ABPS Orthopedic Surgery flashcards

31 cards. Read the term and the definition here. The deck at the top of this page is optional.

Salter-Harris type II

Fracture through the physis extending into the metaphysis; the most common pediatric physeal fracture pattern and generally good prognosis with anatomic reduction.

Compartment syndrome

Elevated pressure within a closed fascial compartment causing ischemia; hallmark is pain out of proportion and pain with passive stretch, not loss of pulses.

Gustilo-Anderson IIIC

Open fracture with arterial injury requiring vascular repair; highest severity grade, associated with high infection and amputation risk and requiring urgent combined orthopedic-vascular care.

Cauda equina syndrome

Compression of lumbar nerve roots causing saddle anesthesia, bladder or bowel dysfunction, and bilateral weakness; a surgical emergency needing urgent MRI and decompression.

Radial nerve palsy

Wrist drop and impaired thumb extension; classically associated with humeral shaft fractures, often a neurapraxia that may recover with observation.

Axillary nerve injury

Deltoid weakness and decreased sensation over the lateral shoulder; associated with surgical neck humerus fractures and anterior shoulder dislocations.

Peroneal nerve palsy

Foot drop with impaired dorsiflexion and sensation over the lateral leg; associated with fibular neck fractures and knee dislocations.

Septic arthritis

Joint infection presenting with fever, joint pain, and refusal to bear weight; diagnosis by aspiration with elevated white count and positive Gram stain or culture.

Osteomyelitis pathogen

Staphylococcus aureus is the most common cause of bone infection; Salmonella is classically linked to sickle cell disease and Pseudomonas to puncture wounds.

Bone healing phases

Sequence of inflammation, soft callus, hard callus, and remodeling; smoking, NSAIDs, and infection impair progression to union.

Lachman test

Anterior cruciate ligament assessment performed at about 30 degrees of knee flexion; the most sensitive examination maneuver for ACL deficiency.

McMurray test

Knee maneuver applying rotation with flexion and extension to elicit a click or pain, suggesting a meniscal tear; specificity exceeds sensitivity.

Ottawa ankle rules

Imaging indicated for ankle injury with malleolar pain plus bone tenderness at specified sites or inability to bear weight four steps.

Open fracture antibiotics

Early intravenous antibiotics covering gram-positive organisms, with broader coverage for higher Gustilo grades, plus tetanus prophylaxis and urgent irrigation and debridement.

Delta pressure

Diastolic blood pressure minus measured compartment pressure; a value of 30 mmHg or less suggests compartment syndrome and supports fasciotomy.

Displaced femoral neck fracture

In elderly patients, arthroplasty (hemiarthroplasty or total hip) is preferred over internal fixation because of high rates of avascular necrosis and nonunion.

Intertrochanteric fracture

Extracapsular proximal femur fracture typically treated with cephalomedullary nailing or a sliding hip screw; blood loss can be substantial.

Antibiotic prophylaxis timing

Administer prophylactic antibiotic within 60 minutes before surgical incision; redose intraoperatively for prolonged cases or major blood loss.

Informed consent elements

Document diagnosis, proposed procedure, material risks, benefits, alternatives including no treatment, and confirmation the patient's questions were answered.

Case presentation structure

Oral case format: mechanism and history, focused physical exam, imaging findings, differential diagnosis, definitive management plan, and anticipated complications.

Pediatric remodeling potential

Younger patients and fractures near the physis remodel more; acceptable displacement depends on age, bone, and whether the physis is involved.

VTE prophylaxis arthroplasty

After major lower-limb arthroplasty, combine mechanical and pharmacologic prophylaxis per risk stratification, balancing bleeding risk against clot prevention.

Pain with passive stretch

Stretching the muscles of a compartment reproduces severe pain; a key clinical sign of compartment syndrome that precedes late findings like pulselessness.

Varus and valgus stress

Collateral ligament testing at about 30 degrees of knee flexion; laxity indicates medial or lateral collateral ligament injury respectively.

Neurovascular exam documentation

Record pulses, capillary refill, sensation, and motor function before and after reduction or splinting to detect changes requiring urgent intervention.

Saddle anesthesia

Reduced sensation in the perineal and inner thigh distribution; a red-flag finding for cauda equina syndrome requiring urgent imaging and decompression.

Joint aspiration

Diagnostic aspiration of a swollen joint for cell count, crystals, Gram stain, and culture; distinguishes septic arthritis from gout and inflammatory arthritis.

Smoking and bone union

Nicotine impairs osteogenesis and blood flow, increasing nonunion and infection risk; cessation counseling is part of fracture and fusion management.

Hard callus stage

Later healing phase in which mineralized callus bridges the fracture, providing clinical stability before final remodeling restores normal architecture.

Salmonella osteomyelitis

Bone infection classically associated with sickle cell disease; consider this organism and obtain cultures before starting empiric antibiotics.

Fasciotomy indication

Urgent surgical release of fascial compartments for compartment syndrome; delay risks muscle necrosis, nerve injury, and limb loss.