Orthopaedics Basics and Trauma Practice Flashcards

Flashcards covering bone anatomy, fracture classifications, upper and lower limb trauma, metabolic bone disorders, oncology, nerve injuries, and pediatric orthopaedics based on Marrow lecture transcripts.

Collagen Type I

The principal protein in bone and the primary constituent of menisci, ligaments, and tendons.

Collagen Type II

The specific type of collagen found in hyaline cartilage.

Osteoid

The organic component or matrix of the bone, representing $5 - 10\%$ of bone constituents.

Calcium hydroxyapatite

The principal mineral and primary inorganic component of bone.

Osteoblast

A mononuclear cell rich in alkaline phosphatase (ALP) that lays down the osteoid matrix.

Osteoclast

A multinucleated giant cell derived from monocyte aggregates, rich in TRAP and carbonic anhydrase, responsible for bone resorption and remodelling.

Osteocyte

A mature or resting osteoblast that is the most abundant bone cell with the longest life span.

Metaphysis

The most vascular part of the bone containing spongy/cancellous bone with a hairpin arrangement of blood vessels.

Sharpey’s fibers

Structures that anchor the periosteum to the bone.

Stress fracture

A fracture occurring in normal bone due to repetitive abnormal loading, characterized by point tenderness.

Pathological fracture

A fracture occurring in abnormal or weak bone, often preceded by pain due to a pre-existing lesion.

Mirel’s criteria

A scoring system for managing pathological fractures where a score $\ge 8$ indicates prophylactic internal fixation.

March fracture

A type of stress fracture most commonly occurring in the metatarsals, specifically the 2nd over the 3rd metatarsal, and the neck over the shaft.

Primary healing

Also known as direct or intramembranous healing, it requires absolute stability, utilizes devices like compression plates, and results in no callus formation.

Secondary healing

The most common type of fracture healing (indirect/endochondral) which occurs with relative stability and results in callus formation.

Woven bone

The initial, irregular collagen bone formed during the consolidation stage of secondary healing, which later remodels into lamellar bone.

Malunion

Healing of a fracture in an anatomically abnormal position, most commonly caused by improper reduction.

Non-Union

Failure of a fracture to heal, categorized as hypertrophic (good bone biology but improper immobilization) or atrophic (abnormal bone biology).

Osteogenesis

The ability of a bone graft to form new bone.

Osteoconduction

The ability of a bone graft to act as a scaffold, typical of substitutes like calcium phosphate or PMMA.

Osteoinduction

The ability of a bone graft to stimulate the host to form new bone, often via Bone morphogenic protein.

Fractures of necessity

Fractures that require surgical management, such as intra-articular, displaced patella, Monteggia/Galeazzi, or neck of femur fractures.

Thomas splint

A common splint used specifically for femur fractures.

Gallow’s traction

A traction system used for shaft of femur fractures in children younger than $2$ years or weighing less than $12\,kg$.

Gustilo-Anderson Classification

A grading system for open fractures ranging from Type I (wound < $1\,cm$) to Type IIIc (open fracture with vascular injury).

Distraction osteogenesis

Also known as Callotaxis, a process used with Ilizarov ring fixators to lengthen bone at a rate of $1\,mm/day$.

Ring sequestrum

The most common complication of external fixation, occurring at pin tract sites due to heat necrosis or infection.

Mangled extremity severity score (MESS)

A trauma score where a value $> 7$ indicates amputation; ischemia time is the most important component.

Syme’s amputation

A common type of lower limb amputation performed at the ankle.

Avascular Necrosis (AVN)

Osteonecrosis occurring most commonly in the head of the femur, proximal pole of the scaphoid, and body of the talus.

Hamilton’s ruler test

A clinical test used to diagnose anterior shoulder dislocation.

Regimental badge sign

Paresthesia over the lateral aspect of the upper arm indicating axillary nerve injury, commonly seen after shoulder dislocation.

Bankart lesion

Anteroinferior tearing of the glenoid labrum associated with anterior shoulder dislocation.

Hill Sach’s lesion

An indentation or excavation on the posterolateral surface of the head of the humerus caused by recurrent shoulder dislocations.

Holstein-Lewis fracture

A fracture at the lower $1/3rd$ of the humerus that may entrap the tethered radial nerve, leading to wrist drop.

Volkmann ischemic contracture

A late complication of compartment syndrome resulting in ischemia, necrosis, and fibrosis of muscles.

Myositis Ossificans

Ossification of a fracture hematoma inside a muscle, most commonly the brachialis, often caused by massage.

Tardy ulnar nerve palsy

A late complication of lateral condyle fractures and cubitus valgus deformity due to the stretching of the ulnar nerve.

Pulled Elbow

Also known as Nursemaid’s elbow, it involves subluxation of the radial head outside the annular ligament due to axial traction.

Monteggia Fracture

A fracture of the upper $1/3rd$ of the ulna associated with radial head dislocation.

