p.43
Injuries Around the Knee and Shoulder
What is the O'Donoghue triad?
Injury to MCL, ACL, and medial meniscus.
p.22
Fracture Types and Diagnosis
What mechanism of injury can cause posterior shoulder dislocation?
High voltage electric shock, ECT, seizure, or fall on an outstretched hand.
p.4
Fracture Healing Stages
What occurs during the granulation stage of healing?
Fibroblasts mature into osteoblasts over 2-3 weeks.
p.19
Injuries Around the Knee and Shoulder
What mechanism commonly causes a clavicle fracture?
Fall on an outstretched arm.
p.6
Fracture Types and Diagnosis
What are the types of fractures based on articular involvement?
Intra-articular and extra-articular.
p.45
Injuries Around the Knee and Shoulder
What is a common injury associated with the long head of the biceps tendon?
Tear of the long head of the biceps tendon.
p.26
Orthopaedic Trauma Management Techniques
What indicates compartment syndrome in terms of elbow movement?
Restriction of elbow movement / ROM decreases.
p.24
Fracture Types and Diagnosis
What does the Fatpad/Sail sign indicate?
Fat pushed by the fracture haematoma, resulting in lucency around the bone.
p.13
Metabolic Bone Disorders: Osteoporosis and Rickets
What is the primary defect in Scurvy?
Defect in collagen maturation but mineralization is normal.
p.12
Metabolic Bone Disorders: Osteoporosis and Rickets
What is the White line of Frankel?
A dense white line seen at the growth plate, used to assess healing of rickets.
p.13
Metabolic Bone Disorders: Osteoporosis and Rickets
What is a common radiological finding in the phalanges due to Hyperparathyroidism?
Subperiosteal resorption.
p.25
Fracture Types and Diagnosis
What is the most common complication of malunion in the context of elbow injuries?
Cubitus varus deformity (gunstock deformity).
p.13
Metabolic Bone Disorders: Osteoporosis and Rickets
What is a brown tumor in the context of Hyperparathyroidism?
Blood filled in bony cavity leading to hemosiderin deposition.
p.6
Fracture Types and Diagnosis
What is displacement in relation to fractures?
Described in relation to the distal fragment.
p.32
Fracture Types and Diagnosis
What is a Bennet's fracture?
A fracture involving the base of the first metacarpal bone.
p.22
Fracture Types and Diagnosis
What is a Hill Sach's lesion?
A defect on the postero-lateral surface of the humeral head due to repeated impact against the anterior glenoid rim.
p.37
Orthopaedic Trauma Management Techniques
What is the common procedure for a hip fracture in elderly patients?
Hemiarthroplasty with Thompson prosthesis.
p.32
Fracture Types and Diagnosis
What is a Jersey finger?
An avulsion of the flexor digitorum profundus (FDP) tendon.
p.24
Fracture Types and Diagnosis
What does the Fish tail sign indicate?
The distal fragment of the fracture looks like a fish tail, also seen in resorption of the lateral part of the distal humerus.
p.36
Fracture Types and Diagnosis
What does the anatomical classification of neck of femur fractures indicate?
The more proximal the fracture, the worse the prognosis.
p.23
Fracture Types and Diagnosis
What is a three-point bony relationship in the elbow?
Elbow flexion, elbow extension, and the lateral condyle of the humerus.
p.4
Fracture Healing Stages
What is the first stage of fracture healing?
Hematoma, occurring within 2-3 days.
p.2
Basics of Bone Structure and Function
From where does growth occur in the growth plate (Physis)?
From epiphysis to metaphysis.
p.4
Fracture Healing Stages
What is the remodeling stage of fracture healing?
Occurs after 3 years, where bone structure is refined.
p.23
Orthopaedic Trauma Management Techniques
What is the typical recovery time for nerve palsy associated with wrist drop?
Usually resolves in 3 months.
p.42
Injuries Around the Knee and Shoulder
What is the purpose of the Anterior Drawer Test?
To assess the integrity of the anterior cruciate ligament (ACL).
p.33
Orthopaedic Trauma Management Techniques
What are the principal abductors of the hip?
Gluteus medius and gluteus minimus.
p.31
Injuries Around the Knee and Shoulder
What is the Terry Thomas sign associated with?
Injury to the scapholunate ligament leading to a gap greater than 3-4mm between the scaphoid and lunate.
p.10
Bone Cells: Osteoblasts, Osteoclasts, and Osteocytes
What effect does Denosumab have on RANK ligand?
Denosumab inhibits RANK ligand.
p.7
Orthopaedic Trauma Management Techniques
What solutions can be used to wash a wound?
Normal saline (NS), povidone iodine, or hydrogen peroxide (H2O2).
p.16
Metabolic Bone Disorders: Osteoporosis and Rickets
What is Raloxifene classified as?
A SERM (Selective Estrogen Receptor Modulator).
p.26
Orthopaedic Trauma Management Techniques
What is the treatment for myositis ossificans?
Modified French osteotomy (Lateral closing wedge).
p.4
Fracture Healing Stages
What characterizes the callus stage of fracture healing?
Formation of osteoid with less calcium, occurring over 2-3 months.
p.4
Fracture Healing Stages
What happens during the consolidation stage of healing?
Woven bone forms a rigid callus with irregular collagen, replaced by lamellar bone over 2-3 years.
p.36
Fracture Types and Diagnosis
What is the significance of external rotation greater than 45° in hip fractures?
It indicates a potential intertrochanteric fracture.
p.32
Fracture Types and Diagnosis
What is a Mallet finger?
An avulsion injury of the extensor digitorum communis (EDC) at the distal interphalangeal (DIP) joint.
p.36
Fracture Healing Stages
What is the consequence of malunion in hip fractures?
It can lead to coxa vara.
p.45
Injuries Around the Knee and Shoulder
Which tendon is primarily affected in Tennis elbow?
