ABOS Orthopaedic Surgery Part II flashcards
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32 cards. Read the term and the definition here. The deck at the top of this page is optional.
- Lachman test
- Knee flexed 20-30 degrees; anterior tibial translation with a soft endpoint indicates ACL deficiency. It is the most sensitive clinical test for ACL tear.
- Thompson test
- With the patient prone, squeezing the calf produces no plantarflexion when the Achilles tendon is ruptured. It is highly sensitive for complete Achilles rupture.
- Ortolani maneuver
- In infant hip screening, the maneuver reduces a dislocated femoral head into the acetabulum, producing a palpable clunk. It detects developmental dysplasia of the hip.
- Gartland classification
- Grades supracondylar humerus fractures in children: type I nondisplaced, type II displaced with intact posterior cortex, type III completely displaced, type IV unstable in all directions.
- Salter-Harris types
- Physeal fracture classification I through V: I through the physis, II through physis and metaphysis, III through physis and epiphysis, IV through both, V crush injury.
- Enneking staging
- Musculoskeletal tumor staging: stage I low grade, II high grade, III metastatic; A intracompartmental and B extracompartmental. Guides limb-salvage versus amputation.
- Codman triangle
- A periosteal reaction in which elevated periosteum forms an angle at the tumor margin. It suggests an aggressive bone lesion such as osteosarcoma.
- Mirels score
- Predicts pathologic fracture risk in metastatic bone disease using site, pain, lesion type, and size. A score of 9 or higher generally warrants prophylactic fixation.
- Scaphoid blood supply
- The scaphoid receives retrograde blood flow entering distally, so proximal pole fractures risk avascular necrosis and nonunion.
- Bennett fracture
- An intra-articular fracture of the base of the first metacarpal with subluxation, caused by an axial load. It is treated with closed pinning or screw fixation.
- Kienbock disease
- Avascular necrosis of the lunate, associated with negative ulnar variance. It presents with dorsal wrist pain and is staged radiographically.
- Dupuytren contracture
- Fibroproliferative disease of the palmar fascia causing nodules and cords. A positive tabletop test, inability to lay the hand flat, indicates surgical release.
- Bankart lesion
- Detachment of the anteroinferior labrum from the glenoid, commonly after anterior shoulder dislocation. It is a key target of stabilization surgery.
- Hill-Sachs lesion
- A posterolateral humeral head impaction fracture created when the head engages the anterior glenoid during dislocation. It is associated with anterior instability.
- Terrible triad
- Elbow dislocation combined with radial head and coronoid fractures. Treatment requires restoration of the lateral collateral ligament complex and bony stability.
- Cauda equina syndrome
- Compression of the lumbosacral nerve roots causing saddle anesthesia and bowel or bladder dysfunction. It requires emergent MRI and surgical decompression.
- Meyerding grading
- Grades spondylolisthesis by the percentage of superior vertebral slip over the inferior vertebra: I is 0-25%, II 26-50%, III 51-75%, IV 76-100%, V spondyloptosis.
- Hoffman sign
- Flicking the distal phalanx of the middle finger produces thumb flexion, indicating upper motor neuron dysfunction. It suggests cervical myelopathy.
- Gustilo-Anderson
- Classifies open fractures by wound size, soft tissue injury, and contamination. Higher grades carry greater infection risk and require more aggressive debridement.
- Compartment pressure threshold
- A compartment pressure greater than 30 mmHg, or within 30 mmHg of diastolic pressure, with clinical signs warrants emergent fasciotomy.
- Colles versus Smith
- Colles fracture is a distal radius fracture with dorsal displacement; Smith fracture has volar displacement. Both are commonly treated with reduction and fixation.
- Piriformis entry point
- The starting point for antegrade femoral intramedullary nailing, located at the base of the greater trochanter. It aligns the nail with the femoral canal.
- Ficat staging
- Stages osteonecrosis of the femoral head: I normal radiograph, II sclerosis, III crescent sign and collapse, IV secondary acetabular arthritis.
- Modified MSIS criteria
- Periprosthetic joint infection criteria include a sinus tract communicating with the joint or two positive cultures with identical organisms, plus minor serum and synovial criteria.
- Dorr classification
- Assesses proximal femoral bone quality for arthroplasty: type A has thick cortices, type C is osteoporotic with a wide canal requiring diaphyseal-engaging stems.
- Weber ankle classification
- Classifies distal fibula fractures relative to the syndesmosis: type A below, type B at the level, type C above. Type C implies syndesmotic injury.
- Lisfranc interval
- A widened space between the base of the second metatarsal and the medial cuneiform on weight-bearing films indicates a Lisfranc ligament injury.
- Wolff law
- Bone remodels along lines of mechanical stress, adding mass where loaded and resorbing where unloaded. It explains stress shielding around stiff implants.
- Primary bone healing
- Direct healing without callus occurs when fracture fragments are rigidly compressed, with osteons crossing the gap. It requires stable fixation.
- Time-out procedure
- A preoperative pause verifying patient identity, procedure, site, side, and consent before incision. It is a core wrong-site surgery prevention measure.
- Informed consent elements
- Disclosure of diagnosis, proposed treatment, risks, benefits, reasonable alternatives, and consequences of refusal. The patient must be competent and voluntarily agree.
- Pivot shift test
- A dynamic test for ACL deficiency in which the tibia reduces from anterior subluxation as the knee is brought into extension. It is specific but less sensitive than Lachman.