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T&O Flashcards

1
Q

Which sites are most commonly affected by compartment syndrome?

A

Leg
Thigh
Forearm
Foot
Hand
Buttock

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2
Q

Features of compartment syndrome

A

Severe pain - worse on stretching
Paraesthesia
Tense

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3
Q

Diagnostic test for compartment syndrome

A

Intra-compartmental pressure monitor

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4
Q

Management of compartment syndrome

A

Urgent fasciotomy
Monitor for rhabdomyolysis & reperfusion injury

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5
Q

Causes of compartment syndrome

A

High energy trauma
Crush injury
Iatrogenic vascular injury
Tight casts
DVT
Burns

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6
Q

Classification system for clavicle fractures

A

Allman Classification

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7
Q

Type 1 clavicle fracture

A

Fracture of middle 1/3 clavicle
Generally stable

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8
Q

Type II clavicle fracture

A

Lateral 1/3 clavicle
Unstable

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9
Q

Type III clavicle fracture

A

Medial 1/3 clavicle
Rarest
Neurovascular compromise, pneumothorax

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10
Q

Management of clavicle fracture

A

Conservatively with sling
Early shoulder movement encouraged
Surgical ORIF if open

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11
Q

Major complication of clavicle fracture

A

Non-union

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12
Q

Muscles in the rotator cuff

A

Supraspinatous - abduction
Infraspinatous - external rotation
Teres minor - External rotation
Subscapularis - Internal rotation

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13
Q

Cause of rotator cuff injury

A

Degenerative microtears
High force

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14
Q

Risk factors for rotator cuff injury

A

Age
Trauma
Overuse
Repetitive overhead shoulder motions
Obesity
Smoking

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15
Q

Specific tests for rotator cuff injury

A

Jobe’s test - supraspinatous
Gerber’s lift-off test - subscapularis
Posterior cuff test - infraspinatous & teres minor

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16
Q

Investigations in suspected rotator cuff injury

A

Plain film radiograph
Ultrasonography
MRI

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17
Q

Management of rotator cuff injury

A

Analgesia
Physiotherapy
surgical repair in large tears

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18
Q

Complication of rotator cuff injury

A

Adhesive capsulitis

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19
Q

Which nerve is at highest risk in humeral shaft fractures

A

Radial nerve

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20
Q

Signs of radial nerve injury

A

Reduced sensation over dorsal 1st webspace
Weakness of wrist extension

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21
Q

Management of humeral shaft fracture

A

Re-alignment of limb
Functional humeral brace
ORIF
Intramedullary nail if pathological

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22
Q

Pathophysiology of adhesive capsulitis

A

Glenohumeral joint capsule becomes contracted & adherent to humeral head

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23
Q

Causes of secondary adhesive capsulitis

A

Rotator cuff tendinopathy
Subacromial impingement syndrome
Biceps tendinopathy
Previous shoulder surgery
Joint arthropathy

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24
Q

Features of adhesive capsulitis

A

Deep & constant pain
Pain disturbs sleep
Joint stiffness
Deltoid atrophy
Loss of arm swing
Limited external rotation and flexion

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25
Management of adhesive capsulitis
Self limiting over months/years Education Analgesia Glenohumeral joint steroid injections
26
Characteristic MRI finding in adhesive capsulitis
Thickening of the glenohumeral joint capsule
27
Peak age of incidence for supracondylar humeral fracture
5-7 years
28
Most common mechanism of injury in supracondylar fracture
FOOSH
29
Which nerves are at risk in supracondylar fracture
Median nerve Anterior interosseous nerve Radial nerve Ulnar nerve
30
Xray signs for supracondylar fracture
Posterior fat pad sign Displacement of anterior humeral line
31
Classification system for supracondylar fractures
Gartland classification
32
Gartland type 1 fracture
Undisplaced supracondylar fracture
33
Gartland type II fracture
Displaced supracondylar fracture with intact posterior cortex
34
Gartland type III fracture
Supracondylar fracture that is displaced in 2 or 3 planes
35
Gartland type IV fracture
Supracondylar fracture that is displaced with complete periosteal disruption
36
Management of supracondylar fracture with neurovascular compromise
Immediate closed reduction with K wire fixation
37
Management of type 1 supracondylar fracture
Above elbow cast at 90 degrees flexion
38
Management of displaced supracondylar fractures
Closed reduction with percutaneous K wire fixation
39
Complications of supracondylar fracture
Anterior interosseous nerve palsy Ulnar nerve palsy Malunion Volkmann's contracture
40
Which muscle inserts at the olecranon
Triceps muscle
41
Common mechanism of olecranon fracture
FOOSH
42
When would you surgically manage an olecranon fracture
Displacement >2mm
43
What is the most common elbow fracture
Radial head fracture
44
What does the radial head articulate with at the elbow
Capitulum of the humerus Proximal ulna
45
What classification system for radial head fractures
Mason classification
46
Mason type 1 fracture
Non-displaced/minimally displaced fracture of the radial head
47
Mason type 2 fracture
Partial articular fracture of the radial head with displacement >2mm
48
Mason type 3 fracture
Comminuted fracture of the radial head with displacement
49
Management of radial head fracture
Type 1 - Sling <1 week with early mobilisation Type 2&3 - ORIF
50
Types of distal radius fractures
Colles' Smith's Barton's
51
What is the most common type of wrist fracture
Colles'
52
Colles' fracture
Extra articular fracture of distal radius with dorsal angulation and displacement. Forward fall with forced wrist supination
53
Smith's fracture
Extra articular fracture of distal radius with volar angulation and displacement Backward fall with forced wrist pronation
54
Barton's fracture
Intra articular fracture of distal radius with dislocation of radiocarpal joint
55
Risk factors for distal radius fractures
Increasing age Female gender Early menopause Smoking Alcohol excess Prolonged steroid use
56
Assessing median nerve
Abduction of the thumb Sensation of radial surface of distal 2nd digit
57
Assessing ulnar nerve
Adduction of the thumb Sensation of ulnar surface of distal 5th digit
58
Assessing radial nerve
Extension of IPJ of thumb Sensation of dorsal 1st webspace
59
Management of distal radius fracture
Closed reduction Below elbow backslab cast ORIF if unstable
60
Complications of distal radius fracture
Malunion Median nerve compression Osteoarthritis

Surgery (4 decks)

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