Orthopedics /B
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| Anterior cruciate ligament injury mechanism? | Hyperextension and internal rotation of tibia on femur
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| Anterior cruciate ligament injury tests? | Lachman’s test, Ant Drawer, Pivot Shift
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| Anterior cruciate ligament injury Hx and point of tenderness? | Knee gave away, inability to continue activity; Posterolateral joint line tenderness
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| Medial colateral ligament injury if with knee in slight flextion usually associated with? | Anterior cruciate ligament and menscai injuries
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| Posterior cruciate ligament (PCL) injury mechanism? | Sudden posterior displacement of tibia when knee is flexed or hyper extended dashboard MVA injury
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| PCL history and point of tenderness? | inability to descend stairs; anteromedial joint line tenderness
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| PCL tests? | Posterior sag, posterior drawer
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| Medial and lateral colateral ligament tests? | Valgus and varus stress tests
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| 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
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| Menisci injuries tests? | McMurray’s: Patient supine; figure of 8, Appley’s: Patient prone
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| Barton: | ant portion of distal radius: ORIF
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| Colles: | distal radius + dorsal and ulnar tilt: closed/pin
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| Smith: | distal radius + volar tilt: closed/pin
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| Galeazzi: | dist radius + ulnar head disloc: ORIF
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| Monteggia: | prox ulna + radial head disloc: ORIF
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| Hutchinson fracture : | “Chauffeur’s Fx” intra articular Fx of radial styloid (avulsion of radial collateral ligament
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| Boxer: | head of the 5th (or 4th) MC with ant tilt: angulation up to 40 is OK
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| Bennett: | intra-articular Fx of proximal end of 1st MC
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| Rolando: | a comminuted Bennett ( intra-articular Fx of proximal end of 1st MC )
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| Chance: | seat belt and vertebra Fx in the posterior (failure of posterior and middle columns)
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| Jones: | base of 5th MT, Cast/ORIF
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| Jefferson: | burst Fx of C1 into 4 pieces
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| Hangman's fracture: | an unstable fracture of the C2 pedicles, with forward displacement of C1 and the body of C2 on C3
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| 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
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| Hill-sacks: | Anterior dislocation of shoulder; H humerus (postero-lateral head at junction with neck
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| Bankart: | inferior rim of glenoid in anterior dislocation of shoulder
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| 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)
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| Developmental Dysplasia of Hip; Ortolani: | attempt to relocate hip into acetabulum: Gently abduct the hip while applying upward force
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| Developmental Dysplasia of Hip; Barlow: | attempting to sublux unstable hip: adduct the hip while applying downward force
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| Ankylosing spondylitis tests | Faber’s (cross leg) and Schober’s tests (< 20 cm), chest expansion (<5 cm at T4)
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| 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
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| Ankle drawer test positive in: | injury to the anterior talo-fibular ligament
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| Talar tilt positive in? | injury to the calcaneo-fibular ligament
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| Ankle fracture types and their treatment? | Weber A-C; Weber A fracture of lateral malleolus can be treated like sprains, others need ORIF
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| 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
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| 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
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| 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
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| 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
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| 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)
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| Congenital scoliosis treatment? | <20°: observe for changes; >20°: or progressive: bracing (many types); >40°: cosmetically unacceptable or respiratory problems: surgical correction
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| Open reduction indications? | NO CAST): Non-union, Open Fx, Compromised NV, intra-Articular, Salter-Harris 3,4 and 5, poly-Trauma
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| 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
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| Aneurysmal bone cyst: | Peds: spongy hemorrhagic multi-locular cyst in metaphysis of tibia and femur that expands the bone and erodes the cortex
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| Chondroma: | benign cartilaginous tumor in medullary cavity of phalangeal, metacarpal and metatarsal bones
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| Ewing Sarcoma: | moth eaten area with periosteal reaction and onion skin appearance; neural differentiation; Rx: surgery, chemo and radiotherapy
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| 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
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| women who wear high heeled pointed shoes: | Plantar fasciitis of heel and hallux rigidus of first mp joint and Morton neuroma
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| Bones with distal to proximal circulation (so risk of avascular necrosis on Fx of shaft): | Scaphoid, femoral neck and talus
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| Charcot joint can be seen in: | DM, alcoholic neuropathy, cerebral palsy, leprosy, syphilis (3°, tabes dorsalis), spinal cord injury, intra-articular steroid injection
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| 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
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| Tests for DDH? | Barlow, Ortolani and Galeazzi Signs
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| Fractures involving radius? | Colles, Smith, Hutchinson (Chauffeur’s Fx), Barton, Galeazzi,
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| Knee injury with "snap" or "pop" at time of injury and immediate knee instability and swelling? | ACL or PCL injuries
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| Knee injury with insidious swelling in 24 hours? | Menisci injuries
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