Arab Board Orthopedic Surgery Clinical flashcards
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32 cards. Read the term and the definition here. The deck at the top of this page is optional.
- Compartment syndrome pressure
- A compartment pressure greater than 30 mmHg or within 30 mmHg of diastolic pressure indicates compartment syndrome and requires emergent fasciotomy.
- Gustilo-Anderson classification
- Grades open fractures: I clean wound <1 cm, II 1-10 cm without extensive soft tissue damage, III >10 cm or high-energy; III subdivided A, B, C.
- Neck of femur management
- Intracapsular displaced femoral neck fractures in elderly are treated with arthroplasty; extracapsular fractures are treated with intramedullary nailing or dynamic hip screw.
- Cup inclination and anteversion
- In total hip arthroplasty, the acetabular cup should be placed at 40-45 degrees inclination and 15-20 degrees anteversion to optimize stability and wear.
- Periprosthetic joint infection criteria
- Major criteria: sinus tract communicating with joint or two positive cultures with same organism; minor criteria include elevated CRP, ESR, synovial WBC, and alpha-defensin.
- Aseptic loosening signs
- Progressive radiolucent lines >2 mm, component migration, cement mantle fracture, or osteolysis around implant indicate aseptic loosening.
- Cauda equina syndrome
- Saddle anesthesia, bowel/bladder dysfunction, and bilateral leg pain require emergent MRI and decompression within 24-48 hours to prevent permanent deficits.
- TLICS score
- Thoracolumbar Injury Classification and Severity score: ≥5 operative, ≤3 nonoperative, 4 either; based on morphology, posterior ligamentous complex, and neurology.
- Cobb angle progression
- In adolescent idiopathic scoliosis, a Cobb angle >45-50 degrees with skeletal immaturity indicates high risk of progression and often requires surgical fusion.
- ACL reconstruction graft options
- Common grafts include hamstring, patellar tendon, and quadriceps tendon; each has trade-offs in donor site morbidity, fixation, and graft strength.
- Bankart and Hill-Sachs lesions
- Bankart is labral tear at anteroinferior glenoid; Hill-Sachs is impaction fracture of posterolateral humeral head; both seen in anterior shoulder instability.
- Meniscal tear management
- Peripheral tears in the vascular red-red zone may be repaired; unstable or degenerative tears are treated with partial meniscectomy to relieve symptoms.
- DDH Ortolani and Barlow
- Ortolani maneuver reduces a dislocated hip; Barlow maneuver dislocates a reducible hip; used for neonatal screening of developmental dysplasia of the hip.
- Ponseti method
- Serial casting, Achilles tenotomy, and bracing is the first-line treatment for idiopathic clubfoot, achieving correction in most cases.
- SCFE stable vs unstable
- Stable slipped capital femoral epiphysis can bear weight; unstable cannot; stable treated with in situ pinning, unstable with urgent reduction and pinning.
- Carpal tunnel syndrome
- Median nerve compression at wrist causing nocturnal paresthesia and thenar atrophy; diagnosis by EMG/NCS; treatment is transverse carpal ligament release.
- Scaphoid fracture risk
- Most occur at waist; risk of nonunion and avascular necrosis, especially proximal pole; immobilization and follow-up imaging are essential.
- Dupuytren contracture treatment
- Palmar fibromatosis causing finger contracture; treatment indicated for MCP contracture >30 degrees or any PIP contracture; options include fasciectomy, needle aponeurotomy, collagenase.
- Ankle sprain management
- Lateral ligament sprain treated with functional rehabilitation; chronic instability may require Broström ligament repair.
- Achilles tendon rupture
- Acute rupture in active patients treated with surgical repair; sedentary patients may be treated nonoperatively with functional bracing.
- Hallux valgus surgery
- Intermetatarsal angle >15 degrees and hallux valgus angle >30 degrees often require first metatarsal osteotomy for correction.
- Osteosarcoma features
- Most common primary malignant bone tumor in children; metaphysis of long bones; treated with neoadjuvant chemotherapy and surgery.
- Giant cell tumor
- Benign aggressive tumor at epiphysis of long bones; soap-bubble appearance; treated with intralesional curettage and adjuvants.
- Mirels score
- Predicts risk of pathologic fracture in metastatic bone disease based on site, pain, lesion type, and size; score ≥9 indicates prophylactic fixation.
- Septic arthritis management
- Urgent joint aspiration, empiric IV antibiotics, and surgical drainage; in children, Kocher criteria aid diagnosis.
- Osteoporosis diagnosis
- DEXA T-score ≤ -2.5 defines osteoporosis; FRAX estimates fracture risk; treatment includes bisphosphonates, denosumab, or teriparatide.
- Paget disease of bone
- Disorder of increased bone turnover with elevated alkaline phosphatase, bone pain, and deformities; treated with bisphosphonates.
- Bone healing modes
- Primary healing occurs with rigid fixation and no callus; secondary healing involves callus formation and occurs with micromotion and less stability.
- Stress and strain
- Stress is force per unit area; strain is change in length divided by original length; Young's modulus is the ratio of stress to strain in elastic region.
- Antibiotic prophylaxis timing
- Prophylactic antibiotics should be administered within 1 hour before surgical incision; cefazolin is typical, with vancomycin for MRSA colonization.
- Informed consent elements
- Discussion of risks, benefits, alternatives, and consequences of refusal; documentation of patient understanding and voluntary agreement.
- Patient safety time-out
- A preoperative team pause to confirm patient identity, procedure, site, and side; part of WHO surgical safety checklist to prevent wrong-site surgery.