operative treatment.

MCQs on Lumbar Disc Herniations

Interactive MCQs .answer, .explanation { display: none; } MCQs on Lumbar Disc Herniations What is the preferred imaging study for diagnosing and classifying lumbar

Clavicle Fractures

  Clavicle Fractures EPIDEMIOLOGY Clavicle fractures account for approximately 2.6% of all fractures and for 44% to 66% of fractures about the shoulder. Middle third fractures account for 80% of all clavicle fractures, whereas fractures of the

Thoracic Outlet Syndrome‌‌

 Thoracic Outlet Syndrome&zwnj;&zwnj;   Summary Thoracic outlet syndrome (TOS) refers to a group of conditions that produce varying neurologic or vascular symptoms depending on the etiology. Etiologies include compression of neurologic or vascular structures at various anatomical

Proximal Humeral Fractures

  Summary Proximal humeral fractures are the third most common fractures and affect both young and elderly patients. Neer’s classification system is commonly used in determining fracture patterns but has recently been found to have poor reliability and reproduc-ibility. Protecting

HOLSTEIN–LEWIS FRACTURE

A 32-year-old man is admitted with an injury to his right arm. He has a dense radial nerve palsy. He tells you that this happened while arm wrestling.   1. Describe these radiographs. These are an AP radiograph of the right humerus and a lateral radiograph of the distal humerus

Distal Tibia Medial plating and screws

        Distal Tibia Medial plating and screws       Case description A 65-year-old man fell down a flight of stairs and presented to the emergency department with a chief complaint of left leg pain. Clinically, the patient had

BILATERAL CERVICAL FACET DISLOCATION

A 32yearold woman is brought to the emergency department following a road traffic collision. She complains of neck pain and is immobilised in a cervical collar with blocks and on a spinal board. The initial ATLS assessment suggests that this is an isolated injury and there is no obvious neurologic

PEDIATRIC KNEE Fractures and Dislocations

PEDIATRIC KNEE         OVERVIEW The knee is a ginglymoid (hinge) joint consisting of three articulations: patellofemoral, tibiofemoral, and tibiofibular. Under normal cyclic loading, the knee may experience up to five times body

PEDIATRIC FEMORAL SHAFT and KNEE Fractures and Dislocations

PEDIATRIC FEMORAL SHAFT         EPIDEMIOLOGY Represent 1.6% of all fractures in the pediatric population. Males are more commonly affected at a ratio of 2.6:1. Bimodal distribution of incidence: The first peak is from 2 to 4 years

FRACTURES OF THE MIDFOOT AND FOREFOOT

FRACTURES OF THE MIDFOOT AND FOREFOOT             MIDTARSAL (CHOPART) JOINT Epidemiology Injuries to the midfoot are relatively rare. The annual incidence of midfoot fractures is 3.6 per 100,000 population per

CALCANEUS FRACTURES

CALCANEUS FRACTURES         EPIDEMIOLOGY Calcaneus fractures account for approximately 1% to 2% of all fractures. The calcaneus, or os calcis, is the most frequently fractured tarsal bone. Represents 60% of all tarsal fractures

KNEE DISLOCATION (FEMOROTIBIAL)

KNEE DISLOCATION (FEMOROTIBIAL)             EPIDEMIOLOGY Traumatic knee dislocation is an uncommon injury that may be limb threatening; it should therefore be treated as an orthopaedic emergency. True incidence is

ACETABULUM Fractures and Dislocations

ACETABULUM         EPIDEMIOLOGY The incidence of acetabular fractures is 3 per 100,000 population per year. Neurologic injuries occur in up to 30% of cases and are usually partial injuries to the sciatic nerve, with the peroneal division

OLECRANON FRACTURES

OLECRANON FRACTURES         EPIDEMIOLOGY Bimodal distribution, with younger individuals sustaining an olecranon fracture as a result of high-energy trauma and older individuals as a result of a simple fall. Incidence in the adult

DISTAL HUMERUS fractures

DISTAL HUMERUS fractures         EPIDEMIOLOGY This is a relatively uncommon injury, comprising approximately 2% of all fractures and one-third of all humerus fractures. Incidence of distal humerus fractures in adults is 5.7 per

CASE 45 compartment syndrome

A 26-year-old man involved in a high-speed motor vehicle collision arrives to the emergency department with an obvious deformity of the right leg. Orthogonal radiographs of the right tibia/fibula are depicted in Figure 6–47A and B. An initial assessment deems the

humeral shaft fracture

A 68-year-old, right-hand-dominant female fell onto her left arm while walking her dog. An injury radiograph is shown in Figure 6–8.       Figure 6–8   What is her best treatment option? Closed reduction

middle-third clavicle fractures

A 32-year-old, right-hand-dominant male who works as a rancher fell off his horse onto an outstretched left upper extremity with immediate pain and deformity to his left clavicle. He presents later the same day. His injury radiograph is shown

