Orthopedic Surgery Quiz

Orthopaedic Nomenclature

• Sprain: Injury to a ligament.
• Strain: Injury to a muscle.
• Subluxation: Partial dislocation of articular surfaces of a joint.
• Dislocation: Complete displacement of articular surfaces of a joint.
• Osteoarthritis: Degenerative condition causing inflammation, cartilage breakdown, and new bone formation.
• Osteochondritis dissecans: Injury to the joint surface of a bone, often from trauma, involving detachment of the subchondral bone and its cartilage.
• Tendinitis: Acute inflammation of a tendon.
• Tendonosis/tendonopathy: Degenerative breakdown of a tendon.
• Bursitis: Inflammation of a synovial sac (bursa).
• Spondylolisthesis: Abnormal forward translation of one vertebra on another.
• Spondylolysis: Fracture of the pars interarticularis of a vertebra, usually resulting from repetitive stress.
• Spondylosis: Osteoarthritis of the spine.

Movement

• Abduction: Movement away from the body's midline.
• Adduction: Movement towards the body's midline.
• Eversion: Rotation of the foot and ankle outward.
• Inversion: Rotation of the foot and ankle inward.
• Pronation: Rotary movement of the forearm, palm faces inferiorly.
• Supination: Rotary movement of the forearm, palm faces superiorly.

Procedures

• Debridement: Surgical removal of contaminated or necrotic tissue.
• Arthrocentesis: Aspiration of synovial fluid from a joint using a needle.
• Arthroscopy: Minimally invasive surgical technique using a small camera to diagnose and treat joint conditions.
• Arthrotomy: Surgical incision into a joint through the capsule.
• Arthrodesis: Surgical fusion of a joint.
• Open reduction: Surgical incision with visualization of the fracture site.
• Closed reduction: Reduction of fracture without surgical incision.

Principles of fracture management

• Open Fractures: Sometimes external fixation is needed but always requires surgery.
• Intra-articular fractures
• Diaphyseal fractures: of long bones (Femur, Tibia, Radius/Ulna, Humerus).
• Fractures in polytrauma patients:
• Fracture-dislocations: of joints (dislocations associated with a periarticular fracture).

Open fractures (NB)

• Definition: Any fracture where the fracture haematoma communicates with the external environment.
• Management: Analgesia (Morphine IV) Anti-tetanus (prophylaxis) Antibiotics

Gustilo and Anderson classification (Open Fracture)

• Type I: Wound less than 1 cm; minimal contamination and soft-tissue injury; simple fracture.
• Type II: Wound 1 to 10 cm; moderate comminution and contamination.
• Type IIIA: Minimal periosteal stripping; soft-tissue coverage required.
• Type IIIB: Significant periosteal stripping; soft-tissue coverage needed.
• Type IIIC: Indicates an associated repairable vascular injury.

Compartment syndrome (NB)

• Description of what a compartment syndrome is: Excessive pressure in a confined muscle compartment leading to potentially serious complications.
• Diagnosis: Physical examination, measurement of compartmental pressures, and evaluation with imaging
• Causes, and implications
• Possible treatments & prevention
• Possible complications and risk factors

Fat embolism syndrome (NB)

• Definition: Inflammatory response to embolized fat globules, often accompanying fracture.
• Characteristics: ARDS (Acute respiratory distress syndrome), encephalopathy, petechiae, DIC (diffuse intravascular coagulopathy).
• Pathogenesis: Mechanical and metabolic theories propose causes of fat embolism.
• Diagnosis: Clinical presentation, including symptoms and signs.
• Management: Supportive treatment.

Procedures of fracture management

• Surgical treatment: Open reduction and internal fixation (ORIF) and external fixation are common surgical techniques. ORIF is the surgical fixation of a fracture using plates, screws, or other devices to immobilize the bone. External fixation uses pins placed outside the skin to hold the fragments in place.

Specific fractures, dislocations and injuries

• Middle 1/3rd clavicle fracture: fracture
• Shoulder Dislocation: Characterized by the dislocation of the shoulder joint. (Anterior, Posterior, Inferior)
• Proximal humerus fractures.
• Humerus shaft fractures:
• Distal humerus fracture:
• Radial head fractures:
• Olecranon fractures:
• Radius and ulna shaft fractures
• Galleazzi fractures: Combination of Radius and Ulna injuries.
• Monteggia fractures: ulna fracture with radial head dislocation.
• Nightstick fracture: Isolated ulna shaft fracture.
• Radial styloid (shear) fracture (a.k.a. Chauffeur's fracture)
• Dorsal Barton (shear/distal radius)
• Extra-articular (metaphyseal bending) distal radius fracture.
• Scaphoid fracture
• Boxer's fracture
• Metacarpal fractures
• Bennett's fracture: Fracture of the base of the 1st metacarpal (intra-articular, oblique pattern).
• Phalanx fractures: fractures to the bones in your fingers (Management varies depending on specific injury).
• Peripheral nerve injuries: damage to various nerves in the hand (Median,Ulnar, Radial)

Spinal Injuries

• Important definitions
• Causes
• Types of spinal trauma
• Common symptoms that arise from spinal injuries
• Diagnosis process, and possible tests
• Treatment and outcomes

Knee dislocations

• Associated injuries: Multiple ligament injuries
• High risk: of popliteal artery injury
• Tibial plateau fractures: (Fracture-dislocations)
• Compartment syndrome: in lower leg
• Immediate closed reduction in casualties is needed

Tibia shaft fracture

• Associations: Most common open fractures, compartments syndrome

Ankle fractures

• Danis-Weber classification: Type A, B and C

Lateral ankle ligament injuries (sprains)

• Grades: I, II, and III
• RICE and immobilization.

Paediatric Orthopaedic Trauma

• Greenstick fracture: one cortex in tension and the other intact

Femur shaft fracture

• Associations: High energy injury (typically younger patients) – look for other injuries.

Distal femur fracture

• Definitive management: ORIF (nail or plate)

Patella dislocaitons

• Associations: Hyperlaxity, recurrent dislocations.
• Management:
• Reduce patella
• MRI recommended
• Above-knee backslab for a period of time
• Physiotherapy, as soon as tolerated, can begin.

Pelvis Fractures

• Associated injuries: Bleeding, bowel injury.
• Initial management: ATLS approach, reduce hemorrhage, bind pelvis.
• Criteria for determining instability.

Hip dislocaitons

• Types: Posterior, Anterior
• Associations: Sciatic nerve damage, Acetabulum fractures
• Initial treatment: Emergency reduction in emergency department

Orthopaedic Nomenclature

• General terms with an orthopaedic and anatomical focus.

Test your knowledge on key concepts in orthopedic surgery. This quiz covers topics such as Open Reduction and Internal Fixation (ORIF), external fixation, internal fixation devices, and management of fractures. Ideal for medical students and healthcare professionals looking to reinforce their understanding of orthopedic procedures.