Extensor carpi radialis brevis.
p.44
Injuries Around the Knee and Shoulder
What is impingement syndrome?
Impingement of the supraspinatus tendon between the head of the humerus and the acromion.
p.16
Metabolic Bone Disorders: Osteoporosis and Rickets
What is the role of Denosumab in osteoporosis treatment?
It decreases bone resorption.
p.12
Metabolic Bone Disorders: Osteoporosis and Rickets
What are Milkman’s fractures?
Transverse fractures perpendicular to the long axis of the bone that heal with callus deficient in calcium.
p.18
Metabolic Bone Disorders: Osteoporosis and Rickets
What is the treatment to suppress osteoclasts?
Bisphosphonates, such as Zoledronate.
p.37
Orthopaedic Trauma Management Techniques
What is the aim of managing an intertrochanteric fracture of the femur?
To maintain the normal neck-shaft angle using a proximal femoral nail.
p.13
Metabolic Bone Disorders: Osteoporosis and Rickets
What is the characteristic skull appearance in Hyperparathyroidism?
Salt & pepper appearance.
p.24
Orthopaedic Trauma Management Techniques
What is the common treatment for a complete fracture?
Open reduction and internal fixation (ORIF).
p.24
Fracture Types and Diagnosis
What happens to the distal fragment in an extension type fracture?
It goes posteriorly due to the pull of the triceps.
p.6
Fracture Types and Diagnosis
What characterizes an open fracture?
It communicates with the environment.
p.5
Fracture Types and Diagnosis
What is malunion?
A fracture that has healed in an anatomically abnormal position.
p.10
Bone Cells: Osteoblasts, Osteoclasts, and Osteocytes
What is the role of osteoclasts in bone metabolism?
Osteoclasts are responsible for the resorption of calcium.
p.11
Metabolic Bone Disorders: Osteoporosis and Rickets
What deformity is characterized by a prominent sternum?
Pigeon chest or pectus carinatum.
p.29
Fracture Types and Diagnosis
What is the mechanism of injury (MOI) for a Colle's fracture?
Fall on an outstretched hand with the wrist in extension.
p.12
Metabolic Bone Disorders: Osteoporosis and Rickets
What is Protrusio acetabuli?
A condition where the head of the femur protrudes into the acetabulum.
p.21
Orthopaedic Trauma Management Techniques
What difficulty is commonly observed in shoulder dislocation?
Difficulty in adduction or internal rotation of the shoulder.
p.5
Fracture Types and Diagnosis
What is the most common site for non-union fractures?
Lower 1/3rd of the tibia.
p.6
Orthopaedic Trauma Management Techniques
What is the definitive treatment for upper limb fractures?
Closed reduction (CR) and plaster of Paris (POP).
p.23
Orthopaedic Trauma Management Techniques
What is wrist drop?
A condition characterized by sensory loss, thumb drop, and finger drop due to nerve palsy.
p.30
Fracture Types and Diagnosis
What is another name for Chauffeur's fracture?
Hutchinson fracture or backfire fracture.
p.7
Orthopaedic Trauma Management Techniques
What is the purpose of broad spectrum antibiotics in wound management?
To prevent or treat infection.
p.34
Orthopaedic Trauma Management Techniques
What are the typical limb positions in a posterior dislocation?
Flexion, adduction, internal rotation, and limb shortening.
p.14
Metabolic Bone Disorders: Osteoporosis and Rickets
What are the symptoms associated with excess Ca2+ in serum?
Bones (pains), stones (renal), groans (abdomen), fatigue, overtones (psych).
p.40
Orthopaedic Trauma Management Techniques
What is the first step in managing a fracture?
Assess for neurovascular deficit.
p.2
Fracture Types and Diagnosis
What defines a fracture?
A breach or a break in the continuity of the cortex of bone.
p.23
Fracture Types and Diagnosis
What type of injury is a lateral condyle humerus fracture classified as?
Intra-articular fracture/fracture of necessity.
p.44
Injuries Around the Knee and Shoulder
Which clinical tests are used to diagnose impingement syndrome?
Neer’s impingement test, Hawkin’s impingement test, and Painful arc test.
p.22
Fracture Types and Diagnosis
What is the clinical attitude of a patient with posterior shoulder dislocation?
Adducted and internally rotated arm.
p.33
Orthopaedic Trauma Management Techniques
What is a waddling gait indicative of?
Bilateral failure of abductors.
p.2
Pathological Fractures and Causes
What is a common cause of pathological fractures in normal bone?
Repetitive loading (stress fractures).
p.4
Fracture Healing Stages
What is hypertrophic non-union?
Good biology with exuberant callus due to improper immobilization.
p.29
Orthopaedic Trauma Management Techniques
What is the treatment for a Colle's fracture?
Closed reduction internal fixation (CRIF) with a POP cast or open reduction internal fixation (ORIF) with plates.
p.20
Orthopaedic Trauma Management Techniques
What neurovascular injuries can occur with a figure of 8 bandage?
Branchial plexus and subclavian vessels injury.
p.11
Metabolic Bone Disorders: Osteoporosis and Rickets
What radiological findings indicate Rickets?
Cupping, splaying, and fraying of joints due to absence of calcification.
p.36
Orthopaedic Trauma Management Techniques
What is the management approach for patients over 65 years with neck of femur fractures?
Replacement if <3 weeks; CRIF with cannulated cancellous screws if >3 weeks.
p.31
Fracture Types and Diagnosis
What causes Mallet finger?
Avulsion of the extensor digitorum communis tendon at the DIP joint due to hyperflexion injury.
p.41
Injuries Around the Knee and Shoulder
Which ligament is most commonly injured around the knee?
Medial collateral ligament (MCL).
p.35
Fracture Types and Diagnosis
What is the age and gender prevalence for neck of femur fractures?
