Sutures, Rearfoot, and Trauma Flashcards by Keegan Duelfer

What is a Keith Needle

straight needle

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What are some common needle point configurations (3) and their uses

Taper point- for soft, easily penetrated tissue

Cutting- cutting edge on inner curve

Reverse cutting- cutting edge on outer curve for tough, difficult to penetrate tissue

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What is orthofix

polyglycolic acid

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How long for orthofix to lose strength/absorb

Loses strength in 6-12 weeks

Absorbed in 1-3 years

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What is orthosorb

PDS

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How long before PDS loses its strength/ absorb

Loses strength in 4-6 weeks

Absorbed in 3-6 months

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What are two sutures that are the least reactive to tissue

Stainless steel (least of all)

Prolene

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How is Vicryl broken down

Hydrolysis

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How long does it take to absorb Vicryl (in terms of tensile strength)

Tensile strength:

75% at 2 weeks
50% at 3 weeks
25% at 4 weeks

absorbed completely in 10 weeks

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Should you use Vicryl with an infection

avoid it if possible, since Vicryl is too reactive

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Describe a Keck and Kelly procedure

For Haglund deformity with cavus foot and high calcaneal inclination angle. Remove the wedge from posterior-superior aspect of calcaneus. The posterior superior process is moved anteriorly

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What are treatments for equinus (conservative-2)

Stretching/exercises and night splints

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What are treatments for equinus (2 broad categories- with 10specifics)

Gastroc recession

Strayer
Vulpius
Baker
McGlamary and Fulp

Tendoachilles lengthening

open/closed Z
Hauser
White
Hoke
Sgarlato
Stewart

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What is the Murphy Procedure

Achilles advancement for spastic equinus

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Name transverse surgical procedures for pes planus (3)

Evans
Kidner
C-C distraction arthrodesis

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Name sagittal procedures for pes planus

Cotton
Cobb
Hoke
Young
Lowman
Miller

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Name frontal procedures for pes planus

Koutsogiannis
Dwyer
Chambers
Gleich
Baker-Hill
Lord

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Name surgical procedures for pes cavus (2 broad categories and 7 specifics)

Tendon

Jones
Hibbs
STATT
PT

Bone

dorsiflexory osteotomy of 1st met
Cole
Japas

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What is an arthroereisis

a surgical procedure to limit joint mobility (MBA implant in sinus tarsi)

Typically want 2-4 degrees of STJ eversion with implant

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What is the Valente procedure

STJ blocking using a polyethylene plug with screw threads. Will allow 4-5 degrees of STJ pronation

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What order do you resect and what order to you fixate the joints in a triple arthrodesis

Resection

1) Midtarsal joints (TN&CC)
2) STJ

Fixation

1) STJ
2) Midtarsal joints

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What are some types of fixation for a triple arthrodesis

6.5-7.0mm interfragmental compression screws

Staples
Plates

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What are FDA- approved total ankle implants

Two component devices

Agility
Eclipse
INBONE
Salto Talaris

Three component devices
-STAR

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What should always be asked with a break in the skin

Tetanus status

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Appropriate classification for distal phalangeal/nail

Rosenthal

Appropriate classification for 1st MTPJ

Jahss

Appropriate classification for 5th metatarsal base

Stewart

Appropriate classification for Lisfranc joint (2)

Quenu and Kuss, Hardcastle

Appropriate classification for navicular

Watson Jones

Appropriate classification for Posterior tibial tendon

Conti

Appropriate classification for Talar neck

Hawkins

Appropriate classification for Talar body

Sneppen

Appropriate classification for Talar dome (2)

Berndt-Hardy, Fallot and Wy

Appropriate classification for calcaneus (3)

Rowe, Essex Lopresti and Sanders

Appropriate classification for anterior process calcaneal fractures

Degan

Appropriate classification for ankle sprains (3)

O'Donoghue, Leach, Rasmussen

Appropriate classification for physeal ankle fractures (2)

Dias and Tachdjian

Appropriate classification for epiphyseal fractures

Salter-Harris

Appropriate classification for ankle fracture

Lauge-Hansen and Danis Weber

Appropriate classification for Pilon fracture (2)

Ruedi&Allgower, Dias&Tachdjian

Appropriate classification for Achilles ruptures

Kuwada

Appropriate classification for open fractures

Gustilo anderson

Appropriate classification for non-unions

Weber &Cech

Appropriate classification for Frostbite (2)

Orr and Fainer, Washburn

What is a clinical test for a fracture

point tenderness over fracture site

What is the most table fracture pattern

transverse

What is the weakest region of the physis

one of cartilage maturation

What is the Vassal principle

initial fixation of the primary fracture will assist stabilization of the secondary fractures

