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This flashcard set covers key principles, definitions, complications, investigations, and treatments across orthopaedic trauma, pediatric fractures, rehabilitation, rheumatology, bone tumors, metabolic bone disease, spine, gait, and emergency care as presented in the lecture notes.
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What term describes anterior inclination of the femoral neck relative to the distal femoral condyles?
Anteversion
Which joint classification best describes the hip joint?
Synovial (ball-and-socket)
What is the hallmark pain finding in compartment syndrome?
Severe pain on passive stretching of muscles within the compartment
What surgical procedure treats established compartment syndrome?
Fasciotomy (surgical decompression)
What is the earliest objective physical sign of compartment syndrome?
Tense, swollen compartment
What pediatric fracture location remodels best?
Fractures close to the physis
Which structure is responsible for longitudinal bone growth in children?
Epiphyseal (growth) plate
Most common elbow fracture in children?
Supracondylar fracture of the humerus
Most common complication (late) of supracondylar humerus fracture in children?
Cubital varus (mal-union, ‘gun-stock’ deformity)
Most serious acute complication of supracondylar humerus fracture?
Compartment syndrome
Supracondylar fracture with ‘pointing index’ indicates injury to which nerve?
Anterior interosseous nerve
Usual direction of traumatic elbow dislocation?
Posterior
Commonest nerve injured in posterior elbow dislocation?
Ulnar nerve
First step in Advanced Trauma Life Support (ATLS) primary survey?
Airway management with cervical-spine protection
A high-energy open tibial fracture needing muscle flap but intact vessels is Gustilo-Anderson grade?
Grade III-B
Primary goal of passive exercises in rehabilitation?
Maintain joint range of motion and prevent disuse atrophy
Who performs passive therapeutic exercise?
Therapist moves the limb for the patient
Deep-heat modalities exclude which of the following: microwave, short wave, ultrasound, ultraviolet?
Ultraviolet (it is NOT a deep-heat modality)
Best modality to correct distal extremity contractures (e.g., wrist, ankle)?
Paraffin wax bath therapy
Which effect is NOT produced by cold therapy?
Vasodilation (cold causes vasoconstriction)
Electrotherapy modality used specifically for pain control?
TENS (Transcutaneous Electrical Nerve Stimulation)
Faradic current is primarily used to stimulate which type of muscle?
Innervated (normally supplied) muscle
Massage technique producing pain/tension relief via micro-circulation improvement?
General therapeutic massage (compression, stroking, friction, etc.)
Primary purpose of splints in rheumatology?
Maintain joints in functional position and prevent/correct deformity
Example of a superficial heat source used in physiotherapy?
Infra-red heat lamp
Ultrasound therapy exerts a to-and-fro ‘micromassage’ effect on tissue to soften adhesions. True or False?
True
Most common fracture of proximal humerus in adults?
Surgical neck fracture
Nerve most often injured in anterior shoulder dislocation?
Axillary nerve
Mid-shaft humeral fracture commonly injures which nerve causing wrist drop?
Radial nerve
Best standard treatment for closed mid-shaft femur fracture in adults?
Locked intramedullary nail
Post-immobilization limitation of abduction & external rotation with preserved flexion in elderly shoulder injury suggests what lesion?
Rotator cuff tear
Treatment of middle-third both-bone forearm fracture in an 8-year-old?
Above-elbow cast with neutral rotation
Commonest functional loss after childhood both-bone forearm fracture?
Partial loss of pronation/supination
Definition of a Galeazzi fracture?
Fracture of distal radius with dislocation of distal radio-ulnar joint (DRUJ)
Definition of a Smith’s fracture?
Fracture of distal radius with volar (palmar) displacement of distal fragment
Most common complication of distal radius fractures?
Mal-union
Carpal bone fractured most frequently?
Scaphoid
Proximal scaphoid fractures risk what serious complication?
Avascular necrosis
Monteggia fracture consists of?
Proximal ulnar fracture with radial-head dislocation
Radiographic disruption of Shenton’s line indicates what around the hip?
Dislocation or fracture of the hip (commonly posterior dislocation)
Limb attitude of posterior hip dislocation?
Flexion, adduction, internal rotation, and shortening
Nerve commonly injured in posterior hip dislocation producing foot drop?
Sciatic nerve
Ideal time to reduce traumatic hip dislocation?
Immediately (within 6 hours)
Most common organ injured with pelvic fractures?
Urethra (especially posterior urethra)
Definitive treatment for a stable intertrochanteric femur fracture in elderly?
Dynamic hip screw or intramedullary device (mal-union most common, but here question? flashcards referencing earlier note) – Main complication: Malunion
Gold-standard imaging for initial evaluation of developmental dysplasia of hip in neonates?
Ultrasound
Shenton line on pelvic radiograph runs from which anatomical landmarks?
Inferior border of superior pubic ramus to medial aspect of femoral neck
Name the vertical line through the lateral edge of the acetabulum used in DDH assessment.
Perkin’s line
Garden type III subcapital femoral-neck fracture in a 75-year-old – best treatment?
Total hip arthroplasty (replacement)
First priority in management of multiple-injury (polytrauma) patient?
