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Ortho-misc-2

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medmaestro's version from 2015-11-03 04:18

Section

GAITS
Question Answer
Antalgic gaitpainful condition of lower limb
Trendelenburg gaitunstable hip due to CDH,Gluteus Medius weakness(Superior gluteal nerve injury)
Stiff hip gaitankylosis of hip
Duck waddling gaitB/L CDH
Scissoring gaitCeebral palsy
High stepping gaitfoot drop
Circumduction gaithemiplegia
Charlie Chaplin gaitTibial torsion
Sailor’s gaitB/L CDH
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POSTPOLIOMYELITIS RESIDUAL PARALYSIS
Question Answer
Muscle involvementassymetrical
Commonly involovelower limbs
m/c muscle involvedquadriceps (only partial paralysis)
muscle undergoing complete paralysistibialis anterior
m/c muscle affected in upper limbopponens pollicis
type of nerve involvementpure motor involvement without sensory loss
common deformity in the hipFlexion deformity with hip abducted and externally rotated
deformity in kneeflexion,posterior subluxation and external rotation
deformity in footequinovarus deformity is commonest in foot
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NERVE INVOLVEMENT IN ORTHOPAEDIC INJURIES
Question Answer
Anterior shoulder dislocationaxillary nerve-circumflex branch
# surgical neck humerusaxillary nerve
# shaft of humerusradial nerve
# supracondylar humerusradial/median nerve
Medial condyle humerusulnar nerve
Monteggia # dislocationposterior interrosseous nerve
Volkmann’s ischemic contracturemedian nerve
Lunate dislocationmedian nerve
Hip dislocationsciatic nerve
Knee dislocationperoneal nerve
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Syndromes
Question Answer
Apert’s syndrometower shaped head with syndactyly
Ollier’s diseasemultiple enchondromas
Melorrheostosiscandle bone disease
Osteopathia striatastriped bone disease
Osteopoikolosisspotted bone disease
Caffey’s diseaseinfantile cortical hyperostosis
Pyle’s diseasemetaphyseal dysplasia(modelling defect resulting in ERLENMEYER FLASK deformity of the distal femur & proximal tibia )
Blount diseasesevere tibia vara in childhood ,common in West Indies
Nail Patella syndromeHypoplastic nails with absence of patella
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RADIOLOGICAL VIEWS
Question Answer
Judet viewacetabular #
Oblique view of the wristscaphoid #
Mortice viewankle injuries
Merchant view / skyline view/axial view# patella
Sunset viewpatella femoral dysplasia
Von Rosen viewfor CDH
Shenton’s linehip Xray
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TRACTIONS
Question Answer
Gallow’s traction/Bryant’s traction# shaft of fmur in children <2 yrs
Russel’s tractiontrochanteric #
Buck’s tractionconventional skin traction
Perkin’s traction# shaft of femur in adults
90o-90o traction# shaft of femur in children
Agnes Hunt tractioncorrection of hip deformity
Well Leg tractioncorrection of adduction / abduction deformity in hip
Dunlop/Smith tractionsupracondylar fracture of humerus
Calcaneal tractionopen # of ankle or leg
Metacarpal tractionopen forearm #
Head – Halter/Crutchfield tractioncervical spine injuries
Crutchfield tongsskull traction in cervical spine injuries
Halo pelvic tractionscoliosis
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AMPUTATION
Upper limb amputation
Question Answer
Ray amputationremoval of fingers with metacarpals from CMC joint
Krukenberg’s amputationmaking forceps with two forearm bones
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Foot Amputation
Question Answer
MIDFOOT amputation
Lisfranc amputationtarsometatarsal jt (Lisfranc jt)
Chopart amputationmid tarsal amputation
Pirogoff amputationcalcaneum is rotated forward and fused to tibia after vertical section through its middle
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HINDFOOT amputation
Question Answer
Syme amputationdistal tibia & fibula 0.6 cm proximal to the periphery of ankle joint
Sarmiento amputationdistal tibia & fibula 1.3 cm proximal to the ankle joint and excision of medial and lateral malleoli
Boyd amputationTalectomy
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TYPES OF JOINT

Synovial joint

Question Answer
Plane jointacromioclavicular joint
Hinje joint –only flexion & extensionelbow,ankle,interphalangeal joint
Ellipsoid jointwrist,all MCPs,Atlanto-occipital joint
Pivot (TROCHOID) jointSuperior & Inferior radioulnar ,Atlanto-axial joint
Condylar jointknee,temperomandibular joint of jaw
Saddle jointthumb(first CMC),sternoclavicular,calcanocuboidal,incudo-malleolar joint
Ball & socket jointshoulder ,hip,talo-calcaneonavicular,incudo-stapedial joint
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Fibrous joint