50-60 years, Female more than Male.
p.24
Fracture Types and Diagnosis
What is a Type 2 fracture?
Incomplete/partial fracture.
p.13
Metabolic Bone Disorders: Osteoporosis and Rickets
What happens to the lamina dura in teeth due to Hyperparathyroidism?
Resorption of lamina dura.
p.3
Metabolic Bone Disorders: Osteoporosis and Rickets
What is Osteopetrosis?
A condition characterized by abnormally dense bones due to excessive osteoclast activity.
p.19
Metabolic Bone Disorders: Osteoporosis and Rickets
What gene defect is associated with Osteogenesis Imperfecta?
COLA 1 gene (Defective collagen).
p.26
Orthopaedic Trauma Management Techniques
Which muscle is the earliest involved in compartment syndrome in a supracondylar fracture?
Flexor digitorum profundus.
p.15
Fracture Types and Diagnosis
What are the common sites for fragility fractures?
Spine, Neck of Femur, Hip, Colle’s fracture.
p.7
Orthopaedic Trauma Management Techniques
What is debridement?
The removal of dead or infected tissue from a wound.
p.29
Fracture Types and Diagnosis
What is a Colle's fracture?
A fracture of the distal end of the radius at the cortico-cancellous junction, commonly seen in elderly post-menopausal women.
p.32
Fracture Types and Diagnosis
What does Shenton’s line indicate on an X-ray of the pelvis?
It runs from the inferior margin of the superior pubic ramus to the medial part of the head and neck of the femur.
p.38
Orthopaedic Trauma Management Techniques
What is a common complication of proximal femoral nail fixation?
Malunion leading to coxa vara and Trendelenburg gait.
p.39
Orthopaedic Trauma Management Techniques
What is the management technique for a patella fracture?
ORIF with Tension band wiring.
p.29
Fracture Types and Diagnosis
What are the types of displacement for a distal fragment in a Colle's fracture?
Dorsal tilt/shift, lateral tilt/shift, impaction, and supination.
p.34
Orthopaedic Trauma Management Techniques
What does palpation reveal in a posterior dislocation?
Head palpable in the gluteal region.
p.36
Fracture Types and Diagnosis
What is the basis of Garden’s classification?
It is based on the disruption of trabecular alignment.
p.22
Fracture Types and Diagnosis
What is the light/electric bulb sign associated with?
AP view of posterior shoulder dislocation.
p.12
Metabolic Bone Disorders: Osteoporosis and Rickets
What are some conditions where Looser's zone is also seen?
Hypothyroidism, Paget's disease, fibrous dysplasia, osteogenesis imperfecta, renal osteodystrophy, and X-linked hypophosphatemic rickets.
p.23
Fracture Types and Diagnosis
What is the most common fracture around the elbow in children?
Supracondylar humerus fracture.
p.29
Orthopaedic Trauma Management Techniques
What is the position to apply a cast for a Colle's fracture?
Pronation, ulnar deviation, and flexion (hand shaking position).
p.40
Fracture Types and Diagnosis
What is an aviator fracture?
Fracture of the talar neck.
p.24
Fracture Types and Diagnosis
What characterizes a Type 3 fracture?
Complete fracture with a breach in both anterior and posterior cortex.
p.6
Orthopaedic Trauma Management Techniques
What is the definitive treatment for lower limb fractures?
Closed reduction (CR) and internal fixation (IF) with intramedullary interlocking nails and rods.
p.15
Metabolic Bone Disorders: Osteoporosis and Rickets
What is the primary type of osteoporosis associated with post-menopausal women?
Primary Post Menopausal Osteoporosis.
p.33
Orthopaedic Trauma Management Techniques
What does the Trendelenburg test assess?
The abductor mechanism of the hip.
p.3
Metabolic Bone Disorders: Osteoporosis and Rickets
What is the most common cause of osteoporosis?
Age-related bone density loss.
p.30
Fracture Types and Diagnosis
What type of fracture is a Chauffeur's fracture?
Isolated radial styloid fracture.
p.19
Injuries Around the Knee and Shoulder
What is the most common site for a clavicle fracture?
Junction of medial 2/3rd & lateral 1/3rd or at Middle 1/3rd.
p.44
Injuries Around the Knee and Shoulder
What is the typical pain range for impingement syndrome?
Mid-abduction pain occurs between 60° to 120°.
p.14
Metabolic Bone Disorders: Osteoporosis and Rickets
What causes renal osteodystrophy?
Secondary hyperparathyroidism due to renal failure.
p.32
Fracture Types and Diagnosis
What is the significance of the femur neck-shaft angle in diagnosing coxa vara?
It indicates shortening, Trendelenburg gait, and limitation of abduction and internal rotation.
p.26
Orthopaedic Trauma Management Techniques
What is the most common type of elbow dislocation in children?
Posterior/posterolateral.
p.15
Metabolic Bone Disorders: Osteoporosis and Rickets
What diagnostic tool is used for measuring bone mineral density?
DEXA scan (Dual energy X-ray absorptiometry).
p.12
Metabolic Bone Disorders: Osteoporosis and Rickets
What is the Stoss regimen for Vitamin D supplementation?
3 lac - 6 lac IU deep IM/oral (Stat over 1-5 days).
p.21
Orthopaedic Trauma Management Techniques
What is a common clinical feature of shoulder dislocation?
Flattened shoulder contour.
p.6
Open Fractures and Gustilo-Anderson Classification
What is the feature of a Type 3C open fracture?
Wound with vascular injury.
p.45
Injuries Around the Knee and Shoulder
What are some treatment options for elbow injuries?
Rest and immobilization, counterforce brace, ortho-biologics.
p.25
Fracture Healing Stages
What is the treatment for mild contracture in Volkmann’s ischemic contracture?
Passive stretching using a Turn buckle splint (Volkmann’s splint).
p.9
Orthopaedic Trauma Management Techniques
What type of IV fluids are preferred in trauma management?
