CAQ-Ortho flashcards

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

Compartment syndrome early sign

The earliest reliable sign is pain out of proportion to the injury that worsens with passive stretch of the muscles in the affected compartment. Pulselessness and paralysis are late findings.

Gustilo-Anderson type I

An open fracture with a clean wound smaller than 1 cm in length. It carries the lowest infection risk among open fractures and still requires antibiotics and tetanus prophylaxis.

Salter-Harris type II

A physeal fracture that passes through the growth plate and exits through the metaphysis, producing a metaphyseal fragment. It is the most common type of physeal fracture in children.

Axillary nerve injury

The most common nerve injury with anterior shoulder dislocation. It causes weakness of deltoid abduction and sensory loss over the lateral shoulder; examination should follow every reduction.

Lachman test

A knee examination performed with the knee flexed about 20-30 degrees, applying anterior tibial translation. It is more sensitive than the anterior drawer test for acute anterior cruciate ligament tears.

Ortolani maneuver

A screening maneuver in infants that abducts and lifts the flexed hip to reduce a dislocated femoral head, producing a palpable clunk. It detects developmental dysplasia of the hip.

Slipped capital femoral epiphysis

Displacement of the femoral head through the physis in adolescents, presenting with hip or knee pain and an externally rotated gait. Treatment is in situ screw fixation.

Carpal tunnel syndrome

Median nerve compression at the wrist causing nocturnal numbness in the thumb, index, and middle fingers. Thenar atrophy indicates advanced disease; nerve conduction studies confirm the diagnosis.

Scaphoid fracture risk

Fractures through the waist of the scaphoid risk avascular necrosis and nonunion because blood supply enters distally. Tenderness in the anatomic snuffbox with normal radiographs warrants immobilization and repeat imaging.

Colles versus Smith fracture

A Colles fracture displaces the distal radius fragment dorsally, while a Smith fracture displaces it volarly. Both are distal radius fractures usually caused by a fall on an outstretched hand.

Thompson test

Squeezing the calf with the patient prone should produce plantar flexion. Absence of plantar flexion indicates an Achilles tendon rupture and supports surgical or functional bracing treatment.

Osteoporosis T-score

A dual-energy x-ray absorptiometry T-score of -2.5 or lower defines osteoporosis. Fragility fractures of the hip, spine, and wrist are the classic osteoporotic fractures.

Septic arthritis synovial fluid

A joint aspirate with a white blood cell count above 50,000 per microliter with neutrophil predominance suggests septic arthritis. Staphylococcus aureus is the most common organism; urgent drainage and antibiotics are required.

Gout crystals

Monosodium urate crystals are needle-shaped and negatively birefringent under polarized light. Calcium pyrophosphate crystals of pseudogout are rhomboid and positively birefringent.

Paget disease of bone

A disorder of increased bone turnover with elevated alkaline phosphatase and normal calcium. Bone expands with a cotton-wool appearance; complications include pathologic fracture and deafness.

Cauda equina syndrome

Compression of the lumbosacral nerve roots causing saddle anesthesia, urinary retention, and bilateral leg weakness. It requires emergent MRI and surgical decompression.

Posterior hip dislocation

After a dashboard injury, the leg is shortened, adducted, and internally rotated. Urgent reduction reduces the risk of avascular necrosis of the femoral head.

Knee dislocation vascular risk

A multiligament knee injury threatens the popliteal artery. An ankle-brachial index below 0.9 or asymmetric pulses warrants CT angiography before and after reduction.

Pelvic binder

A device applied around the pelvis to compress and stabilize an unstable pelvic ring fracture with hemodynamic instability. It is a temporizing measure before angiography or preperitoneal packing.

Fat embolism syndrome

A complication after long bone fractures presenting with hypoxemia, petechiae, and confusion, typically 24-72 hours after injury. Treatment is supportive with oxygen and fracture stabilization.

Open fracture antibiotics

Antibiotics are given within 1 hour of arrival for open fractures, along with tetanus prophylaxis and urgent irrigation and debridement. Delay increases the risk of deep infection.

Neurapraxia

A nerve injury consisting of a conduction block without axonal disruption. Recovery is expected, usually within weeks to months, and no surgical repair is required.

Autograft bone graft

Bone harvested from the patient, usually the iliac crest, providing osteoconduction, osteoinduction, and osteogenic cells. It is the gold standard but causes donor site morbidity.

Total hip arthroplasty indications

Disabling hip pain with radiographic arthritis, avascular necrosis, and displaced femoral neck fracture in older adults. Aseptic loosening and periprosthetic fracture are late complications.

Lisfranc injury

Disruption of the tarsometatarsal joint complex with widening between the first and second metatarsal bases. Weight-bearing radiographs or CT confirm it; unstable injuries require fixation.

Osteosarcoma radiograph

A primary malignant bone tumor of adolescents in the metaphysis of the distal femur or proximal tibia. Radiographs show a sunburst periosteal reaction and Codman triangle.

Trigger finger

Stenosing tenosynovitis of the flexor tendon sheath causing catching at the A1 pulley. Corticosteroid injection is first-line; surgical release is for refractory cases.

De Quervain tenosynovitis

Pain over the radial styloid with a positive Finkelstein test, involving the abductor pollicis longus and extensor pollicis brevis tendons. Treatment includes splinting and corticosteroid injection.

Ponseti method

Serial casting, percutaneous Achilles tenotomy, and foot abduction bracing for clubfoot. It is most effective when started in the first weeks of life and avoids extensive surgery.

Adolescent idiopathic scoliosis

Curves assessed with the Adam forward bend test and Cobb angle. Bracing is used for curves of 25-40 degrees in growing children; surgery is considered above 45-50 degrees.

Neurogenic claudication

Leg pain from lumbar spinal stenosis relieved by sitting or leaning forward, unlike vascular claudication relieved by standing still. MRI confirms canal narrowing.

Prosthetic joint infection

Presents with pain, swelling, and elevated ESR and CRP after arthroplasty. Diagnosis requires joint aspiration with culture; chronic infection is treated with staged exchange and an antibiotic spacer.