Shared Flashcard Set

Details

Med Surg: Ortho - Hip
Winter Semester - 2011
56
Medical
Graduate
01/25/2011

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Cards

Term
What is a common cause of Pelvic Ring injuries?
Definition
MVA, Fall from Height (TRAUMA)
Term
If a pt presents with painful hip, leg or foot ROM as well as pubic crepitus (griding) after a fall off their ladder, what condition should you suspect?
Definition
Pelvic Ring Injury
Term
Which organ is commonly injured with pelvic ring injuries? How do you test for it?
Definition
Bladder Injury
Foley - Retrograde Pyelogram or Contrast CT
Term
Which test should be done if a Pelvic Ring Injury is suspected?
Definition
CT (Best!!)
Bladder Imaging
Term
What is the best treatment for an unstable Pelvic Ring Injury?
Definition
ORIF - Open Reduction Internal Fixation
Term
With a pelvic injury, what is a MAJOR life-threatening concern that you must monitor?
Definition
Hemovascular status
Term
What does diastasis mean essentially?
Definition
Dislocation (of sliding joint)
Term
Where will the pain associated with Sacro-Illiac Diastasis be located?
Definition
anterior/posterior pelvis
Term
How is Sacro-Illiac Diastasis treated?
Definition
Surgical Stabilization
Term
What are the MC causes of Acetabular fractures?
Definition
direct trauma with axial force (MVA, fall from height)
Term
If a patient presents s/p MVA and has pelvic pain, limb shortening and protrusio, what condition should you suspect?
Definition
Acetabular Structure
Term
Which x-ray view is used for Acetabular Fractures?
Definition
Judet View
Term
What is protrusion and what injury can it accompany?
Definition
dislocation of femoral head through the acetabulum and into the pelvis
Acetabular Fracture
Term
What is the treatment for protrusio?
Definition
traction pin
Term
What type of evaluation should be done when a patient presents with acetabular fracture?
Definition
Neurovascular evaluation
(Blood Loss and Sciatic Nerve)
Term
What is important to note about high energy sacral fractures that needs to focus your evaluation?
Definition
High energy Sacral fractures cause nerve injury 25% of the time
Term
What regions of sacral fracture can cause nerve impairment and what tx should be done?
Definition
2 & 3 - Surgical fixation
Term
What injury in the pelvis indicates the need for a rectal exam?
Definition
Coccyx fractures
Term
What is the MC cause of Coccyx fractures?
Definition
Fall (#1)
Childbirth and Surgical
Term
What are the signs and symptoms of coccyx fractures?
Definition
Pain
Rectal Bleeding
Deformity
Term
What is the treatment for a non-displaced coccyx fracture?
Definition
NSAIDs/Pain Meds
Donut
STOOL SOFTNERS!!! (Don't forget these...)
Term
What is the treatment for a displaced/deformed/anal tears caused by a coccyx fracture?
Definition
Manual reduction and Surgical Repair

NSAIDs/ PAin Meds
Donut
Stool Softeners
Term
What is a complication of a femoral neck fracture?
Definition
Avascular necrosis
Term
What is the treatment for a fracture of the femoral head?
Definition
Open reduction
Internal fixation
Arthroplasty
Term
What are the signs and symptoms of a femoral neck fracture?
Definition
Decreased ROM
Hip Pain
Term
How does a femoral neck fracture affect mortality rate of elderly?
Definition
20% mortality rate within 1 yr
Term
Where does the blood supply to the femoral head come from?
Definition
Circumflex artery
Term
What is the treatment for a femoral neck fracture?
Definition
hemiprothesis (replacement of the femoral head
Term
If a pt presents with gradual onset hip pain for 4 - 6 months, a slight limp w/walk, increased pain on internal rotation and has a PMH of sickle cell disease, what condition should you suspect?
Definition
Atraumatic Avascular necrosis
Term
What is the best early diagnostic tool for avascular necrosis?
Definition
MRI
Term
What is a common finding on x-ray in early and late avascular necrosis?
Definition
Early - Bird's Neck deformity
Late - Key-Fit Acetabulum
Term
What is the ortho treatment for avascular necrosis?
Definition
Disimpacting the femoral head - drill into femoral head (50% chance of improvement, but not other results)
Term
If a pt presents with pain in the lateral hip that increases with running or cycling and decreases with rest, what condition should you suspect?
Definition
ITBS - Iliotibular Tendonitis Band Syndrome
Term
What is the cause of ITBS?
Definition
inflammation & irritation of the distal portion of the iliotibial tendon
Caused by IT band rubbing over the lateral femoral condyle or the greater tuberosity
Term
What is the MC cause of ITBS?
Definition
Overuse - repetitive flexion and extension of the knee
Term
What is the diagnostic image study of choice for ITBS?
Definition
MRI (not usually done as Hx is usually diagnostic)
Term
What is the treatment for ITBS?
Definition
Rest
Heat before stretching; Ice after stretching
PT Consult
NSAIDS
If no improvement in 6 weeks, Ortho – injection and/or surgery
Term
If a pt complains of hip pain that is increased with sitting and has tenderness w/pressure over ischial bursa, what condition should you suspect?
Definition
Ischial Bursitis
Term
What is the treatment for Ischial Bursitis?
Definition
Best - injection of steroid/lidocaine
Rest, Heat, NSAIDs
Term
If a pt presents with hip pain that is increased with walking or climbing stairs and tenderness with pressure over greater trochanter bursa, what condition should you suspect?
Definition
Greater Trochanteric Bursitis
Term
What imaging test is diagnostic for Greater Trochanteric Bursitis?
Definition
MRI - (not usually needed)
Term
What is the treatment for Greater Trochanteric Bursitis?
Definition
BEST - Injection steroid/lidocaine
Rest/Heat/NSAIDs
Term
If a patient presents with achy pain over the hip, pain in the anterior groin that radiates to medial knee and decreased ROM of hip (especially flexion), what condition should you suspect?
Definition
Osteoarthritis of the hip
Term
What is the treatment for osteoarthritis of the hip?
Definition
Most Effective - Surgery
ROM Exercises, NSAIDs, Heat, Injection
Term
What is found on x-ray with osteoarthritis of the hip?
Definition
joint space narrowing
sclerosis
Term
If a pt presents with c/o hip pain that radiates down posterior aspect of leg and is worsened with sitting for long periods of times, what condition should you suspect?
Definition
Sciatica
Term
What is the treatment for sciatica?
Definition
massage, heat, PT, lifestyle changes
Term
What is the MC type of hip dislocation?
Definition
Posterior Dislocation
Term
What is the MC cause of posterior dislocation?
Definition
MVA (knee hitting dash)
Term
What positioning is common with posterior dislocation?
Definition
Flexion, internal rotation & adduction
Term
What positioning is common with anterior dislocation?
Definition
External rotation, abduction & mild flexion
Term
Which x-ray film views are needed to help in viewing a possible hip dislocation?
Definition
AP, LAteral , internal and external obliques
Term
What is the treatment for hip dislocation?
Definition
Ortho - Closed Reduction (unless complicated)
Term
If an athlete feels a pop or pain in the posterior thigh while playing soccer, what condition do you suspect?
Definition
Hamstring strains
Term
What is the treatment for hamstring strains?
Definition
R.I.C.E
NSAIDs and PT Consult
Term
What imaging needs to be done for a hamstring strain and why?
Definition
Plain films: evaluate for ischial avulsion fracture
Bone scan for stress fractures
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