Ringer's Lactate (RL) over Normal Saline (Ns).
p.18
Fracture Types and Diagnosis
What is the outcome of Type II banana fracture?
Usually lethal, often stillborn.
p.7
Orthopaedic Trauma Management Techniques
What are the indications for using an external fixator?
Open fractures, non-union, infected non-union, deformity correction, fractures with bone loss, and limb lengthening.
p.9
Orthopaedic Trauma Management Techniques
What technique is used for transporting a patient with spinal precautions?
Log roll technique (requires 4-5 members).
p.30
Fracture Types and Diagnosis
What is the best X-ray view for diagnosing a scaphoid fracture?
AP/lateral/oblique wrist view.
p.12
Metabolic Bone Disorders: Osteoporosis and Rickets
Which method is better for assessing healing of rickets?
X-ray is preferred over Serum ALP.
p.11
Metabolic Bone Disorders: Osteoporosis and Rickets
What laboratory findings are associated with Rickets/Osteomalacia?
Decreased or normal serum calcium, increased serum PTH, decreased serum phosphate, and increased serum ALP.
p.12
Metabolic Bone Disorders: Osteoporosis and Rickets
What are common symptoms of Osteomalacia?
Polyarthralgia, bone pains, and proximal myopathy due to hypocalcemia.
p.22
Fracture Types and Diagnosis
What is the most common complication of shoulder dislocation?
Recurrent shoulder dislocation.
p.13
Metabolic Bone Disorders: Osteoporosis and Rickets
What are some differential diagnoses for the white line of Frankel?
Healing rickets, congenital syphilis, plumbism, leukemia.
p.21
Orthopaedic Trauma Management Techniques
What is the typical attitude of the limb in shoulder dislocation?
Arm by the side of the body, abduction, and external rotation.
p.17
Metabolic Bone Disorders: Osteoporosis and Rickets
What lab findings are indicative of the condition?
Increased alkaline phosphatase (↑↑ ALP), normal calcium and phosphate levels.
p.33
Orthopaedic Trauma Management Techniques
What characterizes Trendelenburg gait?
Lurching towards the pathological side while lifting the healthy side.
p.43
Injuries Around the Knee and Shoulder
What is the blood supply to the red zone of the meniscus?
Supplied by genicular vessels.
p.23
Fracture Types and Diagnosis
What are the complications of a lateral condyle humerus fracture?
Stiffness of elbow and non-union.
p.31
Fracture Types and Diagnosis
What characterizes a Rolando's fracture?
A complete comminuted fracture at the base of the 1st metacarpal joint, often T or Y-shaped.
p.24
Fracture Types and Diagnosis
What are the treatment options for a Type 2 fracture?
Reduction + POP or Reduction + k-wires.
p.34
Orthopaedic Trauma Management Techniques
What does X-ray show in a posterior dislocation?
Shenton’s line broken; AP view shows superior position of femoral head.
p.43
Injuries Around the Knee and Shoulder
What is the most commonly injured ligament in the body?
Anterior talofibular ligament.
p.14
Metabolic Bone Disorders: Osteoporosis and Rickets
What happens to phosphate levels in renal failure?
Phosphate is not excreted.
p.10
Metabolic Bone Disorders: Osteoporosis and Rickets
What is osteogenesis imperfecta related to?
It is related to a deficiency in procollagen.
p.2
Pathological Fractures and Causes
What are some localized causes of pathological fractures?
Infection, ischemia, lesions, cysts, radiation.
p.37
Orthopaedic Trauma Management Techniques
What is the Austin Moore prosthesis used for?
It is used in hemiarthroplasty for hip fractures.
p.29
Fracture Healing Stages
What are common complications of a Colle's fracture?
Stiffness of fingers, malunion leading to dinner fork deformity, complex regional pain syndrome, rupture of extensor pollicis longus tendon, and carpal tunnel syndrome.
p.39
Pathological Fractures and Causes
What is a runner's fracture?
A stress fracture of the fibula seen in marathon runners.
p.28
Fracture Types and Diagnosis
What is a Night stick fracture?
A minimally displaced oblique fracture of the ulna without associated fracture of the radius.
p.11
Metabolic Bone Disorders: Osteoporosis and Rickets
What is Rachitic rosary?
Swelling at the costochondral junction, which is blunt and non-tender.
p.24
Fracture Types and Diagnosis
What is Baumann’s angle used for?
To assess supracondylar humerus fractures.
p.23
Orthopaedic Trauma Management Techniques
What type of splint is used for managing wrist drop?
Cock-up splint (static or dynamic).
p.37
Fracture Types and Diagnosis
What imaging is done to rule out a neck of femur (NOF) fracture?
MRI, as X-rays can still be normal.
p.34
Orthopaedic Trauma Management Techniques
What is a common injury mechanism for anterior dislocation?
Deceleration injury or fall from height.
p.17
Fracture Types and Diagnosis
What is the characteristic radiological appearance in the lytic phase?
Flame shaped or blade of grass appearance.
p.11
Metabolic Bone Disorders: Osteoporosis and Rickets
What is the most common cause of knee deformity in children?
Rickets, leading to bilateral genu varum.
p.31
Fracture Types and Diagnosis
What type of fracture is a Bennet's fracture?
An intra-articular fracture at the base of the 1st metacarpal joint.
p.27
Injuries Around the Knee and Shoulder
What is Nursemaid’s elbow?
An unossified radial head condition, smaller compared to the annular ligament.
p.36
Fracture Types and Diagnosis
What does Pauwell’s classification indicate about neck of femur fractures?
The more vertical the angle, the more unstable the fracture.
p.9
Orthopaedic Trauma Management Techniques
What does 'A' in the ABCDE protocol stand for?
