Term
| Interpretation of WBC count in joint fluid |
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Definition
<200 w/ <25% PMN: NL
<400 w/ <25% PMN - non inflam, traumatic arthritis, osteoarthritis
4000-5000 w > 50% PMN: inflam, RA, gout, pseudogout
>10,000 w/ >75% PMN: infectous |
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Term
| MC pelvic fracture mechanism |
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Definition
Peds: Auto-pedestrian
Adults: MVC
Falls
Crush injuries |
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Term
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Definition
< 15 y/o
Supracondular extension fx: MC fall outstretched arm w/extended elbow; distal hymeral fx displaced post
Supracondylar flexion fx: direct blow post on flexed elbow |
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Term
| Ottawa ankle rules for X-rays |
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Definition
Ankle s-rays onlye if bone pain neal melleoli + one of the following:
1. Inability to bear weight immed. after injury or in ED (4 steps)
2. bone tenderness at post edge on tip of either malleolus |
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Term
| Ottawa rules for foot x-rays |
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Definition
Foot x-rays only if pain in midfoot, and:
1. no bear weight
2. bone tenderness over the navicular or base of 5th metatarsal bone
[image] |
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Term
| MC assoc. injury w/ humeral shaft fx |
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Definition
Radial nerve damage -> wrist drop
Brachial artery injury |
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Term
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Definition
Neer: Amount of displacement
-Anatomical neck
-Surgical neck
-Greater tuberosity
-Lesser tuberosity
1 Part - 0 displacement
2 part - displ of 1 fragment
3 part - displ of 2 fragments
4 part - displ of all 4 segments |
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Term
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Definition
MC mid-foot fx
Tarsometatarsal fx
2nd metatarsal base w/ separation b/w base of the1st & 2nd metatartsal |
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Term
| Complication scaphoid/navicular fx |
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Definition
Avascular necrosis (the more proximal the fx, the greater the risk)
Malunion
Delayed union
Non-union |
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Term
| Anterior hip dislocation complications |
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Definition
Early fem. AV N injury
Late fem AV thrombosis
PE
Avascular necrosis
Osteoarthritis |
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Term
|
Definition
Avascular necrosis of lunate 2ry to improper immobilization of fx
Avascular necrosis of proximal segment |
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Term
| Life threatening cause of shoulder pain |
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Definition
| Sternoclavicular joint dislocaton |
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Term
| MC injured component of rotator cuff |
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Definition
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Term
|
Definition
GRe: Galeazzi
-Radial fx distal w/radioulnal dislocation
- Mech direct blow to back of wrist or fall on outstretched hand
MV: Monteggia
-Prox ulnar fx w/radial head dislocation
-Mech direct blow to post ulna or fall w/forecful pronation |
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Term
|
Definition
Posterior
-Assoc. injuries: fx above elbow, brachial artery injury, ulnar n. & median n. injury |
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Term
| 1ry dynamic knee stabilizer |
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Definition
| Quadriceps tendons, rectus femoris, vastus lat, interm, med. |
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Term
| Volkmann's Ischemic Contracture |
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Definition
AKA: compartment syndrome
Pain out of proportion w/phys exam & that incr. w/passive stretching
Paralysis
Paresthesia
Pallor
Pulselessness
Normal pressure 10 mmHg, if >30-> fasciotomy |
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Term
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Definition
| Chondromalacia patella (patellofemoral pain syndrome/patellar malalignment syndrome) |
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Term
| Presentation Chondromalacia patella/Patellofemoral pain syndrome/patellar malalignment syndrome |
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Definition
| •Young adult, F>M •Intermittent peripatellar pain ↑ w/sitting & climbing steps, ↑Q angle |
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Term
| Physical findings Chondromalacia patella/Patellofemoral pain syndrome/patellar malalignment syndrome |
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Definition
| (+) patellar compression test & pain with knee extension agianst resistance. (+) palpable crepitance |
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Term
| Tx Chondromalacia patella/Patellofemoral pain syndrome/patellar malalignment syndrome |
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Definition
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Term
| Complications of Anterior shoulder dislocation |
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Definition
•MC-Recurrence (↓age=↑recurr) •Hill sachs •Brachial plexus injury: MC Axillary - sensory area over deltoid mm)
[image] |
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Term
|
Definition
Compression fx of posterolateral astpect of humeral head (50%), usally 2ry to anterior dislocation of glenohumeral unit
[image] |
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Term
| Assoc. injuries w/Knee dislocation |
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Definition
| •Complete disruption of all ligaments •Popliteal artery injury (30-40%), especially w/ant. dislocation •Peroneal N. injury (35-35%) w/ medial, posterolateral dislocation •Prox tibial fx |
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Term
| Pelvic fx assoc. injuries |
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Definition
