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Flashcards in SAQ 2 Deck (48):
1

List 5 risk factors for failure of bracing in AIS

Male
Suboptimal correction in-brace
Non-compliance
Obesity
Hypokyphotic thoracic curve

2

List 5 radiographic findings of femoral head AVN in DDH

Delayed development of ossific nucleus
Fragmentation of ossific nucleus
Lateral physeal irregularity
Metaphyseal widening
Varus neck with GT overgrowth

3

List 5 radiographic findings in pediatric rheumatoid spine

Apophyseal fusion (C2-3 usually)
Dens waist erosion (apple core deformity)
Atlantoaxial instability
Hypoplastic vertebral bodies
Loss of cervical lordosis

4

List 6 risk factors for PJK

Combined approached
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)
Osteopenia

5

What are the transfers for a wrist drop?

PL to EPL
FCR to EDC
Pronator teres to ECRB

6

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

7

List 5 criteria for selective thoracic fusion in AIS

Lenke C modifier
Thoracic prominence > lumbar on Adams FBT
Lifestyle factors
Skeletally mature
Absence of hyperlaxity

8

What is congenital radioulnar synostosis associated with?

MACKA
Mandibulfacial dysostosis
Apert syndrome
Carpenter's syndrome
Klinefelter's syndrome
Arthrogryposis

9

What is syndactyly associated with?

PACA
Poland syndrome
Apert syndrome
Carpenter's syndrome
Acrosyndactyly

10

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

11

List 5 poor prognostic factors in pilon fractures

Male
Multiple comorbidities
Lower SES
Lower education level
WSIB

12

When is a valgus osteotomy indicated in coxa vara?

Hilgenreiner epiphyseal angle >60 degrees and neck-shaft angle <110

13

List 4 risk factors for Blount's

Early walkers
Overweight
African American
Hispanic

14

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
optic glioma
axillary/inguinal freckling
characteristic bony abnormality
family history in 1st degree relative

15

What are the features of Klippel-Feil syndrome?

Multiple cervical levels of failure of segmentation
Cervical stenosis
Sprengel's deformity
Scoliosis
VACTERL

16

What's the best predictor of progression of spondylolisthesis?

Slip angle >45

17

What are the 2 most common comorbid findings in patients with myelodysplasia?

Chiari II malformation
Severe latex allergy

18

What conditions arise from abnormalities in COMP?

Pseudoachondroplasia
MED

19

Ehlers-Danlos is a disorder of which collagen type?

V

20

Which factor is deficient in Hemophilia A? B?

A: F VIII
B: F IX

21

List 5 features of DISH that differentiate it from ankylosing spondylitis

HLA-B27 negative
No sacroiliitis
Disc spaces preserved
Nonmarginal syndesmophytes at 4 successive vertebrae
Strongly-associated with diabetes and gout

22

List 5 changes that occur in the intervertebral disks with aging

Decreased proteoglycans
Decreased water content
Decreased pH
Increased fibrocartilage
Increase degradative enzyme activity

23

Are MEPs or SEPs affected by inhalational anesthetics?

MEPs

24

What are Waddell's 5 signs of non-organic back pain?

Overreaction to physical exam
SLR negative when patient distracted
Non-dermatomal pattern
Superficial tenderness
Pain with axial compression

25

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.

26

What's the rate of depression after acute orthopaedic trauma? What about PTSD?

MDD: 1/3
PTSD: 1/4

27

Compared to delayed closure, what are the advantages of early primary closure?

Fewer infections
Fewer non-unions

28

What's the rate of articular malreductions in tibial plateau fractures? Where is the malreduction usually? What's a risk factor?

32%
Posterolateral
Fluoroscopic-assisted reduction alone (submeniscal arthrotomy-assisted reduction had much fewer)

29

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

30

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

31

What's the most significant risk factor for hardware removal after ankle fracture surgery?

Female

32

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)

33

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

34

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

35

Are NSAIDs safe after acute fracture surgery?

For primary bone healing, yes.
For secondary bone healing, only during the 1st week.

36

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

37

List 5 risk factors for reoperation following ORIF of a tibial plateau fracture

open fracture
bicondylar
associated tibial shaft
surgery performed at night/weekend
surgery performed at a non-academic centre

38

What are the 2 risk factors for hardware removal after clavicle ORIF?

plate not pre-contoured
height <175 cm

39

What are the 5 risk factors for revision surgery for major complication (infection, non-union, hardware failure) after clavicle ORIF?

age >55
diabetes
ETOH
drug use
previous shoulder surgery

*2 predictors = 90% risk

40

List 5 predictors of poor outcome after limb salvage/amputation

nonwhite race
low SES
low self-efficacy
smoker
WSIB

41

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

42

List 5 poor prognostic factors following tibial IMN

high-energy mechanism
stainless steel nail
fracture gap
immediate WBAT
open fracture (only if treated with reamed IMN)

43

What were the findings of the FLOW study?

no differences between high, medium and low pressure
saline > soap

44

List 5 factors that differentiates juvenile hallux valgus from adult

bilateral
metatarsus primus varus
increased IMA
increased DMAA
associated with flatfoot

45

Which 5 factors automatically convert an open fracture to a Gustillo III?

exposure to water
exposure to soil
exposure to fecal material
bite wounds
delay >12 hrs

46

List 5 risk factors for distal humerus fractures in the elderly

Female
Active
Independent living
Polypharmacy
ETOH

47

Rank cobalt, chromium, titanium and nickel in order of delayed hypersensitivity reaction-association

Nickel
Cobalt
Chromium
(Titanium is inert)

48

List 5 risk factors for metal hypersensitivity

female
smoker
family Hx
ear piercings
hand eczema