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Trauma + Orthopaedics > 2: Simple Practical Procedures > Flashcards

2: Simple Practical Procedures Flashcards

1
Q

What are the 3 principles of fracture management

A
  1. Reduce
  2. Hold
  3. Rehabilitate
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2
Q

What is reduction of a fracture

A

Fractures are re-aligned

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3
Q

What is immobilisation

A

A joint or bone is held in place using a splint, cast or brace

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4
Q

What is the purpose of immobilisation

A

To protect damaged structures and prevent further damage

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5
Q

What is the most common method of immobilisation

A

Splint or plaster cast

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6
Q

What type of cast should not be used in the first 2W following a fracture and why

A

Circumfrential cast

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7
Q

What type of case should be used in the first 2W

A

Back-slab cast

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8
Q

When is a total hip replacement indicated

A

OA of the hip

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9
Q

What structure are approaches for total hip replacement referenced to

A

Gluteus medius

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10
Q

What are the approaches for total hip replacement

A
  • Anterior
  • Anterolateral
  • Lateral
  • Posterior
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11
Q

What is the most common approach for total hip replacement

A

Posterior

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12
Q

What is the main advantage of posterior approach

A

Does not disrupt the hip abductors and therefore enables quick recovery

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13
Q

What is the main disadvantage of the posterior approach

A

Increased risk of damaging sciatic nerve

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14
Q

What are the main advantages of the anterior approach

A

Avoids abductor muscles permitting quick recovery

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15
Q

What is the main disadvantage of the anterior approach

A

There is a 10% risk of loss of sensation over distribution of the lateral femoral cutaneous nerve

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16
Q

Explain what happens in the anterolateral approach

A

The abductors are removed and excessive adduction to expose the acetabulum

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17
Q

What is the advtange of the anterolateral approach

A

It does not disrupt the superior reticular vessels and therefore reduces risk of avascular necrosis

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18
Q

What are disadvantages of anterolateral approach

A

Slow recovery

Risk of damage to superior gluteal nerve

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19
Q

What is the advantage of lateral approach

A

Lower dislocation rate

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20
Q

What is the main disadvantage of the lateral approach

A

Abductors are disrupted - resulting in longer recovery

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21
Q

Explain approach of total knee arthroplasty

A

There is a cap approached to femur and tibia with a plastic space between

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22
Q

What is arthroscopy

A

small incision is made in the joint and endoscope used to visualise within the joint

23
Q

What procedure can arthroscopy be used for

A

meniscectomy

24
Q

How can a tear in the outer 1/3 of the meniscus be repaired

A

sutured - due to being highly vascular

25
Q

How can a tear in the inner 1/3 of the meniscus be repaired

A

trimmed - due to being avascular

26
Q

How can a tear in the middle 1/3 be repaired

A

sutured or trimmed

27
Q

Explain ACL reconstruction

A

Surgical tissue graft is used to replace the ACL ligament. Native ACL can either be removed (more common) or the graft can be sewn inside

28
Q

What is used to perform an ACL reconstruction

A

Arthroscopy

29
Q

What can be used as autografts for ACL repair

A
  • Patella ligament

- Hamstring tendon

30
Q

What can be used as allografts for ACL repair

A

Following from a cadaver:

  • Patella ligament
  • Tibialis anterior tendon
  • Achilles tendon
31
Q

When is a reverse shoulder replacement indicated

A

If the rotator cuff muscles are torn (or rotator cuff arthropathy)

32
Q

What is wound debridement

A

surgical removal of devitalised tissue

33
Q

What is carpal tunnel decompression

A

flexor retinaculum is cut releasing pressure on the median nerve

34
Q

What are 5 complications of carpal tunnel syndrome

A 
Infection 
Trigger thumb 
Scar
Nerve damage 
Incomplete decompression
35
Q

What is open reduction

A

Fracture fragments are surgically exposed by dissecting tissues and reduced. Often accompanied by internal fixation

36
Q

When is open reduction with internal fixation performed

A
  • Open Fracture
  • Pathological Fracture
  • Fracture w/neurovascular compromise
37
Q

What are 3 risks of ORIF

A
  • Infection
  • Neurovascular injury
  • Malunion
38
Q

What is closed reduction

A

Manipulation of fragments without surgical exposure

39
Q

What are 3 advantages of closed reduction

A
  • Lower risk of infection
  • Removes skin tension and reduces swelling
  • Quick healing
40
Q

What are 2 disadvantages of closed reduction

A
  • Neurovascular injury

- VTE

41
Q

What are kitschier wires

A

Thin flexible wires used to hold fracture fragments together as a temporary measure of open reduction and internal fixation

42
Q

What are plates

A

Internal splints that hold parts of broken bone together. May be left in place or removed following healing.

43
Q

What is intra-medullary nailing

A

A metal rod is nailed into medullary cavity following long bone fracture

44
Q

What are the 5 types of complete fracture

A
  1. Transverse
  2. Oblique
  3. Spiral
  4. Comminuted
  5. Segmental
45
Q

What is a transverse fracture

A

complete fracture horizontal to the long axis

46
Q

What is an oblique fracture

A

fracture oblique to long axis of the bone

47
Q

What is a spiral fracture

A

severe oblique fracture with rotation along the long axis

48
Q

What is a comminuted fracture

A

fracture into more than 2 segments

49
Q

What is a segmental fracture

A

More than two fractures within a long bone

50
Q

What is a salter-harris fracture

A

Fracture of a growth plate

51
Q

What are 3 types of incomplete fracture

A
  • Greenstick
  • Bowing
  • Buckle
52
Q

What is bowing

A

bending of a bone

53
Q

What is buckle fracture

A

fracture on concave aspect of bone

54
Q

What is a green-stick fracture

A

fracture on convex aspect of bone

Trauma + Orthopaedics (11 decks)

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