Question Answer
Classic example of fibrous jointsutures of skull
Syndesmosisbones are connected by the interosseus ligament Eg.Distal Tibiofibular ligament ,Foot plate of stapes with Oval window ( Tympanostapedial syndesmosis)
Gomphosis-peg and socket jointeg-Tooth in socket
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Cartilaginous joint

Question Answer
Primary (Synchondrosis)/hyaline cartilage joint )Joint Between Epiphysis And Diaphysis Of Growing / Long Bones,Spheno-Occipital Joint, 1st Chondrosternal Joint ,Costochondral Joints
Secondary (Symphyses)/Fibrocartilaginous joint)symphysis pubis,manubriosternal joint ,intervertebral joints,sacrococcygeal joints
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Genetic basis of orthopaedic diseases
Question Answer
Musculoskeletal genetic disordergenetic mutation
AchondroplasiaFGF receptor 3
Osteogenesis imperfectType I collagen
Pseudoachondroplasiacartilage oligomeric matrix protein (COMP)
Marfan syndromeFibrillin
Spondyloepiphyseal dysplasiaType II collagen
Multiple Epiphyseal Dysplasiacartilage oligomeric matrix protein (COMP) or Type IX collagen(COL9A2)
Thanatophoric dysplasiaFGF Receptor 3(also achondroplasia)
Diatrophic dysplasiasulphate transporter
Duchenne muscular dystrophydystrophin
X-Linked hypophosphatemic ricketsPEX (Cellular Endopeptidase)
Osteopetrosiscarbonic anhydrase type II
Fibrous dysplasiaGs1(receptor coupled signalling protein)
Schmid metaphyseal dysplasiatype X collagen
Jansen metaphyseal chondrodysplasiaPTH/PTHrP Receptor
Multiple hereditary exostosesEXT1,EXT2 genes
HypochondroplasiaFGF receptor 3 (also achondroplasia,thanatophoric dysplasia)
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FGF Receptor 3
• Hypochondroplasia
• Achondroplasia
• thanatophoric dysplasia

 

OSTEOCHONDRITIS
Kienbock’s disease is osteochondritis/osteochondrosis/avascular necrosis of LUNATE
Diseasesite
Kohler’snavicular bone
Kienbock’sLunate
Perthe’sfemoral head
Scheurmann’sring epiphysis of vertebra
Calve’scentral bony nucleus of vertebral body
Frieberg’s2nd metatarsal head
Islene’s5th metatarsal base
Osgood Shlatter’stibial tuberosity
Sever’scalcaneal apophysis
Johansson’s –Laren’slower pole of patella
Presiser’sScaphoid
Panner’scapitulum
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Signs and tests
Conditiontest/sign
Thoracic outlet syndromeadson’s test
Patency of radial & ulnar arteryallen’s test
CDHalli’s test
Testing tenderness of spineanvil test
Median nerve injuryape thumb deformity
Meniscus injuryapley’s grinding test
Recurrent shoulder dislocationapprehension test
CDHBarlow’s test
Anterior shoulder dislocationbryant’s test & callaway’s test
Dorso lumbar TB of spinecoin test
Tennis elbowcozen’s test
Anterior –ACL Injury(1)anterior drawer test
Posterior-PCL injuryposterior drawer test
Cervical spine involvement in ankylosing spondylitisFle’che test
De Quervain’s tenovaginitisfinkelstein’s test
Common peroneal nerve injuryfoot drop
Ulnar nerve injuryfroment’s sign/test
Sacro-iliac joint involvement in ankylosing spondylitisganslen’s test
Anterior shoulder dislocationHamilton ruler tst
Infection of ulnar bursakanavel’s sign
Disc prolapse (1)lasegue test
ACL injury(2)Lachmann test
Avulsion of lesser trochanterludolff’s sign
Menisci injuryMc Murray’s test
Disc prolapse (2)nagffziger test
Tight ilio tibial band in polioober’s test
CDHortolani’s test
ACL injury (3)pivot shift test
Erb’s palsypolice man tip hand
Inferior dislocation of the shouldersulcus sign
Hip flexion deformityThomas test
Unstable hip due to any reasontrendelenberg’s test
Nerve degenerationtinel’s sign
Ischemic contracture of forearm musclesvolkmann’s sign
Patellar tendinitisrunner’s test
Four cardinal signs of kanavel in acute suppurative tenosynovitis1)pain on passive digital extension 2)flexed position of the digit 3)symmetric swelling of the digit,which may include the palm 4)tenderness with palpation along the flexor tendon sheath
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