Arab Board Orthopedic Surgery Clinical key terms

Raised pressure within a closed fascial compartment that compromises capillary perfusion and threatens muscle and nerve viability. Presents with pain out of proportion, pain on passive stretch, and tense swelling; pulselessness is a late finding.

The difference between diastolic blood pressure and measured compartment pressure. A value of 30 mmHg or less is commonly used as a threshold supporting urgent fasciotomy in a clinically suspicious limb.

Surgical division of fascia and skin over an affected compartment to restore perfusion in compartment syndrome. Wounds are usually left open initially and closed secondarily or with skin grafting once swelling resolves.

A staged strategy in severely injured patients where temporary stabilization of fractures (external fixation, traction, spanning devices) is performed to limit surgical insult, with definitive fixation deferred until physiology has recovered.

A device using pins or wires inserted into bone and connected by clamps and bars outside the limb to hold fractures or osteotomies. Commonly used for open fractures, damage control, limb lengthening, and arthrodesis.

Failure of a fracture to heal within the expected time with no further prospect of union without intervention, typically showing no progression on serial radiographs and persistent pain on loading.

A nonunion with abundant callus but a persistent radiolucent line, indicating adequate biology but insufficient mechanical stability. Treatment is usually improved stabilization rather than bone grafting.

A nonunion with absent or minimal callus and rounded, sclerotic bone ends, reflecting deficient biology. Management typically requires débridement of fibrous tissue plus bone grafting and stable fixation.

A grading of open fractures by wound size, soft tissue injury, and contamination, from type I (clean wound under 1 cm) to type IIIC (arterial injury requiring repair), guiding antibiotic choice and urgency of débridement.

A fracture communicating with the external environment through a skin and soft tissue breach. Requires early intravenous antibiotics, tetanus assessment, wound débridement, and stable fixation to reduce deep infection risk.

Early intravenous antibiotics given to reduce infection after an open fracture, typically a first-generation cephalosporin, with an aminoglycoside added for severe contamination and penicillin for soil or farm injuries.

Failure of a prosthetic implant fixation without infection, driven by particle wear, macrophage activation, osteolysis, and progressive radiolucent lines. It is the commonest cause of late revision arthroplasty.

Infection involving a joint prosthesis and surrounding tissue, diagnosed using clinical features, inflammatory markers, synovial fluid analysis, and cultures. Management ranges from débridement with implant retention to staged exchange arthroplasty.

A temporary cement implant releasing high local antibiotic concentrations, used after removal of an infected prosthesis to maintain joint space, deliver drugs, and preserve soft tissue tension before reimplantation.

A strategy for chronic prosthetic joint infection: implant and cement removal with débridement, a temporary antibiotic spacer, a course of systemic antibiotics, then reimplantation once infection markers have normalized.

Progressive bone loss around an implant caused by an inflammatory response to wear particles, producing lytic lesions and risking implant loosening or periprosthetic fracture. Often asymptomatic until advanced.

A fracture occurring near or around an orthopedic implant, usually from low-energy trauma in osteopenic bone. Treatment depends on implant stability, fracture pattern, and bone quality, ranging from fixation to revision arthroplasty.

Compression of the lumbosacral nerve roots causing saddle anesthesia, bladder or bowel dysfunction, and variable leg weakness. It is a surgical emergency requiring urgent decompression to limit permanent deficit.

Clinical features suggesting serious spinal pathology rather than mechanical pain, including night pain, fever, weight loss, neurological deficit, sphincter disturbance, trauma history, and cancer history.

Infection of an intervertebral disc and adjacent vertebral bodies, usually hematogenous, presenting with back pain, fever, and elevated inflammatory markers. Diagnosis uses blood cultures and imaging; treatment is prolonged antibiotics with surgery for instability or abscess.

A lateral curvature of the spine with vertebral rotation, defined by a Cobb angle greater than 10 degrees. Classified as idiopathic, congenital, or neuromuscular, with treatment based on magnitude and remaining growth.

The radiographic measure of spinal curvature, taken between the endplates of the most tilted vertebrae above and below the curve. It quantifies severity and guides bracing and surgical decisions.

A three-dimensional spinal deformity of unknown cause arising in otherwise healthy children around the adolescent growth spurt. Management depends on curve size and growth remaining, using observation, bracing, or fusion surgery.

Disruption of the ligament restraining anterior tibial translation, typically from a noncontact pivoting injury with a pop, swelling, and instability. Treatment is rehabilitation with or without reconstruction depending on demands and instability.

A clinical test for anterior cruciate ligament integrity performed with the knee slightly flexed, assessing anterior tibial translation and endpoint quality. It is more sensitive than the anterior drawer test.

A tear of the knee meniscus, causing joint line pain, swelling, and mechanical catching. Management favors repair or conservative care where possible because meniscal preservation reduces later osteoarthritis risk.

A spectrum of abnormal hip development ranging from instability to frank dislocation, screened for by clinical examination and ultrasound in infancy. Early treatment with bracing usually avoids later surgery.

