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Orthopedics /B

Anterior cruciate ligament injury mechanism? Hyperextension and internal rotation of tibia on femur
Anterior cruciate ligament injury tests? Lachman’s test, Ant Drawer, Pivot Shift
Anterior cruciate ligament injury Hx and point of tenderness? Knee gave away, inability to continue activity; Posterolateral joint line tenderness
Medial colateral ligament injury if with knee in slight flextion usually associated with? Anterior cruciate ligament and menscai injuries
Posterior cruciate ligament (PCL) injury mechanism? Sudden posterior displacement of tibia when knee is flexed or hyper extended dashboard MVA injury
PCL history and point of tenderness? inability to descend stairs; anteromedial joint line tenderness
PCL tests? Posterior sag, posterior drawer
Medial and lateral colateral ligament tests? Valgus and varus stress tests
Menisci injuries mechanism and presentation? Meniscus injury often results in a "locked-up" knee and is usually due to traumas that have a twisting component
Menisci injuries tests? McMurray’s: Patient supine; figure of 8, Appley’s: Patient prone
Barton: ant portion of distal radius: ORIF
Colles: distal radius + dorsal and ulnar tilt: closed/pin
Smith: distal radius + volar tilt: closed/pin
Galeazzi: dist radius + ulnar head disloc: ORIF
Monteggia: prox ulna + radial head disloc: ORIF
Hutchinson fracture : “Chauffeur’s Fx” intra articular Fx of radial styloid (avulsion of radial collateral ligament
Boxer: head of the 5th (or 4th) MC with ant tilt: angulation up to 40 is OK
Bennett: intra-articular Fx of proximal end of 1st MC
Rolando: a comminuted Bennett ( intra-articular Fx of proximal end of 1st MC )
Chance: seat belt and vertebra Fx in the posterior (failure of posterior and middle columns)
Jones: base of 5th MT, Cast/ORIF
Jefferson: burst Fx of C1 into 4 pieces
Hangman's fracture: an unstable fracture of the C2 pedicles, with forward displacement of C1 and the body of C2 on C3
Clay Shoveler’s Fracture: Avulsion fracture of spinous process of C6 or C7, occurs as a result of rotation of trunk relative to neck; stable with no neurologic deficit
Hill-sacks: Anterior dislocation of shoulder; H humerus (postero-lateral head at junction with neck
Bankart: inferior rim of glenoid in anterior dislocation of shoulder
Developmental Dysplasia of Hip; Galeazzi Sign: Observe for inequality of knee height when hips and knees flexed with feet flat on examining table (False negative if bilateral: 20% of cases)
Developmental Dysplasia of Hip; Ortolani: attempt to relocate hip into acetabulum: Gently abduct the hip while applying upward force
Developmental Dysplasia of Hip; Barlow: attempting to sublux unstable hip: adduct the hip while applying downward force
Ankylosing spondylitis tests Faber’s (cross leg) and Schober’s tests (< 20 cm), chest expansion (<5 cm at T4)
Management of ankle sprain PRICE: Protection of the joint with splint or immobilizing boot (always); Rest; Ice application; Compression with elastic and Elevation; o Rehabilitation in 48 to 72 hours and not more
Ankle drawer test positive in: injury to the anterior talo-fibular ligament
Talar tilt positive in? injury to the calcaneo-fibular ligament
Ankle fracture types and their treatment? Weber A-C; Weber A fracture of lateral malleolus can be treated like sprains, others need ORIF
Slipped Capital Femoral Epiphysis (SCFE) features and its test: a chubby, 12- 14 y/o boy with hip pain and inability to internally rotate the hip;  Whitman's sign: with flexion there is an obligate external rotation of the hip
Developmental Dysplasia of the Hip features? Painless, positive FHx, uneven gluteal folds, hip easily dislocated posteriorly and returned with a click and snapping, more in girls
Legg-Calve-Perthes dis self-limited AVN of femoral head, presents at 4-10 years of age (younger age compared to slipped capital femoral epiphysis); o child with hip pain and limp, tender over anterior thigh; flexion contracture: decreased internal rotation, abduction of hip
Osgood-Schlatter dis Ant knee pain due to stress reaction of the insertion of patella tendon into the tibia tubercle in young teenagers active in sports; tender lump over tibial tuberosity
Congenital Club Foot 50% bilateral, occurrence M>F, severity F>M; examine hips for associated DDH; examine knees for deformity; examine back for unfused vertebral bodies)
Congenital scoliosis treatment? <20°: observe for changes; >20°: or progressive: bracing (many types); >40°: cosmetically unacceptable or respiratory problems: surgical correction
Open reduction indications? NO CAST): Non-union, Open Fx, Compromised NV, intra-Articular, Salter-Harris 3,4 and 5, poly-Trauma
Osteoid osteoma: Peds: nocturnal unilateral bone pains that relieves promptly by aspirin; X-Ray: radiolucent nidus surrounded by a wide rim of osteosclerosis at metaphyseal cortex of long bones especially femur and tibia. Surgical removal
Aneurysmal bone cyst: Peds: spongy hemorrhagic multi-locular cyst in metaphysis of tibia and femur that expands the bone and erodes the cortex
Chondroma: benign cartilaginous tumor in medullary cavity of phalangeal, metacarpal and metatarsal bones
Ewing Sarcoma: moth eaten area with periosteal reaction and onion skin appearance; neural differentiation; Rx: surgery, chemo and radiotherapy
Osteosarcoma: most common 1° malignant tumor of bone in ages 10-20; intense pain, swelling, pathological fractures; X-Ray: destruction of cortical pain with periosteal reaction (Codman triangle); high association with retinoblastoma; Rx: surgery and chemo
women who wear high heeled pointed shoes: Plantar fasciitis of heel and hallux rigidus of first mp joint and Morton neuroma
Bones with distal to proximal circulation (so risk of avascular necrosis on Fx of shaft): Scaphoid, femoral neck and talus
Charcot joint can be seen in: DM, alcoholic neuropathy, cerebral palsy, leprosy, syphilis (3°, tabes dorsalis), spinal cord injury, intra-articular steroid injection
DDx of DDH and specific features: Avascular necrosis: around 6 y/o with pain and limping; Septic arthritis: toddler refuse to move leg and let anyone touch it; Slipped capital femoral epiphysis: Early teens who limp and cannot rotate tigh internally
Tests for DDH? Barlow, Ortolani and Galeazzi Signs
Fractures involving radius? Colles, Smith, Hutchinson (Chauffeur’s Fx), Barton, Galeazzi,
Knee injury with "snap" or "pop" at time of injury and immediate knee instability and swelling? ACL or PCL injuries
Knee injury with insidious swelling in 24 hours? Menisci injuries
Created by: Bijan39