Radio Capstone

bfg818's version from 2015-05-06 21:57

Section 1

Question Answer
Jahss Type 1dislocation of the hallus and sesamoids, no disruption of the ligament
Jahss Type 2Adisruption of the intersesamoid ligament, closed reduction is possible
Jahss Type 2Btransverse fracture of one of the sesmaoids
Stewart 1jones fracture
Stewart 2intra-articular simple fx of 5th met base
Stewart 3extra-articular simple fx of 5th met base
Stewart 4intra-articular comminuted fx of 5th met base
Stewart 5extra-articular avulsion fx of 5th met base (peds)
Watson-Jones 1avulsion of the navicular tuberosity
Watson--Jones 2fx of dorsal lip of navicular
Watson-Jones 3fx through the body of the navicular
Hardcastle Adislocation of all the metatarsal either homolateral or homomedial
Hardcastle Bdisocation of less than all the metatarsals in one direction
Hardcastle Cdislocation in a divergent direction of all the metatarsals
Rowe 1AFx of tubercle of calcaneus
Rowe 1BFx of sustentaculum tai
Rowe 1CFx of anterior process of calcaneus
Rowe 2AFx of posterior superior calcaneus
Rowe 2BFx of entire insertion of Achilles tendon
Rowe 3Asimple calcaneal fracture not involving the STJ
Rowe 3Bcomminuted calcaneal fracture not involving the STJ
Rowe 4Asimple calcaneal fracture involving the STJ
Rowe 4Bcomminuteed calcaneal fracture involving the STJ
Rowe 5Acomminuted fracture involving the STJ with a displaced piece and without CC involvement
Rowe 5Bcomminuted depressed fracture involving the STJ and CC joint
Essex-Lopresti 1Atuberosity of calcaneus fracture not involving the STJ or CC joint
Essex-Lopresti 1Bcalcaneal fracture without STJ involvement but CC joint involvement
Essex-Lopresti 2Acalcaneal fracture with STJ involvement and a 2ndary line posteriorly out the calcaneus
Essex-Lopresti 2Bcalcaneal fracture with STJ involvement and 2ndary fracture line superiorly that causes displacement of the fracture
Essex-Lopresti 2Ccalcaneal fracture with STJ involvement and gross comminution
Sanders Type 1non-displaced fracture of posterior facet
Sanders Type 2 (A,B,C)two part fracture of posterior facet of STJ, with A=lateral
Sanders Type 3 (AB, BC,AC)3 part fracture with a centrally displaced piece
Sanders Type 44 part comminuted fracture
Hawkins 1talar neck fracture
Hawkins 2talar neck fracture with STJ involvment
Hawkins 3talar neck fracture with AJ involvment
Hawkins 4talar neck fracture with TNJ involvement
Berndt- Hardy 1small area of compression on the talar dome
Berndt-Hardy 2partially detached fragment on talar dome
Berndt-Hardy 3completely detached fragment on talar dome
Berndt-Hardy 4completely detached and displaced fragment on talar dome
Salter Harris 1separation of the epiphysis from the metaphysis
Salter Harris 2fracture through the physis and metaphysis, has the thurston holland sign
Salter Harris 3fracture through the physis and epiphysis, intra-articular
Salter Harris 4fracture through the epiphysis, physis, and metaphysis
Salter Harris 5crush fracture of the physis
Salter Harris 6contusion on the zone of ranvier
Salter Harris 7fracture of only the epiphysis
Salter Harris 8transient disruption of vascularity
Salter Harris 9degloving injury
Danis Weber Aavulsion fracture off the tip of the fibula
Danis Weber Bfibular fracture at the level of the ankle joint, may go in a spiral direction
Danis Weber Cfibular fracture aboe the level of the ankle joint
LH that includes a Danis Weber ASAD 1
LH that includes Danis Weber BSER 2 or PAB 3
LH that includes a Danis Weber CPER 3
Mechanism of SER (1-4)AITF, Fib, PITF, medial malleolus
Mechanism of PER (1-4)Deltoid, AITF, Fib, PITF
Mechanism of SAD (1-2)Fib, medal malleolus
Mechanism of PAB (1-3)medial malleolus, AITF/PITF, and lateral malleolus
Mechanism of PDF (1-4)medial malleolus, ant tib, fib, posterior lip tib
Pott's (Dupuytren's) fracturebimalleolar fracture
Cotton's fracturetrimalleolar fracture
Tilleaux fracture (tubercle of Chaput)avulsion off the anterior lateral tibia
Volkmann fractureavulsion off posterior malleolar (tibia) fracture
Wagstaffe fractureavulsion off of anterior medial fibula
Bosworth's Fracturelateral malleolar fracture w/ ankle displacement
Maisonneuve fractureproximal fibular fracture