Airway: Chin lift/jaw thrust & cervical spine immobilization (Philadelphia collar).
p.35
Pathological Fractures and Causes
What is the increased risk associated with neck of femur fractures?
Avascular necrosis (AVN) and non-union.
p.14
Metabolic Bone Disorders: Osteoporosis and Rickets
What is the effect of renal failure on calcium absorption?
Calcium is not absorbed, leading to decreased Ca2+ levels.
p.1
Bone Cells: Osteoblasts, Osteoclasts, and Osteocytes
What is the primary function of osteoblasts?
They are builders of bone.
p.30
Fracture Types and Diagnosis
What is the mechanism of injury (MOI) for a scaphoid fracture?
FOOSH (Falling On Outstretched Hand).
p.37
Fracture Types and Diagnosis
What type of fracture is most likely in elderly patients with a history of falls and hip pain?
Neck of femur (NOF) fracture unless proven otherwise.
p.22
Fracture Types and Diagnosis
What is Luxatio erecta?
Inferior shoulder dislocation due to hyperabduction injury.
p.25
Fracture Healing Stages
What surgical procedure is indicated for moderate contracture in Volkmann’s ischemic contracture?
Muscle sliding (Max Page) operation.
p.31
Orthopaedic Trauma Management Techniques
What is the treatment for Mallet finger?
Mallet splint or stax splint.
p.18
Metabolic Bone Disorders: Osteoporosis and Rickets
What lab finding is associated with blue sclera?
Increased ALP (Alkaline Phosphatase).
p.9
Metabolic Bone Disorders: Osteoporosis and Rickets
What happens to calcium homeostasis when calcium levels decrease?
Parathyroid hormone (PTH) increases.
p.35
Fracture Types and Diagnosis
What is the age and gender prevalence for intertrochanteric fractures?
70-80 years, Female more than Male.
p.40
Pathological Fractures and Causes
What is the most common complication of a talar neck fracture?
Subtalar arthritis or avascular necrosis (AVN) of the body of the talus.
p.16
Metabolic Bone Disorders: Osteoporosis and Rickets
What are the three stages of Paget's disease?
Lytic phase, Mixed phase, Blastic phase.
p.10
Metabolic Bone Disorders: Osteoporosis and Rickets
What inhibits parathyroid hormone (PTH) levels?
Normal calcium (Ca2+) levels inhibit PTH.
p.6
Open Fractures and Gustilo-Anderson Classification
What are the types in the Gustilo-Anderson classification of open fractures?
Type 1, Type 2, Type 3, Type 3A, Type 3B, Type 3C.
p.24
Orthopaedic Trauma Management Techniques
What is the treatment for a supracondylar humerus fracture?
Dunlop traction for temporary stabilization.
p.40
Orthopaedic Trauma Management Techniques
What should be done if there is no neurovascular deficit?
Attempt closed reduction with a POP slab, not a cast.
p.9
Orthopaedic Trauma Management Techniques
What is the purpose of the ABCDE protocol in trauma care?
To prevent deaths in the golden hour of trauma.
p.10
Fracture Healing Stages
What is indicated by an increase in alkaline phosphatase (ALP) during bone remodeling?
It indicates remodeling of broken bone.
p.7
Orthopaedic Trauma Management Techniques
What are the criteria for delaying wound closure?
If >6 hours, with neurovascular injury, edges cannot be approximated, or if not satisfied with debridement.
p.6
Open Fractures and Gustilo-Anderson Classification
What is the feature of a Type 3B open fracture?
Wound with periosteal stripping.
p.39
Pathological Fractures and Causes
What is a bipartite patella?
An anomaly where the patella has an accessory ossification center that does not fuse.
p.26
Orthopaedic Trauma Management Techniques
What is the 'terrible triad' of the elbow?
Posterior elbow dislocation, coronoid fracture, and radial head fracture.
p.7
Orthopaedic Trauma Management Techniques
What is the principle of the Ilizarov Ring Fixator?
Distraction osteogenesis/callotaxis with rings and pins.
p.44
Injuries Around the Knee and Shoulder
What are the common causes of rotator cuff injuries in the elderly and young?
Elderly: Degeneration; Young: Trauma.
p.26
Orthopaedic Trauma Management Techniques
What is 'Nursemaid’s elbow'?
Distal subluxation of the radial head out of the annular ligament in children <4-5 years.
p.4
Fracture Healing Stages
What is atrophic non-union?
Abnormal biology due to infections or ischemia, with no callus formation.
p.33
Orthopaedic Trauma Management Techniques
What happens to lumbar lordosis when flexing the normal hip in the Thomas test?
It disappears, revealing flexion contracture of the pathological hip.
p.17
Fracture Types and Diagnosis
What is the significance of 'banana fracture'?
It is a complication associated with the condition.
p.15
Metabolic Bone Disorders: Osteoporosis and Rickets
What are some secondary causes of osteoporosis?
Drugs (steroids, heparin), Cushing's syndrome, immobilization, weightlessness, rheumatoid arthritis.
p.41
Injuries Around the Knee and Shoulder
What forces do the MCL and LCL resist?
MCL resists valgus force and LCL resists varus force.
p.35
Fracture Types and Diagnosis
What are common symptoms of a neck of femur fracture?
Mild pain, pain in Scarpa’s triangle, shortening < 1 inch, external rotation < 45°.
p.37
Orthopaedic Trauma Management Techniques
What is the significance of the term 'active space' in orthopaedics?
It refers to the area of concern in managing hip fractures.
p.15
Fracture Types and Diagnosis
What deformities can occur due to spine fractures in osteoporosis?
Kyphosis, Codfish/Fish mouth vertebrae.
p.43
Injuries Around the Knee and Shoulder
What does a posterior drawer test assess?
Injury to the posterior cruciate ligament (PCL).
p.14
Metabolic Bone Disorders: Osteoporosis and Rickets
What is a common radiological feature of subperiosteal resorption?