Galeazzi Fracture

A fracture of the lower $1/3rd$ of the radius associated with distal radioulnar joint (DRUJ) disruption.

Colle’s Fracture

An extra-articular fracture of the distal radius at the cortico-cancellous junction with dorsal displacement, creating a dinner-fork deformity.

Smith’s Fracture

Also called a reverse Colle’s fracture, it involve ventral displacement of the distal radius fragment, creating a garden spade deformity.

Terry Thomas sign

An increased gap between the scaphoid and lunate bones on an X-ray, indicating scapho-lunate dissociation.

Bennett’s fracture

A partial intra-articular fracture at the base of the $1st$ metacarpal.

Mallet Finger

Also called baseball finger, it is an avulsion injury of the extensor tendon at the DIP joint resulting in a flexion deformity.

Shenton’s line

An imaginary radiological line from the lower border of the superior pubic ramus to the medial neck of the femur, disturbed in hip pathologies.

Trendelenburg test

A test to assess the hip abductors; failure of the unit (sound side sinks when standing on the pathological side) leads to a Trendelenburg gait.

Coxa vara

A hip deformity where the neck-shaft angle is less than $120^{\circ}$, often causing limb shortening and a Trendelenburg gait.

Fat Embolism Syndrome

A condition caused by intramendullary fat leaking into circulation, characterized by a triad of respiratory symptoms, neurological symptoms, and a petechial rash.

Bohler’s angle

One of the angles used to assess the reduction of a calcaneal fracture.

Aviator’s Fracture

A fracture of the talar neck which carries a high risk of avascular necrosis of the talar body.

Craniotabes

The earliest clinical change in rickets, characterized by softening of the skull or a "ping pong ball" feel.

Wimberger ring sign

A radiological feature of scurvy seen in the epiphysis of bone.

Brown tumor

Cavities formed in the bone due to excess resorption in primary hyperparathyroidism, filled with blood and hemosiderin.

Rugger Jersey spine

A classic X-ray finding for renal osteodystrophy.

T-score

A bone mineral density comparison used in DEXA scans; a score $\le -2.5$ confirms osteoporosis.

Blade of grass deformity

A flame-shaped lytic appearance on an X-ray characteristic of the lytic phase of Paget’s disease.

Blue sclera

A clinical feature of Osteogenesis Imperfecta where the choroid is visible due to a genetically thin sclera.

Codman’s triangle

An aggressive periosteal reaction seen as an elevated triangle of bone, classic for Osteosarcoma.

Onion peel appearance

A lamellated or layered periosteal reaction characteristic of Ewing’s sarcoma.

Neuropraxia

A temporary, reversible physiological conduction block in a nerve with $100\%$ spontaneous recovery.

Bamboo spine

A radiological feature of ankylosing spondylitis caused by syndesmophyte formation and calcification between vertebrae.

Schober test

A clinical test used to measure lumbar spine motility, often decreased in ankylosing spondylitis.

Jefferson’s Fracture

A specific fracture involving the $C1$ (Atlas) vertebra.

Hangman’s Fracture

A fracture-dislocation of $C2$ over $C3$, specifically involving the pars interarticularis.

Spondyloarthropathies

A group of seronegative (RF negative) inflammatory arthritides associated with HLA B27, including ankylosing spondylitis and psoriatic arthritis.

Chondrocalcinosis

The presence of calcium pyrophosphate crystals in joint cartilage, visible on X-ray in pseudogout.

Sequestrum

A piece of dead bone formed inside an abscess, characteristic of chronic osteomyelitis.

Involucrum

New bone forming around the dead bone (sequestrum) in chronic osteomyelitis.

Brodie’s abscess

A form of subacute osteomyelitis where the infection is contained and there is no sinus or sequestrum.

Pott’s paraplegia

Neurological manifestations, such as ankle clonus or bowel/bladder involvement, caused by the compression of the spinal cord in TB spine.

Salter-Harris Type II

The most common physeal (growth plate) injury, where the fracture line goes through the growth plate and metaphysis (Thurston Holland fragment).

Sprengel Shoulder

A congenital deformity involving an undescended hypoplastic scapula, often associated with Klippel Feil syndrome.

Perthes’ Disease

Also known as coxa plana, it is an idiopathic, spontaneous osteonecrosis of the femoral epiphysis in children aged $6 - 12$ years.

Ponseti method

The standard serial manipulation and casting treatment for Congenital Talipes Equinus Varus (CTEV), using the CAVE order of correction.

De Quervain’s Disease

Stenosing tenosynovitis of the Abductor pollicis longus and Extensor pollicis brevis in the $1st$ dorsal compartment of the wrist.

Dupuytren’s Contracture

Abnormal cord-like fibrosis of the palmar fascia causing contracture of the fingers, most commonly the ring finger.

Thomas test

Also known as the leg raising test, used to assess flexion contracture or flexion deformity of the hip.