Section 2

Question Answer
True McBridesilver, adductor tendon transfer, and fibular sesamoid excision
Modified McBridesilver, fibular sesamoid excision
Silver bunionectomyremoval of the medial prominence of the 1st metatarsal
Reverdinpie shape cut in head of metatarsal dorsally to plantarly, taking the pie out and leaving hinge intact to correct PASA
Reverdin-GreenReverdin w/ plantar shelf to protect the sesamoids
Reverdin-LairdReverdin w/ plantar shelf and break in lateral cortex and shifting of capital fragment to correct PASA and mild IM
Mitchelltrapezoid wedge taken out of 1st metatarsal
Kalishlong arm austin
Maufrom plantar proximal to dorsal distal
Ludlofffrom dorsal proximal to plantar distal
LogroscinoLB + reverdin
Trethowanmedial opening wedge (opposite of LB)
McKeeverV fusion of the first metatarsal
Kellerremoval of the base of the 1st proximal phalanx
Mayoremoval of the distal head of 1st metatarsal
ValentiV resection at the 1st MPJ with pieces of proximal phalanx and metatarsal
Watermann Joint decompression procedure. Take out wedge of bone from 1st MT head which moves the effective cartilage dorsally so that the toe has more good cartilage to ride on
Hohmannmedial base closing wedge, with capital fragment shifted laterally and plantarly
Watermann-HohmannBreaks through the plantar hinge of the Waterman, which allows for plantarflexion of the MT head.
Watermann-Greenyoungswick austin with a dorsal bumpectomy
Lambrinudiplantar closing wedge to plantarflex the first metatarsal
Juvara Aoblique base osteotomy w/ medial hinge intact
Juvara Boblique base osteotomy w/ broken medial hinge which allows for sagittal plane rotation
Juvara Cno wedge removed but hinge is broken so sagittal plane rotation is possible axial transposition is as well (lengthening/shortening)
Evansanterior calcaneal osteotomy
Dwyer calcaneal osteotomylateral closing wedge in the calcaneus
Silver calcaneal osteotomyopening lateral wedge with graft
Berman-Gartlandcrescentic osteotomies on metatarsals 1-5
Peabody and Muro2-4 met base resection, with 5th ray closing wedge
Lepirdcrescentic osteotomies of mets 2-4 with 1st met lateral closing wedge and 5th medial closing wedge
Steytler and Van Der Waltoblique wedge osteotomies mets 1-5
McCormick and Blountlapidus, 3 lateral closing base wedges on mets 2-4, wedge resection on the cuboid
Keck and Kellyposterior superior closing wedge on calcaneus
LeFort amputationremoval of malleoli and resection of upper half of calcaneus
Pirogoff amputationremoval of the malleoli and resection of the anterior half of the calcaneus, so it is swung plantarly to form a stump
Cotton osteotomymedial opening wedge in 1st cuneiform
Hoffmanresection of all metatarsal heads
Hoffman-Claytonresection of all metatarsal heads and bases of proximal phalanges
Terminal Symesamputation of terminal part of toe through distal interphalangeal joint + anterior reflection of plantar digital pad to dorsum
Symes Amputationamputation of the foot through the articulation of the ankle with removal of the malleoli of the tibia and fibula
Youngswick Austinremoves a dorsal wing of bone that works to PF and shorten the capital fragment.
Bicorrectional Austinplantar wing is same but dorsal wing is a pie instead of straight across; move laterally and swivel head

