Iraqi Board Orthopedic Surgery flashcards
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32 cards. Read the term and the definition here. The deck at the top of this page is optional.
- Wolff law
- Bone remodels in response to mechanical stress, depositing where loads are high and resorbing where loads are low. Explains cortical thickening in weight-bearing regions and bone loss with immobilization.
- Hueter-Volkmann law
- Compression across a growth plate slows physeal growth, while tension accelerates it. This principle underlies guided growth with tension-band plates for angular deformity correction in children.
- Axillary nerve danger zone
- The axillary nerve passes 6-8 mm inferior to the acromion at the surgical neck of the humerus. It is at risk in proximal humerus fractures and shoulder dislocations.
- Damage control orthopedics
- Temporary external fixation of major fractures in physiologically unstable polytrauma patients, followed by definitive fixation after resuscitation. Avoids the second hit of prolonged surgery.
- Compartment syndrome threshold
- Intracompartmental pressure greater than 30 mmHg, or within 30 mmHg of diastolic pressure, with clinical signs warrants urgent fasciotomy. Pain on passive stretch is the earliest reliable sign.
- Gustilo-Anderson IIIB
- An open fracture with extensive soft-tissue loss and periosteal stripping that requires a local or free flap for coverage. IIIA is adequately covered, IIIC needs vascular repair.
- Vancouver B2 periprosthetic fracture
- A periprosthetic femoral fracture around a total hip stem that is unstable, with adequate bone stock. Treated with revision to a long-stem prosthesis.
- Aseptic loosening
- The most common late cause of total joint arthroplasty failure, driven by particulate wear debris and macrophage-mediated osteolysis. Presents with progressive pain and lucent lines on radiographs.
- Neurogenic shock
- Hypotension with bradycardia after spinal cord injury above T6 due to loss of sympathetic tone. Treated with fluids, vasopressors, and atropine for bradycardia.
- Cauda equina syndrome
- Compression of the lumbosacral nerve roots causing saddle anesthesia, urinary retention, and bilateral leg weakness. A surgical emergency needing urgent decompression.
- TLICS score
- Thoracolumbar Injury Classification and Severity score based on fracture morphology, posterior ligamentous complex integrity, and neurologic status. Scores above 4 favor surgical treatment.
- Ponseti method
- Serial manipulation and casting for clubfoot, followed by percutaneous Achilles tenotomy and a foot abduction orthosis. The preferred conservative treatment for idiopathic talipes equinovarus.
- Salter-Harris classification
- Physeal fracture types I to V: Slipped, Above, Lower, Through, Crush. Types III to V cross the physis and risk growth arrest and angular deformity.
- Slipped capital femoral epiphysis
- Displacement of the femoral head through the physis in obese adolescents, presenting with groin or knee pain and external rotation. Treated with in situ screw fixation.
- Lachman test
- Anterior tibial translation assessed with the knee flexed 20-30 degrees; the most sensitive clinical test for anterior cruciate ligament rupture. Compare with the contralateral knee.
- Bankart lesion
- Detachment of the anterior labrum and capsule from the glenoid rim after anterior shoulder dislocation. A predisposing factor for recurrent instability, treated with labral repair.
- Thompson test
- Squeezing the calf with the patient prone should produce plantar flexion. Absence of plantar flexion indicates Achilles tendon rupture.
- Scaphoid avascular necrosis
- The proximal pole of the scaphoid has a retrograde blood supply, so proximal fractures risk avascular necrosis and nonunion. Snuffbox tenderness warrants immobilization and repeat imaging.
- Carpal tunnel syndrome
- Median nerve compression beneath the transverse carpal ligament causing nocturnal numbness, thenar atrophy, and positive Phalen and Tinel tests. Treated with splinting, injection, or surgical release.
- Dupuytren contracture
- Fibrosis of the palmar fascia producing nodules and cords, most often affecting the ring and little fingers. Associated with diabetes and northern European ancestry; treated with fasciectomy or collagenase.
- Lisfranc injury
- Tarsometatarsal fracture-dislocation, often with a fleck sign on radiographs. Weight-bearing views may be needed; treatment is anatomic reduction and fixation.
- Charcot arthropathy
- Neuropathic joint destruction in diabetes, with midfoot collapse, warmth, and erythema. The 6 Ds describe radiographs; treatment is total contact casting and offloading.
- Danis-Weber classification
- Ankle fracture classification by fibular fracture level relative to the syndesmosis: A below, B at, C above. Higher grades imply greater syndesmotic injury.
- Osteosarcoma
- A malignant bone tumor of the metaphysis in adolescents, with sunburst periosteal reaction and Codman triangle. Treated with neoadjuvant chemotherapy and limb-salvage resection.
- Ewing sarcoma
- A small round blue cell tumor of the diaphysis in children, with onion-skin periosteal reaction and t(11;22) EWS-FLI1 translocation. Treated with chemotherapy and surgery.
- Giant cell tumor
- A benign but locally aggressive lytic lesion in the epiphysis of long bones after skeletal maturity, with a soap-bubble appearance. Treated with curettage and bone cement.
- Paget disease of bone
- Increased osteoclast then osteoblast activity producing a mosaic pattern of lamellar bone, elevated alkaline phosphatase, bone deformity, and pain. Treated with bisphosphonates.
- Biofilm resistance
- Bacteria adherent to implants secrete an extracellular matrix that makes them up to 1000 times more resistant to antibiotics. Rifampicin is added for staphylococcal biofilm infections.
- DAIR procedure
- Debridement, antibiotics, and implant retention for acute periprosthetic joint infection within about 3 weeks of onset, with a stable implant and susceptible organism. Chronic infection needs two-stage exchange.
- Three-point pressure orthosis
- An orthotic principle applying forces at three points to correct a deformity, with the middle force opposite the two end forces. Used in scoliosis bracing and knee-ankle-foot orthoses.
- Ischial containment socket
- A transfemoral prosthetic socket design in which the ischial tuberosity bears weight and the socket encloses the ischial ramus. Improves stability and rotational control.
- Informed consent elements
- Diagnosis, nature of the procedure, risks, benefits, alternatives, and consequences of refusal, given by a patient with capacity and without coercion. Documented before the procedure.