| • MC - Urethral tear • Hemorrhage-MCCof death! • Bladder injury • Vaginal laceration (anterior fx) • Nerve damage (post fx) • Ruptured diaphragm • Rectal injury |
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Term
| Post knee dislocation could damage? |
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Definition
| Popliteal artery damage. Do an arteriogram |
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Term
|
Definition
Medial epicondyle fx from repeated valgus stress assoc w/ulnar nerve damage (60%)
[image] |
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Term
| Gamekeeper's thumb (skier's) |
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Definition
Torn ulnar collateral ligament by acute forcefull deviation of thumb assoc / skiin accidents •Pain ↑MCP •Unstable >20° laxity compared to other hand
[image]
[image] |
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Term
| Metacarpal fx accepted angulation |
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Definition
•Boxers fx: 20-30°
• Index, 3rdm 4th: <15° |
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Term
| Kanavels 4 signs of flexor tenosynovitis |
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Definition
| 1. Finger slight flexion 2. Symm (fusiform) finger swelling 3. Tender flexor tendon sheath 4. Pain passive extension of finger |
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Term
|
Definition
| Surgical drainage + abx IV |
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Term
| Bennett's fx vs. Rolando fx |
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Definition
| •Bennett's: Base of thumb metacarpal joint - Tx: OR •Rolando: comminted intra-articular - Tx: ORIF |
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Term
|
Definition
Perilunate, often assoc. w/scaphoid fracture
[image] |
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Term
|
Definition
| Anterior (95-97%) & subcoracoid ✓Mech: abd/external rotation |
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Term
|
Definition
| Superficial hematoma above the inguinal lig = pelvic fx |
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Term
|
Definition
| Colle's fx: dorsal displ of distal radium |
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Term
| Complications of Colle's fx |
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Definition
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Term
| Anterior leg compartment syndrome is MC due to |
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Definition
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Term
| Si/Sx Anterior leg compartment syndrome |
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Definition
| Pain, pallor, paresthesia, paralysis , pulselessness |
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Term
| Si/Sx Anterior leg compartment syndrome |
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Definition
| Pain, pallor, paresthesia, paralysis , pulselessness |
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Term
|
Definition
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Term
| Types of hip dislocations |
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Definition
| Anterior (10%) - external rotation •Posterior (90%) - internal rot, flexed, add, shortened |
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Term
| Complications of hip dislocation |
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Definition
| Sciatic nerve, Avascular necrosis femoral head |
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Term
| De Quervain's tenosynovitis |
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Definition
Inflammation of Dorsal radial compartment of wrist
[image] |
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Term
| Tx De Quervain's tenosynovitis |
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Definition
|
|
Term
| Dx De Quervain's tenosynovitis |
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Definition
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Term
|
Definition
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|
Term
| Dx, Tx & complication of Scaphoid fx |
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Definition
| Dx: snuff box tenderness •Tx: thumbs spica •Compli: AVN |
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Term
|
Definition
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Term
| Second most common carpal bone to be fractured |
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Definition
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Term
|
Definition
| Mallet, swan, boutonniere |
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Term
|
Definition
| Ext tendon injury DIP, unable to extend D phalanx •Tx: splint in ext x 6 wks |
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Term
|
Definition
| •Deformity PIP flexion & DIP extension •Rupture of central slip of ext tendon PIP •Tx: splint PIP in extension |
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Term
|
Definition
| Hyperextension of PIP + mallet finger |
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Term
| Valgus knee stress test for |
|
Definition
At 30° - medial collateral. In extension, med collateral + cruciate lig & post capsule
[image] |
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Term
|
Definition
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|
Term
| Knee dislocation classification |
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Definition
| According to the direction of tibial displacement, relative to the femur: ant & post (50-60%), medial, latral, rotary |
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Term
| Mechanism proximal humerous fx |
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Definition
| 1.MC- Fall out-strerched arm 2. Direct blow •Usually elderly |
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Term
|
Definition
| Fractures affecting the growth plate of a bone. Once bone growth has completed, the term "Salter-Harris Fracture" no longer applies. |
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Term
| Types of Salter Harris Fracture |
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Definition
I - S = Slipped. Slipped growth plate.
II - A = Above. The fracture lies above the growth plate.