Maintenance of airway
Which ankle ligament is most commonly sprained during inversion injury?
Anterior talofibular ligament
Ligament injured in high (syndesmotic) ankle sprain?
Anterior & posterior tibiofibular ligaments
Danis-Weber type C ankle fracture occurs at what level?
Above the syndesmosis (supra-syndesmotic)
Nerve compressed in carpal tunnel syndrome?
Median nerve
Clinical sign used to elicit carpal tunnel syndrome by tapping the volar wrist?
Tinel sign
Steppage gait is due to weakness of which muscle group?
Ankle dorsiflexors (common peroneal nerve lesion)
Hypothenar atrophy points to lesion of which nerve?
Ulnar nerve
Acute mono-arthritis with red, hot joint is most characteristic of which crystal disease?
Gout
Gout most commonly affects which joint first?
First metatarsophalangeal (big-toe) joint
Drug used for acute gouty arthritis pain when NSAIDs contraindicated (renal impairment)?
Colchicine (with cautious dosing)
Diuretic commonly precipitating hyperuricemia and gout?
Furosemide
Biologic agent reserved for RA refractory to conventional DMARDs?
Anti-TNF agents (e.g., adalimumab)
First-line DMARD for rheumatoid arthritis?
Methotrexate
Most specific serologic test for rheumatoid arthritis?
Anti-CCP (anti–cyclic citrullinated peptide) antibodies
Earliest radiographic change in RA?
Peri-articular soft-tissue swelling
Pattern of joint involvement typical for RA?
Bilateral, symmetrical small-joint polyarthritis (PIP, MCP)
Osteoarthritis most commonly affects which large synovial joint?
Knee
Heberden’s nodes occur at which joints?
Distal interphalangeal (DIP) joints
Radiographic hallmarks of osteoarthritis include joint-space narrowing, osteophytes, subchondral sclerosis, and cysts. Which of these is usually asymmetrical?
Joint-space narrowing
Bisphosphonate mechanism in osteoporosis therapy?
Inhibits osteoclast-mediated bone resorption
Gold-standard test for diagnosing osteoporosis?
DEXA (dual-energy X-ray absorptiometry) scan
Anabolic agent (recombinant PTH 1-34) used in severe osteoporosis?
Teriparatide (Forteo)
Paget disease pathophysiology involves first increased activity of which bone cell?
Osteoclasts (followed by compensatory osteoblast activity)
Characteristic radiographic ‘picture-frame vertebra’ or ‘mixed lytic-sclerotic spine’ sign is associated with which bone disease?
Paget’s disease of bone
Most sensitive study for detecting early bone metastases?
Technetium-99m bone scan
Commonest malignant bone lesion in adults overall?
Metastatic bone disease
Osteosclerotic bone metastases in elderly males usually originate from which primary?
Prostate carcinoma
Multiple myeloma originates from proliferation of which cells?
Plasma cells
Classic lab hallmark of multiple myeloma?
Monoclonal (M-protein) spike in serum/urine
Most common benign bone tumor?
Osteochondroma
Osteoid osteoma pain is typically relieved by which medication class?
Salicylates/NSAIDs
Radiographic ‘nidus’ is characteristic of which benign tumor?
Osteoid osteoma
Most common epiphyseal tumor in skeletally immature patients?
Chondroblastoma
Sun-ray (sun-burst) periosteal reaction on X-ray of a teenager’s knee region suggests which tumor?
Osteosarcoma
‘Onion-skin’ (laminated) periosteal reaction in a child’s diaphyseal bone lesion indicates what tumor?
Ewing sarcoma
Triple arthrodesis fuses which three hind-foot joints?
Talocalcaneal, talonavicular, and calcaneocuboid joints
Classic four deformities of congenital talipes equinovarus (clubfoot)?
Forefoot adduction, midfoot cavus, hind-foot varus, ankle equinus
Order of correction in Ponseti method for clubfoot?
Cavus → adduction → varus → equinus
Best maintenance device after serial casting for clubfoot?
Abduction brace (Denis-Browne)
Best initial imaging for suspected neonatal hip dysplasia with family history?
Ultrasound of hips
Initial pathologic change in primary osteoarthritis?
Fibrillation (surface cracking) of articular cartilage
Tri-compartmental knee osteoarthritis definitive surgical option?
Total knee arthroplasty (replacement)
Most common metabolic bone disease worldwide?
Osteoporosis
Risk factor for male osteoporosis involving sex hormones?
Hypogonadism
Commonest site for osteoporotic vertebral compression fracture?
Thoracolumbar junction
Schober test assesses lumbar flexion; ≤ 5 cm increase indicates which disease?
Ankylosing spondylitis
HLA-B27–positive spondyloarthropathy presenting with urethritis, conjunctivitis & arthritis?
Reactive arthritis (Reiter syndrome)
Skin lesion balanitis circinata is associated with which arthropathy?
Reactive arthritis
Extra-articular condition strongly linked to ankylosing spondylitis?
Anterior uveitis
Trendelenburg gait pelvic drop on right indicates weakness of which side gluteus medius?
Left gluteus medius/minimus