What are possible complications of fractures (5)

- Nonunion - delayed union - pseudoarthrodesis - OA - AVN

What is the most common cause of non-healing for a bone fracture

improper immobilization

Are dorsal or plantar lisfranc dislocations more common

dorsal- the plantar ligaments are much stronger than dorsal

What are the Ottowa Ankle Rules

1) A series of ankle X-ray films is required only if there is any pain in the malleolar zone and any of the following findings: - bone tenderness at posterior edge or distal 6cm of lateral malleolus - bone tenderness at posterior edge or distal 6cm of medial malleolus - inability to bear weight both immediately and in the ED A series of foot X-ray films is required only if there is pain in midfoot zone and any of the following findings: -bone tenderness at base of 5th met - bone tenderness at navicular - inability to weight beat both immediately and in ED

What stages of Berndt & Hardy are often associated with lateral ankle ligament ruptures

II, III, and IV

What are the common locations of talar dome lesions and their mechanisms of injury

DIAL A PIMP Anterior lateral portion- dorsiflexion inversion Posterior medial portion- plantarflextion inversion

What is Hawkins sign

Presence of subchondral talar dome osteopenia seen 6-8 weeks after talar fracture signifying intact vascularity. Absence of the sign implies AVN

What is the Sneppen classification

talar body fractures

What % of fractures of the talus involve the calcaneus

60%

What is Mondor sign

plantar, rearfoot ecchymosis that is pathognomonic for calcaneal fractures

How is Bohler angle affected by a calcaneal fracture

decreases with intra-articular calcaneal fracture

How is Gissane angle affected by a calcaneal fracture

increases with intra-articular calcaneal fracture

What fractures are commonly associated with calcaneal fractures (3)

- Vertebral fractures (especially L1) - Femoral neck - Tibial plateau

What is the mechanism of injury for an anterior process fracture

inversion with plantarflexion

What are tests for ankle ligament pathology (5)

- anterior drawer test - calcaneofibular stress inversion - abduction stress - ankle arthrogram - peroneal tenography

What does anterior drawer test

ATF CF PTF

What does the talar tilt test

CFL

What are the clinical symptoms of an Achilles tendon rupture (5)

- Pain with history of pop - Weakness of loss of function - Palpable dell in area of ruptured tendon - Inability to perform single leg rise - Increased ankle dorsiflextion

What is the Thompson test

a positive test result when squeezing of the calf muscle does not plantarflex the foot

What is the Hoffa sign?

increased dorsiflexion compared to the contralateral side along with the inability to perform a single leg rise test

What is a radiographic finding of an Achilles tendon rupture

disruption of Kagers triangle

Where is the most common location for the Achilles tendon to rupture

1.5-4cm proximal to the calcaneal insertion

Name the fracture: | Pott

bimalleolar fracture

Name the fracture: | Cotton

trimalleolar fracture

Name the fracture: | Tillaux-Chaput

avulsion fracture of anterior, lateral tibia from AITFL

Name the fracture: | Wagstaff

avulsion fracture of anterior, medial fibula from AITFL

Name the fracture: Volkman

posterior tibial malleolar fracture from PITFL

Name the fracture: | Cedell

Fracture of posterior medial process

Name the fracture: | Shepard

Fracture of posterior lateral process

Name the fracture: | Foster

entire posterior process

Name the fracture: | Bosworth

lateral malleolar fracture with ankle displacement

Name the fracture: | Maisonneuve

proximal fibular fracture

What is the most common mechanism of injury causing an ankle fracture

SER

What is the MOI causing a transverse lateral malleolar fracture

SADI

What is the MOI causing a short, oblique medial malleolar fracture

SADII

What is the MOI causing a short oblique lateral malleolar fracture

PAB III

What is the MOI causing a spiral lateral malleolar fracture with a posterior spike

SERII

What is the MOI to the ankle with a high fibular fracture? What is this fracture called

PERIII Maisonneuve fracture

When should a posterior malleolar fracture be fixated

ORIF when fragment is greater than 25% of the posterior malleolus

What direction should transsyndesmotic screws be inserted

approximately 30 degress from the sagittal plane from posterior-lateral to anterior medial

What type of screw should be inserted as a transsyndesmotic screw

Fully threaded cortical screws are placed across both cortices of the fibula and the lateral cortex of the tibia. Goal is stabilization rather than compression

What is the Thurston-Holland sign

epiphysis is separated from the physis with the fracture extending into the metaphysis resulting in a triangular fracture fragment

Sutures, Rearfoot, and Trauma Flashcards

(90 cards)