Salt and pepper appearance or pepper pot appearance.
p.31
Fracture Types and Diagnosis
What is the characteristic of the DIP joint in Jersey finger?
The DIP remains in extension with an inability to flex.
p.41
Injuries Around the Knee and Shoulder
What does the ACL prevent?
Anterior translation of the tibia and hyperextension of the knee.
p.1
Bone Cells: Osteoblasts, Osteoclasts, and Osteocytes
What are the formation markers for bone?
Procollagen 1, osteocalcin, osteonectin, and ALP.
p.20
Orthopaedic Trauma Management Techniques
What are the indications for surgery in clavicle fractures?
Open clavicle fracture, massive displacement, involving acromioclavicular joint, and neurovascular injury.
p.3
Orthopaedic Trauma Management Techniques
What is Mirel’s criteria?
A scoring system used to determine the need for prophylactic fixation of fractures, requiring a score of �� 8.
p.16
Metabolic Bone Disorders: Osteoporosis and Rickets
What is the purpose of HRT in osteoporosis?
To manage post-menopausal symptoms and decrease bone resorption.
p.38
Fracture Healing Stages
What is the most common complication after a femur shaft fracture?
Stiffness of the knee joint.
p.23
Pathological Fractures and Causes
What is cubitus valgus deformity?
A condition where tardy ulnar nerve palsy occurs months after injury.
p.31
Fracture Types and Diagnosis
What is a Boxer's fracture?
An extra-articular fracture of the 5th metacarpal.
p.41
Injuries Around the Knee and Shoulder
What are the three types of stabilizers around the knee?
Extracapsular, intracapsular, and intrasynovial.
p.27
Fracture Types and Diagnosis
What is a Monteggia fracture?
A fracture of the ulna with radial head dislocation.
p.32
Fracture Types and Diagnosis
What does the visibility of the lesser trochanter indicate?
Just visible in neutral position, invisible in internal rotation, and completely visible in external rotation.
p.34
Pathological Fractures and Causes
What is a common complication of central fracture-dislocation?
Avascular Necrosis (6-12 hours).
p.38
Orthopaedic Trauma Management Techniques
What treatment is recommended for children aged 6 months to 5 years with femur fractures?
Hip spica cast or Gallows traction for those under 2 years or less than 12 kg.
p.3
Fracture Types and Diagnosis
What is the imaging of choice for stress fractures?
MRI, as X-rays may only show positive results after 2-3 weeks.
p.16
Orthopaedic Trauma Management Techniques
What procedure is used to restore height in vertebral compression fractures?
Vertebroplasty or Balloon Kyphoplasty.
p.27
Fracture Types and Diagnosis
What is the most commonly injured nerve in a Monteggia fracture?
Posterior Interosseous Nerve.
p.7
Orthopaedic Trauma Management Techniques
What is a spanning external fixator used for?
For fractures occurring around the joint.
p.44
Injuries Around the Knee and Shoulder
What does the Empty Can test assess?
The ability to abduct the shoulder against resistance.
p.33
Fracture Types and Diagnosis
What is the mechanism of injury in complex injuries?
Complex injury mechanism.
p.21
Fracture Types and Diagnosis
How is shoulder dislocation confirmed?
By X-ray, showing the head outside of the glenoid cavity.
p.27
Orthopaedic Trauma Management Techniques
What is the treatment for a Monteggia fracture?
Open Reduction and Internal Fixation (ORIF) with plates.
p.21
Orthopaedic Trauma Management Techniques
What is the Modified Kocher’s technique mnemonic?
TEAM: Traction, External rotation, Adduction, Medial rotation/internal rotation.
p.16
Metabolic Bone Disorders: Osteoporosis and Rickets
What is the common cause of Paget’s disease?
Idiopathic (most common).
p.21
Pathological Fractures and Causes
What causes a Bankart lesion?
Tear of the anterior part of the inferior glenohumeral ligament.
p.2
Fracture Types and Diagnosis
How can fractures be diagnosed clinically?
By abnormal bone movement.
p.40
Orthopaedic Trauma Management Techniques
What is the definitive management after swelling reduces for a calcaneum fracture?
Open Reduction and Internal Fixation (ORIF).
p.19
Injuries Around the Knee and Shoulder
What is the clinical presentation of a clavicle fracture?
Patient holds the injured arm and lifts it up by the opposite hand after a history of FOOSH injury.
p.10
Metabolic Bone Disorders: Osteoporosis and Rickets
What metabolic disorder is associated with hyperparathyroidism?
It affects minerals regulated by PTH.
p.43
Injuries Around the Knee and Shoulder
What is the healing potential of the white zone of the meniscus?
Injuries do not heal due to lack of blood supply.
p.25
Fracture Healing Stages
Which muscle is earliest affected by ischemia in Volkmann’s ischemic contracture?
Flexor digitorum profundus (FDP) muscle.
p.33
Orthopaedic Trauma Management Techniques
What does the Hugh Owen Thomas well leg raising test measure?
Flexion contracture or deformity of the hip.
p.17
Fracture Types and Diagnosis
What is the appearance of 'picture frame vertebrae' associated with?
Mixed phase of the condition.
p.1
Bone Cells: Osteoblasts, Osteoclasts, and Osteocytes
What is the composition of the osteoid matrix?
It is made up of collagen 1, osteocalcin, and osteonectin.
p.11
Metabolic Bone Disorders: Osteoporosis and Rickets
What is the effect of weight-bearing on infants regarding bone changes?
These changes are not seen in infants as there is no weight bearing.
p.14
Metabolic Bone Disorders: Osteoporosis and Rickets
What are the lab findings in renal osteodystrophy?
Calcium: ↓, PTH: ↑, PO4: ↑↑↑, ALP: ↑.
p.10
Bone Cells: Osteoblasts, Osteoclasts, and Osteocytes
What is the effect of increased osteoclast function?