Section 3

Question Answer
classification used to discuss osteomyelitisBuckholtz
3 phases of bone healinginflammatory, reparative, and remodeling
inflammatory phase of bone healinghematoma formation, osteocytes die, vasodilation, and edema
reparative phase of bone healingformation of a collar callus and internal callus, necrotic tissue is removed
remodeling phase of bone healingcallus is resorbed, trabecular bone is remodeled along the line of stress
does cancellous or cortical bone heal fastercancellous bone because it has a greater blood supply
classification to describe non-unionsWeber and Cech
delayed unionunion that has not been achieved after 6 weeks
non-unionunion that has not been achieved after 6-8 months post fx
3 types of hypertrophic non-unionselephants foot, horses hoof, and oligotrophic
cause of elephants footearly WB and inadequate fixation
cause of horses hoofinadequate stabilization
cause of oligotrophic non-unioninadequate alignment of fx ends
4 types of atrophic non-uniontorsion wedge, comminuted, defect, and atrophic
mechanism for torsional wedge formationsome pieces fuse together but others do not because of inadequate vascularity
mechanism for comminuted non-unionone or more fragments become necrotic and callus fails
mechanism for defective non-uniondead space that is left between two pieces of bone that cannot be bridged
mechanism for atrophic non-unionbecause of decreased vascularity, fx ends become osteopenic and atrophic with scar tissue sitting between
most common coalitiontalocalcaneal
second most common coalitioncalcaneonavicular
least common coalition of the 3talonavicular
age where a talocalcaneal coalition becomes apparent12-16
age where a talonavicular coalition becomes apparent3-5
age where a calcaneonavicular coalition becomes apparent8-12
imaging study that uses electrostatic forces, visualizes bone and non-metallic foreign bodiespositive xeroradiography
imaging study that uses electrostatic forces to visualize soft tissue and metallic foreign bodiesnegative xeroradiography
another name for stage 2 CRPSSudek's atrophy
radiographic appearance of an osteoblastomamultiple internal calcifications, with a nidus greater than 1.5 cm, looks like an osteoid osteoma
radiographic appearance of an osteoid osteomaless than 1 cm in size, nidus may or may not have central calcification, can cause joint effusion that looks like JRA
radiographic appearance of an osteosarcomacloud-like with sunburst periosteal reaction and Codman's triangle,
radiographic appearance of an osteochondromacauliflower, mushroom cloud appearance with a cartilage cap, points away from the joint
radiographic appearance of an enchondromageographic lesion with central calcifications and endosteal scalloping
4 stages of AVNavascular, revascularization, remodeling, residual deformity
AVN location of Iselinstuberosity of the 5th met
AVN location of Osgood--Schlatter'stibial tuberosity
AVN location of Blount'smedial epiphysis of tibia
AVN location of Trevor'sfibular sesamoid
AVN location of Thiemann'sphalanges of finger and toes
Sequestrumdead bone resulting from cortical and medullary infarcts
Involucrumperiosteal new bone or bony collar; body's attempt to wall off infection process
CloacaA defect which develops in the involucrum which functions to allow continued discharge (decompression) of inflammatory products from the infected bone
Marjolin's UlcerMalignant degeneration to squamous cell carcinoma of the channel within the cloaca.
Brodie's AbscessA localized abortive form of suppurative osteomyelitis, which may present as a chronic nidus of infection.
Routes of ContaminationHematogenous spread, direct implantation (direct inoculation), direct extension (spread from contiguous source), postop infection
Metastatic calcificationdisturbance in calcium or phosphorous metabolism (hyperparathyroidism, vitaminosis D, renal osteodystrophy, sarcoidosis, metastatic cancer)
Dystrophic calcificationcalcium deposits in damaged or devitalized tissue in the absence of a generalized metabolic derangement (EHLERS-DANLOS SYNDROME, PSEUDOXANTHOMA ELASTICUM, FIBROMATOSIS, TUMORS, CYSTS, HEMATOMAS, DEGENERATIVE, NECROTIC AND POST-INFLAMMATORY FOCI., TRAUMA- PHYSICAL, CHEMICAL OR THERMAL)
Calcinosisdeposition of calcium in skin and ST in presence of normal calcium metabolism (calcinosis interstitialis universals, calcinosis circumscripta, tumoral calcinosis)
Types of soft tissue ossificationmyositis ossificans and tumoral ossifications

Section 4

Question Answer
Stage 1 of RAhypertrophy and proliferation of synovial lining leading to joint dissension and pericapsular edema. Radiographically there will be increase in ST contour and density surrounding joint
Stage 2 of RAfurther synovial thickening and inflamed synovial tissue (pannus). Pannus envelopes the hyaline cartilage and erodes bone at the joint margins where it is not protected by cartilage
Stage 3 of RAinflamed cells of the synovium release enzymes that digest additional bone and cartilage. Destruction/erosion leads to a reduction in joint space and altered bone morphology
Stage 4 of RAContinued joint space narrowing and eventual ankylosis
Eichenholtz Stage 1Destruction/Fragmentation (Acute Charcot)
Eichenholtz Stage 2Coalescence (Subacute Charcot)
EIchenholtz Stage 3Reconstruction (Chronic Charcot)
AVN Stage 1Avascular Phase (rarely seen because patient does not present to clinic until later stage)
AVN Stage 2Revascularization Phase
AVN Stage 3Repair and Remodeling Phase
AVN Stage 4Residual Deformity
Paget's Stage 1Destructive Phase
Paget's Stage 2Combined Phase
Paget's Stage 3Sclerotic Phase
Paget's Stage 4Malignant Phase
CRPS Stage 1Acute
CRPS Stage 2Dystrophic
CRPS Stage 3Atrophic
Type 1 CRPS (Reflex Sympathetic Dystrophy)no specific nerve damage identified
Type 2 CRPS (Causalgia)distinct major nerve injury has occurred
Regnauld Stage 1 No degenerative joint changes noted radiographically, MPE, hallux equinus, hyperextension of hallux IPJ
Regnauld Stage 2 Flattening of 1st MT head, fibrillation of cartilage, OCD, small dorsal exostosis, subchondral eburnation, periarticular lipping of proximal phalanx, sesamoids and metatarsal
Regnauld Stage 3Severe flattening of 1st MT head, significant osteophytosis, asymmetric joint space narrowing, subchondral cysts, further breakdown of cartilage
Regnauld Stage 4Obliteration of joint space w/ possible total ankylosis, exuberant osteophytosis w/ 1st MPJ deformity or malalignment, loose bodies/joint mice present
Rosenberg Stage 1Hypertrophic tears
Rosenberg Stage 2Atrophic tears
Rosenberg Stage 3Complete tear (rupture)

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