OMSB Orthopedic Surgery (OEORTHO) flashcards

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

Compartment syndrome threshold

A compartment pressure within 30 mmHg of diastolic blood pressure (delta pressure below 30 mmHg) is the threshold for fasciotomy. Clinical signs include pain on passive stretch and tense compartments.

Gustilo-Anderson type IIIB

An open fracture with extensive soft-tissue loss that requires flap coverage to achieve soft-tissue coverage. It is associated with high infection risk and requires urgent debridement and antibiotics.

Septic arthritis synovial fluid

Synovial fluid WBC above 50,000/mm3 with neutrophil predominance suggests septic arthritis. Gram stain and culture plus blood cultures are required, and urgent drainage and IV antibiotics are indicated.

Cauda equina syndrome features

Bilateral leg pain or weakness, saddle anesthesia, and bladder or bowel dysfunction from lumbosacral nerve root compression. It is a surgical emergency requiring urgent MRI and decompression.

Axillary nerve injury

The most common nerve injury after anterior shoulder dislocation. It causes deltoid weakness and sensory loss over the lateral shoulder (regimental badge area).

Bankart lesion

An avulsion of the anteroinferior glenoid labrum that occurs with anterior shoulder dislocation and predisposes to recurrent instability. It is best seen on MRI or arthroscopy.

Hill-Sachs lesion

A posterolateral humeral head impaction fracture caused by the head striking the anterior glenoid rim during anterior dislocation. It is a radiographic sign of prior dislocation.

Gartland classification

A classification of pediatric supracondylar humerus fractures: I is nondisplaced, II is displaced with intact posterior cortex, III is completely displaced, and IV is unstable in all directions.

Ortolani and Barlow tests

Ortolani reduces a dislocated hip with a clunk on abduction; Barlow dislocates a reducible hip with posterior pressure. Both screen for developmental dysplasia of the hip in infants.

Osteosarcoma features

A primary bone malignancy of adolescents and older adults, typically metaphyseal in the distal femur. Radiographs show a sunburst pattern and Codman triangle; treatment is chemotherapy plus resection.

Garden classification

A classification of femoral neck fractures based on displacement: I is incomplete, II is complete nondisplaced, III is complete partially displaced, and IV is completely displaced. Higher grades increase avascular necrosis risk.

Schatzker classification

A classification of tibial plateau fractures: types I–III involve the lateral plateau, IV involves the medial plateau, and V–VI are bicondylar. Higher types carry greater soft-tissue and compartment risk.

Danis-Weber classification

An ankle fracture classification based on fibular fracture level relative to the syndesmosis: A is below, B is at the level, and C is above. Type C implies syndesmotic injury.

Salter-Harris classification

A classification of physeal fractures: I through V describe involvement of the physis, metaphysis, and epiphysis. Types III–V cross the physis and carry growth arrest risk.

Osteoporosis DEXA threshold

A T-score of -2.5 or lower at the hip or spine defines osteoporosis. A fragility fracture warrants treatment regardless of T-score, and bisphosphonates are first-line.

Paget disease laboratory findings

Elevated alkaline phosphatase with normal calcium and phosphate is characteristic. The pelvis, skull, and femur are commonly involved, and complications include pathologic fracture and deafness.

Rickets laboratory findings

Low calcium and phosphate with elevated alkaline phosphatase and PTH. Vitamin D deficiency is the most common cause, and treatment is vitamin D plus calcium replacement.

Osteomyelitis in sickle cell disease

Salmonella is a classic pathogen in sickle cell disease, whereas Staphylococcus aureus is the most common cause overall. MRI is the most sensitive imaging modality.

Rotator cuff tear signs

The supraspinatus is most commonly torn. The drop-arm test and external rotation lag sign suggest a full-thickness tear, and MRI is the imaging of choice.

Lachman test

The most sensitive examination for anterior cruciate ligament injury. It is performed with the knee flexed about 30 degrees and assesses anterior tibial translation with a soft endpoint.

McMurray test

A provocative test for meniscal tears performed by flexing and rotating the knee while palpating the joint line. A positive test produces a click or pain.

Carpal tunnel syndrome

Median nerve compression causing nocturnal paresthesias in the thumb, index, and middle fingers. Tinel and Phalen tests are supportive, and nerve conduction studies confirm the diagnosis.

L5 root compression

Weakness of great toe dorsiflexion (extensor hallucis longus) and sensory loss over the lateral leg and dorsum of the foot. It most often results from an L4–L5 disc herniation.

S1 root compression

Loss of the ankle reflex with plantar flexion weakness and sensory loss over the lateral foot. It most often results from an L5–S1 disc herniation.

Neurogenic claudication

Leg pain with walking that is relieved by sitting or leaning forward (shopping-cart sign). It is caused by lumbar spinal stenosis and is distinguished from vascular claudication.

Periprosthetic joint infection

A complication of arthroplasty diagnosed with synovial fluid analysis and cultures. It presents with pain, swelling, and elevated inflammatory markers, and treatment often requires staged revision.

Osteoarthritis radiographic signs

Joint space narrowing, subchondral sclerosis, osteophytes, and subchondral cysts on weight-bearing radiographs. Management begins with exercise and weight loss, then NSAIDs and arthroplasty.

Slipped capital femoral epiphysis

Adolescent hip disorder presenting with groin or knee pain and an externally rotated limb. The frog-leg lateral radiograph is diagnostic, and in situ screw fixation is standard.

Anterior hip dislocation precautions

After total hip arthroplasty, avoid hip extension and external rotation, which are the positions that dislocate an anteriorly approached hip. Posterior approach precautions instead limit flexion, adduction, and internal rotation.

Fat embolism syndrome

Occurs after long bone fractures, with hypoxemia, petechiae, and confusion. Supportive care with oxygen is the mainstay, and early fracture fixation reduces the risk.

Osteoarthritis first-line management

Exercise, weight loss, and physical therapy are first-line. NSAIDs and intra-articular corticosteroid injections are added for symptom control, and arthroplasty is reserved for end-stage disease.

Open fracture initial management

Tetanus prophylaxis, IV antibiotics, and urgent irrigation and debridement are standard. Gustilo-Anderson grading guides soft-tissue coverage and the need for flap reconstruction.