It can lead to Paget’s disease.
p.42
Injuries Around the Knee and Shoulder
What is the significance of the medial meniscus being adherent to the MCL?
It affects the stability and injury patterns of the knee.
p.21
Orthopaedic Trauma Management Techniques
What is the purpose of Hamilton’s ruler test?
To assess shoulder dislocation.
p.9
Metabolic Bone Disorders: Osteoporosis and Rickets
What is the effect of 1-α Hydroxylase on calcium absorption?
It increases 1,25 dihydroxy vitamin D3, enhancing calcium absorption from the gastrointestinal tract.
p.14
Metabolic Bone Disorders: Osteoporosis and Rickets
What is Osteitis Fibrosa Cystica?
A condition associated with brown tumors due to increased osteoclastic activity.
p.27
Fracture Types and Diagnosis
What characterizes a Galleazzi fracture?
Dislocation or subluxation of the distal radio-ulnar joint (DRUJ) with a fracture of the radius.
p.40
Fracture Types and Diagnosis
Where does a Jones fracture occur?
At the metaphyseal–diaphyseal junction of the 5th metatarsal.
p.34
Orthopaedic Trauma Management Techniques
What are the typical limb positions in an anterior dislocation?
Flexion, abduction, external rotation, and limb lengthening.
p.38
Fracture Types and Diagnosis
What classification is used for femur shaft fractures?
Winquist & Hansen classification.
p.27
Injuries Around the Knee and Shoulder
What is the mechanism of injury (MOI) for Nursemaid’s elbow?
Elbow extended and pronated with axial traction.
p.3
Fracture Types and Diagnosis
What is a stress fracture?
A fracture caused by repetitive abnormal loading.
p.40
Fracture Types and Diagnosis
What happens to Bohler’s and Gissane’s angles in a calcaneum fracture?
Bohler’s angle is reduced and Gissane’s angle is increased.
p.20
Injuries Around the Knee and Shoulder
What is a clinical sign of acromio-clavicular disruption?
Step-like elevation of the lateral aspect of the shoulder.
p.39
Orthopaedic Trauma Management Techniques
What is the treatment for a tibia shaft fracture?
CRIF with POP application or CRIF with intramedullary interlocking nail/rod.
p.21
Orthopaedic Trauma Management Techniques
What are the symptoms of axillary nerve injury?
Weakness of Deltoid & Teres minor, paresthesia/pain tenderness in the Regimental badge area.
p.1
Bone Cells: Osteoblasts, Osteoclasts, and Osteocytes
What are the characteristics of osteoclasts?
They are multinucleated, phagocytic, and the least in number.
p.19
Injuries Around the Knee and Shoulder
How is the lateral fragment of a clavicle fracture displaced?
Pulled downwards by the weight of the limb and pectoralis muscle.
p.25
Bone Cells: Osteoblasts, Osteoclasts, and Osteocytes
What is the primary nerve injury order in forearm injuries?
Anterior interosseous > Median > Radial nerve.
p.31
Fracture Types and Diagnosis
What is Jersey finger caused by?
Avulsion of the flexor digitorum profundus tendon at the DIP joint due to hyperextension injury.
p.29
Fracture Types and Diagnosis
What is a Smith's fracture?
An extra-articular fracture with volar displacement, typically caused by a fall on an outstretched hand with the wrist in flexion.
p.25
Fracture Types and Diagnosis
What causes the gunstock deformity in malunion?
Medial tilt and internal rotation displacement.
p.44
Injuries Around the Knee and Shoulder
What does the Popeye sign indicate?
Pronounced bulging in the distal aspect of the biceps due to complete rupture.
p.20
Fracture Types and Diagnosis
What is the most common type of shoulder dislocation?
Anterior dislocation (90-98%).
p.9
Metabolic Bone Disorders: Osteoporosis and Rickets
How does the body reabsorb phosphate and calcium from urine?
Through hormonal regulation, particularly by PTH.
p.18
Fracture Types and Diagnosis
What are the characteristics of Type I/Classical banana fracture?
Autosomal dominant, multiple fractures, deformed bones, blue sclera, delayed dentition, easy bruising.
p.17
Pathological Fractures and Causes
What is a common complication associated with this condition?
High output cardiac failure.
p.40
Fracture Types and Diagnosis
What type of injury commonly causes a calcaneum fracture?
Fall from height landing on feet.
p.5
Avascular Necrosis and Its Management
What is the most common cause of avascular necrosis (AVN)?
Idiopathic (non-traumatic).
p.10
Metabolic Bone Disorders: Osteoporosis and Rickets
What condition is associated with a deficiency of vitamin D?
Rickets and osteomalacia.
p.12
Metabolic Bone Disorders: Osteoporosis and Rickets
What is the recommended daily Vitamin D dosage for Osteomalacia treatment?
2,000 - 5,000 IU for 4 - 6 weeks.
p.23
Fracture Types and Diagnosis
What is the Gartland classification Type 1?
An undisplaced fracture where the fracture line is not visible.
p.33
Fracture Types and Diagnosis
What are fracture dislocations?
Any attitude other than pure dislocation.
p.43
Injuries Around the Knee and Shoulder
What does the mnemonic SITS represent?
Supraspinatus, Infraspinatus, Teres minor, Subscapularis.
p.17
Pathological Fractures and Causes
Which cranial nerves can be compressed due to the condition?
Cranial nerves 2, 5, 7, and 8.
p.19
Injuries Around the Knee and Shoulder
How is the medial fragment of a clavicle fracture displaced?
Pulled upwards by the sternocleidomastoid muscle.
p.38
Pathological Fractures and Causes
What is the classical triad of symptoms for fat embolism syndrome?
Respiratory symptoms, neurological symptoms, and petechial rash.
p.43
Injuries Around the Knee and Shoulder
What is indicated by a painful or unhappy triad?