III - L = Lower. The fracture is lower than (below) the growth plate.
IV - T = Through. The fracture is through the growth plate (including the metaphysis and epiphysis).
V - R = Rammed. The growth plate has been rammed (or ruined).
VI - Injury to the peripheral portion of the physis and a resultant bony bridge formation which may produce an angular deformity
[image] |
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Term
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Definition
| II - A type II fracture is a fracture through the physis and the metaphysis, but the epiphysis is not involved in the injury. |
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Term
| MCC septic arthritis >50 y/o |
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Definition
| Gonorrhea - hematogenous spread. Assoc w/ endocarditis, sepsis, meningitis |
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Term
|
Definition
Spiral, prox fibula fx assoc. with rupture of the deep deltoid & distal tibio-fibular ligaments or of the medial malleolus
[image] |
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Term
| Thompson's (Simmonds) Test |
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Definition
| To test rupture of achilles tendon. The patient lies face down w/ feet hanging off the edge of the bed. If the test is positive, there is no movement of the foot (normally plantarflexion) on squeezing the corresponding calf. |
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Term
| Varus knee stress test for? |
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Definition
| At 30° - lateral collateral lig. In extension - lateral collateral + iliotibial band, popliteus mm. lateral capsule & cruciate lig. |
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Term
|
Definition
| lavicle - 80%, middle third |
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Term
| SCFE: presentation, X-Ray, Tx? |
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Definition
| Obese boys, 10-16 y/o, pain referred to knee, gradual onset, limp ❑X-Ray: melting ice cream cone ❑ Tx: ORIF |
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Term
| MCC of painful hip in infants? Dx test? |
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Definition
| Septic arthritis-hematogenous spread, Staph, N.gono in teens ❑ Dx: needle aspiration |
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Term
| MCC of painful hip in children? Presentation? Dx? |
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Definition
| Transient synovitis- limp, inability to weight bear, low fever, ↑ESR ❑ Dx: of exclusion |
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Term
| What is Legg-Calve-Perthes? Presentation? Dx test? |
|
Definition
| •Idiopathic avascular necrosis of femoral head, 15% bilaterally •Boys 5-9 y/o, pain & limp, trivial trauma •Dx test: bone scan (+), x-rays (-), loss of stenton's line (line from top of obturator foramen to the inner side of the neck of the femur), irregular widening of the epiphyseal plate |
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Term
| MC serious ligament injury in adults? children? |
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Definition
| Adults: anterior cruciate lig of the knee (loud pop-snop, Lachman test) / Children: medial collateral lig |
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Term
| DDx of knee hemarthrosis w/neg x-rays |
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Definition
| Torn ACL (75% heamrthrosis), Ligamentous tear, peripheral meniscus tear, osteochondral fx (peds) |
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Term
| Posterior hip dislocation complications |
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Definition
| •Early: sciatic n. injury •Late:osteoartritis, AVN (15-30%) |
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Term
| Mechanism of posterior shoulder dislocation |
|
Definition
| Sz, electric shock, fall on forward-flexed internally rotated arm |
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|
Term
|
Definition
Ankle-calcaneal fx - normal 20-40°
[image] |
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|
Term
|
Definition
| •Calcaneal (ass L/S 10%; bilat 10%) •Harris view, diag X-Rays •Jumpers L/S + bilat calc + U/A |
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|
Term
|
Definition
|
|
Term
| Mech of Radial head sublux |
|
Definition
| •Nurse maids elbow (<5y/o) = Abrupt elongation of arm while pronate, pulls annular ligament over the radial head |
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|
Term
| Normal prevertebral soft tissue in peds |
|
Definition
| < 7 mm anterior C2; <3/4 of adjacent vertebral body width |
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|
Term
| Ant hip dislocations (10% of hip dislocations) |
|
Definition
| Abducted, externally rotated, flexed. Femoral head palpated at ASIS neg. If fem nerve involvement: ↓quad function, ↓DTR at knee, ↓sensation ant. medial thigh |
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Term
|
Definition
| •(+) De Quervain's (Stenosing tenosynovitis - overuse syndrome •Thumb on fish->wrist with ulnar deviation=pain ❑ Tx: NSAIDS, anatomical splint |
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|
Term
|
Definition
1° Sprain-partial tear of AC lig ;(-) X-Ray
2° Subluxation, complete tear; X-Ray 1/2 width of clavicle
3° Dislocation, complete tear, AC & CC lig; X-Ray > 1/2 width of clavicle |
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