic thoracic curve
List 5 radiographic findings of femoral head AVN in DDH
Delayed development of ossific nucleus
Fragmentation of ossific nucleus
Lateral physeal irregularity
Varus neck with GT overgrowth
List 5 radiographic findings in pediatric rheumatoid spine
Apophyseal fusion (C2-3 usually)
Dens waist erosion (apple core deformity)
Hypoplastic vertebral bodies
Loss of cervical lordosis
List 6 risk factors for PJK
Fusion to sacrum (more rigidity but also worse curve)
Pedicle screws at all levels (increased rigidity)
>5 degree kyphosis at UIV preoperatively
High preoperative pelvic incidence (saggital imbalance)
What are the transfers for a wrist drop?
PL to EPL
FCR to EDC
Pronator teres to ECRB
List the two transfers indicated in a high median nerve palsy
BR to FPL
D4/5 FDP side-to-side transfer to D2/3 FDP
List 5 criteria for selective thoracic fusion in AIS
Lenke C modifier
Thoracic prominence > lumbar on Adams FBT
Absence of hyperlaxity
What is congenital radioulnar synostosis associated with?
What is syndactyly associated with?
List 5 methods of assessing for patella alta and indicate normal values for each
1. Caton-Deschamps (0.6-1.3)
2. Insall-Salvati (0.8-1.2)
3. Blackburne-Peel (0.5-1)
4. Plateau-patella angle (normal 20 degrees)
5. Blumenstaat's line should touch the inferior patellar pole at 30 degrees of knee flexion
List 5 poor prognostic factors in pilon fractures
Lower education level
When is a valgus osteotomy indicated in coxa vara?
Hilgenreiner epiphyseal angle >60 degrees and neck-shaft angle <110
List 4 risk factors for Blount's
What are the diagnostic criteria for NF1?
6 or more cafe-au-lait spots
2 or more neurofibromas/1 plexiform neurofibroma
2 or more Lisch nodules
characteristic bony abnormality
family history in 1st degree relative
What are the features of Klippel-Feil syndrome?
Multiple cervical levels of failure of segmentation
What's the best predictor of progression of spondylolisthesis?
Slip angle >45
What are the 2 most common comorbid findings in patients with myelodysplasia?
Chiari II malformation
Severe latex allergy
What conditions arise from abnormalities in COMP?
Ehlers-Danlos is a disorder of which collagen type?
Which factor is deficient in Hemophilia A? B?
A: F VIII
B: F IX
List 5 features of DISH that differentiate it from ankylosing spondylitis
Disc spaces preserved
Nonmarginal syndesmophytes at 4 successive vertebrae
Strongly-associated with diabetes and gout
List 5 changes that occur in the intervertebral disks with aging
Decreased water content
Increase degradative enzyme activity
Are MEPs or SEPs affected by inhalational anesthetics?
What are Waddell's 5 signs of non-organic back pain?
Overreaction to physical exam
SLR negative when patient distracted
Pain with axial compression
What's Ranawat's C1-2 index?
Perpendicular distance from the center of the C2 pedicle to a line connecting the anterior and posterior arches of C1. <13-mm is indicative of basilar invagination.
What's the rate of depression after acute orthopaedic trauma? What about PTSD?
Compared to delayed closure, what are the advantages of early primary closure?
What's the rate of articular malreductions in tibial plateau fractures? Where is the malreduction usually? What's a risk factor?
Fluoroscopic-assisted reduction alone (submeniscal arthrotomy-assisted reduction had much fewer)
What did the RCT comparing standard reaming vs. RIA-reaming in antegrade femoral shaft nailing show?
Fewer total emboli in RIA-reaming group, but this did not correlate with improvement in physiologic parameters
What's the trajectory of functional recovery following tibial shaft fracture and IMN?
Initial decline until 6 months
Improvement from 6-12 months
*At 5 years, patients are NOT back at their pre-injury baseline
What's the most significant risk factor for hardware removal after ankle fracture surgery?
What did the HULC study looking at functional outcomes following radial head arthroplasty for irreconstructable fractures, specifically comparing patients with simple and complex fracture-dislocations show?
No difference between the two groups (ie: concomitant injuries don't affect outcomes)
What did the RCT comparing IMN vs. DHS for unstable intertrochanteric hip fractures in geriatric patients show?
No difference overall, but trend towards significant improvement for physiologically younger and active patients treated with IMN
What did the RCT comparing LISS-plating vs. DCS for distal femoral fractures show?
Same time to union
Same functional outcomes
More complications in the LISS group
Are NSAIDs safe after acute fracture surgery?
For primary bone healing, yes.
For secondary bone healing, only during the 1st week.
1. What's the most common nerve injury after acetabular fracture surgery?
2. What fracture patterns are most associated with neurologic injury (3)?
3. What % of iatrogenic nerve injuries recover?
1. L5 nerve root contained in the sciatic nerve
2. transverse-posterior wall, posterior wall, ABC
3. Only 45% recover
List 5 risk factors for reoperation following ORIF of a tibial plateau fracture
associated tibial shaft
surgery performed at night/weekend
surgery performed at a non-academic centre
What are the 2 risk factors for hardware removal after clavicle ORIF?
plate not pre-contoured
height <175 cm
What are the 5 risk factors for revision surgery for major complication (infection, non-union, hardware failure) after clavicle ORIF?
previous shoulder surgery
*2 predictors = 90% risk
List 5 predictors of poor outcome after limb salvage/amputation
What did the FAITH study (DHS vs. cannulated screws for patients >50 with low-energy hip fracture) show?
No difference in outcomes/reoperations
AVN more common in DHS group
List 5 poor prognostic factors following tibial IMN
stainless steel nail
open fracture (only if treated with reamed IMN)
What were the findings of the FLOW study?
no differences between high, medium and low pressure
saline > soap
List 5 factors that differentiates juvenile hallux valgus from adult
metatarsus primus varus
associated with flatfoot
Which 5 factors automatically convert an open fracture to a Gustillo III?
exposure to water
exposure to soil
exposure to fecal material
delay >12 hrs
List 5 risk factors for distal humerus fractures in the elderly
Rank cobalt, chromium, titanium and nickel in order of delayed hypersensitivity reaction-association
(Titanium is inert)