Injury to MCL, ACL, and medial meniscus.
p.7
Orthopaedic Trauma Management Techniques
Which external fixator is considered the most stable?
The multiplanar Ilizarov ring fixator.
p.9
Bone Cells: Osteoblasts, Osteoclasts, and Osteocytes
What is the role of RANK ligand in bone metabolism?
It activates osteoblasts.
p.39
Orthopaedic Trauma Management Techniques
What is the management approach for ankle fractures?
Specific management techniques vary based on the type of fracture.
p.41
Injuries Around the Knee and Shoulder
What is a bucket handle tear?
A common meniscal injury.
p.36
Fracture Healing Stages
What are some vascularization procedures for non-viable neck of femur fractures?
Fibular vascular graft, Meyers, Bakshi.
p.20
Basics of Bone Structure and Function
What muscles support the shoulder joint?
Rotator cuff muscles: supraspinatus, infraspinatus, teres minor, and subscapularis.
p.23
Fracture Types and Diagnosis
What is the most common mechanism of injury for a supracondylar humerus fracture?
Fall on an outstretched hand (FOOSH).
p.3
Fracture Healing Stages
What are the two types of fracture healing?
Primary healing (direct) and secondary healing (indirect).
p.34
Orthopaedic Trauma Management Techniques
What is the significance of limb length in dislocations?
Limb shortening in posterior dislocation and limb lengthening in anterior dislocation.
p.27
Fracture Types and Diagnosis
What are the symptoms of injury to the posterior interosseous nerve?
Finger drop and thumb drop without any sensory deficit.
p.39
Fracture Types and Diagnosis
What is a Pott's fracture?
A bimalleolar fracture involving the medial and lateral malleolus.
p.28
Orthopaedic Trauma Management Techniques
What are the treatment options for a Night stick fracture?
Closed reduction (CR) with a plaster of Paris (POP) cast or open reduction and internal fixation (ORIF) with plates.
p.38
Pathological Fractures and Causes
What is the recommended prevention strategy for fat embolism?
Immobilize and fix the fracture early.
p.38
Pathological Fractures and Causes
What supportive treatment is given for fat embolism syndrome?
Oxygen therapy and intermittent positive pressure ventilation (IPPV).
p.22
Fracture Types and Diagnosis
What is a Holstein Lewis fracture?
A fracture at the junction of the upper 2/3rd and lower 1/3rd of the humerus.
p.11
Metabolic Bone Disorders: Osteoporosis and Rickets
What is the most common cause of knee deformity in adults?
Rheumatoid Arthritis, leading to bilateral genu valgum.
p.42
Injuries Around the Knee and Shoulder
What is the purpose of Apley’s Grinding Test?
To assess meniscal injuries.
p.39
Pathological Fractures and Causes
What are shin splints?
Pain on the anteromedial aspect of the leg.
p.17
Fracture Types and Diagnosis
What does 'osteoporosis circumscripta' refer to?
A specific radiological finding in the lytic phase.
p.35
Fracture Types and Diagnosis
What is a common symptom of intertrochanteric fractures?
Moderate to severe pain in the trochanteric region.
p.41
Injuries Around the Knee and Shoulder
What is a common clinical sign of ACL injury?
Delayed effusion of the knee and difficulty going downstairs.
p.1
Bone Cells: Osteoblasts, Osteoclasts, and Osteocytes
What is the lifespan of osteocytes compared to other bone cells?
They have the longest lifespan.
p.38
Orthopaedic Trauma Management Techniques
What is the treatment for children aged 5 to 10 years with unstable femur fractures?
Flexible nails or plates.
p.28
Fracture Types and Diagnosis
What is the mechanism of injury (MOI) for a Night stick fracture?
Direct trauma to the forearm while in a defensive stance.
p.3
Fracture Healing Stages
What is the role of callus in fracture healing?
Callus forms due to micromovement at the fracture site and indicates relative stability.
p.17
Fracture Types and Diagnosis
What does the term 'cotton wool skull' describe?
A radiological appearance in the mixed phase.
p.20
Fracture Types and Diagnosis
What are the subtypes of anterior shoulder dislocation?
Preglenoid, subcoracoid (most common), subclavicular, and intrathoracic.
p.27
Orthopaedic Trauma Management Techniques
What is the reduction technique for Nursemaid’s elbow?
Flex the elbow and supinate.
p.1
Basics of Bone Structure and Function
What is the main mineral component of bone?
Hydroxyapatite, primarily composed of Ca2+ and PO42-.
p.41
Injuries Around the Knee and Shoulder
What are the roles of the cruciate ligaments?
They act as rotational stabilizers and shock absorbers.
p.28
Fracture Types and Diagnosis
What direction does the distal end of the radius face in a Colle's fracture?
Towards the palmar/volar side (lateral view).
p.28
Fracture Types and Diagnosis
What direction does the distal end of the radius face in a Smith's fracture?
Towards the ulnar side (AP view).
p.38
Pathological Fractures and Causes
What is the earliest sign of fat embolism according to Gurd's criteria?
Fat globules in urine (lipuria).
p.39
Fracture Types and Diagnosis
What is a Cotton's fracture?
A trimalleolar fracture involving the medial, lateral, and posterior malleolus.
p.1
Bone Cells: Osteoblasts, Osteoclasts, and Osteocytes
What are the breakdown markers for bone?
Hydroxy proline, hydroxy lysine, N & C telopeptide, and TRAP.
p.41
Injuries Around the Knee and Shoulder
What does the McMurray’s test assess?
Meniscal tears, indicated by pain or a click.
p.41
Injuries Around the Knee and Shoulder
What does the PCL prevent?
Posterior translation of the tibia and hyperflexion of the knee.
p.27
Fracture Types and Diagnosis
What can be injured if the DRUJ is disrupted?
Triangular fibrocartilage complex (TFCC).