A clinical maneuver in infants where the flexed hip is abducted and lifted anteriorly to reduce a dislocated femoral head, felt as a clunk. It detects a dislocated but reducible hip.

A dynamic abduction brace used in infants with developmental dysplasia of the hip, holding the hips flexed and abducted to promote reduction. Success is highest when started early and requires monitoring for complications.

A common pediatric elbow fracture, usually from a fall on an outstretched hand, classified by displacement. It risks neurovascular injury and compartment syndrome and often requires closed reduction and pinning.

A grading of pediatric supracondylar humeral fractures from type I (undisplaced) to type III (completely displaced with no cortical contact), with type IV added for unstable fractures in all directions.

A fracture of the carpal scaphoid, usually after a fall on the outstretched hand, presenting with radial wrist tenderness and often occult on early radiographs. It risks nonunion and avascular necrosis of the proximal pole.

Compression of the median nerve within the carpal tunnel causing nocturnal numbness, thenar weakness, and sensory loss in the median distribution. Diagnosis is clinical with nerve conduction support; treatment ranges from splinting to release.

Fibroproliferative thickening of the palmar fascia producing nodules and cords that cause progressive finger flexion contracture, most often at the ring and little fingers. Treatment is surgical or percutaneous release when function is impaired.

Inflammation and thickening of a flexor tendon sheath causing painful catching or locking of a digit, often at the A1 pulley. Treatment includes splinting, corticosteroid injection, and surgical pulley release.

A system classifying ankle fractures by the level of the fibular fracture relative to the syndesmosis: type A below, type B at the level, and type C above. It predicts syndesmotic injury and guides fixation.

A proximal fibular fracture associated with a medial ankle injury and disruption of the distal tibiofibular syndesmosis, often with a medial malleolar fracture or deltoid ligament tear. It requires assessment of the whole fibula.

Disruption of the distal tibiofibular ligaments, causing ankle instability and widening of the mortise. It is assessed by stress testing and imaging and treated with screw or tightrope fixation when unstable.

A primary malignant bone-forming tumor occurring mainly in adolescents, typically in the metaphysis of long bones around the knee. It presents with pain and swelling and is treated with neoadjuvant chemotherapy and wide resection.

A surgical staging system for musculoskeletal tumors based on grade, local extent, and presence of metastasis, guiding the choice between limb salvage and amputation and the margin required.

Removal of a tumor with a cuff of normal tissue beyond the reactive zone, aiming to prevent local recurrence in sarcomas while preserving as much function as possible.

A fracture through bone weakened by a focal lesion such as a tumor, cyst, or metastasis, or by diffuse disease. Management considers the underlying pathology, expected survival, and need for stabilization.

A skeletal disorder of reduced bone mass and microarchitectural deterioration causing fragility fractures. Diagnosis uses bone mineral density and fracture history; management combines calcium, vitamin D, and antiresorptive or anabolic drugs.

A fracture from a fall from standing height or less, or from minimal trauma, indicating underlying bone fragility. It should prompt assessment and treatment of osteoporosis to prevent further fractures.

Death of bone and marrow cells from impaired blood supply, commonly affecting the femoral head, scaphoid proximal pole, and talus. Early stages may be treated with protected weight bearing or decompression, later stages with arthroplasty.

Use of a circular external fixator with fine tensioned wires to gradually distract and regenerate bone, applied to limb lengthening, deformity correction, and treatment of complex nonunions and bone defects.

The process of obtaining a patient's voluntary agreement to treatment after explaining the diagnosis, proposed procedure, alternatives, material risks, and expected benefits, documented in the record.

A collaborative process where clinician and patient discuss evidence, patient values, and preferences to agree on a management plan, supporting autonomy and realistic expectations.

A professional obligation to be open and honest with patients when something goes wrong in their care, including prompt explanation, apology, and explanation of what will be done to address harm.

A structured team checklist used before induction, before incision, and before the patient leaves theater to reduce errors in identity, site, allergies, equipment, and communication.

A set of safeguards including preoperative marking of the operative site, verification of identity and procedure, and time-out confirmation by the team before incision to prevent operating on the wrong side or level.

The principle that bone remodels along lines of mechanical stress, becoming stronger where loaded and resorbing where unloaded. It explains stress shielding, fracture healing patterns, and adaptation around implants.

Reduction in bone density caused by an implant carrying load that would otherwise pass through bone. It can lead to bone resorption around stiff implants and is a consideration in implant design.

The biological process of bone repair through inflammation, soft callus, hard callus, and remodeling, requiring adequate blood supply, mechanical stability, and apposition. Primary healing occurs without callus under rigid compression.

Fixation that eliminates interfragmentary motion, typically with compression plating or lag screws, producing primary bone healing without callus. It requires anatomical reduction and adequate blood supply.

Fixation allowing controlled micromotion at the fracture site, as with bridging plates, intramedullary nails, or external fixators, promoting secondary healing through callus formation.

A strategy of definitive surgical fixation of all major fractures soon after injury in the physiologically stable polytrauma patient, aiming to reduce complications and enable early mobilization.