Reconstruction Cases Avascular necrosis

A 51-year-old male presents with a chief complaint of left hip pain that has been progressively worsening for the past 6 months. He has groin pain and describes radiation to his knee. He has been taking a nonsteroidal anti-inflammatory medication with some relief but continues to limp and

Shoulder and Elbow cases stiff elbow

A 42-year-old female presents to the office for follow up after sustaining a minimally displaced radial head fracture 3 months prior. She states she was initially treated in long-arm splint by the ER and did not follow up with an orthopaedic surgeon until now. Per her report, she removed the splint

Shoulder and Elbow cases acromioclavicular arthritis

A 55-year-old, right-hand-dominant female presents with right shoulder pain for 6 months. She localizes the pain over the anterior and superior aspect of her shoulder. The pain is worsened when she is cleaning her contralateral axilla, while showering, and fastening or unhooking her bra. The

Shoulder and Elbow cases rotator cuff arthropathy

A 70-year-old, right-hand-dominant female presents to clinic complaining of 4 years of gradually worsening chronic right shoulder pain and stiffness. She says the pain is worse at night and with any range of motion, denies a history of trauma, pain in other extremities, or numbness or tingling of

Shoulder and Elbow cases Bony Bankart Hill–Sachs

A 33-year-old male presents to the ED after a fall during a soccer game. He reports significant right shoulder pain and limited ROM. An x-ray taken in the ED is shown below (Fig. 2–29).       Figure 2–29   What is the

Shoulder and Elbow cases rotator cuff tear

A 76-year-old, right-hand-dominant man presents to clinic complaining of right shoulder pain. The pain started several months ago, has gotten progressively worse, and is located diffusely over his deltoid region. He has night pain and pain with overhead activity. On examination, there is no visible

Foot and Ankle cases 23

A 29-year-old woman presents to you with pain on the medial aspect of the ankle and numbness and tingling on the plantar aspect of the foot. She reports no trauma and describes an insidious onset of symptoms over the past month. On physical examination she has neutral hindfoot alignment and no

Foot and Ankle cases 5

A 50-year-old otherwise healthy and active gentleman fell from a height of approximately 8 ft while rock climbing. He had immediate pain in his left ankle and was unable to bear weight on that extremity. He presented to the emergency department with pain isolated to the left ankle and foot. Initial

Foot and Ankle cases 1

A 40-year-old male, recreational basketball player presents 1 week after feeling like he was kicked in the back of the leg while coming down from a rebound. He was initially seen at an outside facility where he was diagnosed with an ankle sprain. One week prior to the injury he reports that he was

20 Pediatrics CASES

CASE                               20

19 Pediatrics CASES

CASE                               19

Shoulder and Elbow CASES 4

CASE                               31

Shoulder and Elbow CASES 3

CASE                               20

    CASE                               11

Shoulder and Elbow CASES 1

CASE 1     A 76-year-old, right-hand-dominant man presents to clinic complaining of right shoulder pain. The pain started several months ago, has gotten progressively worse, and is located diffusely over his deltoid region. He has night pain and pain with overhead activity. On

Spine CASES 5

CASE                               30

Spine CASES 4

CASE                               21

Spine CASE 3

CASE                               11

Spine CASES 2

  CASE 1     A 63-year-old male sustained a hyperextension injury to his neck while diving into a pool. Upon presentation, he reports decreased sensation in his hands and decreased strength in his arms and wrists, but no lower extremity complaints. On motor examination,

Surgery of the Foot

    Principles of foot and ankle&zwnj;&zwnj;     Interdigital neuroma   408 arthrodesis&zwnj; 385 Lesser toe

Total Hip Arthroplasty in Proximal Femoral Deformity

Introduction                        Total Hip Arthroplasty (THA) in the setting of deformity in the proximal femur can be a challenging proposition. For practical purposes during THA,

Reconstruction of Tibialis Anterior Tendon Ruptures

DEFINITION Tibialis anterior rupture may present as an acute injury or as a chronic painless foot drop. The diagnosis is often delayed. Recommended treatment is surgical for active patients and nonsurgical for low-demand patients. Surgical options include direct repair and

Open Achilles Tendon Repair

DEFINITION The Achilles tendon is the strongest tendon in the body and is the primary plantarflexor of the ankle joint.16 Sudden stretch of the tendon tissue can result in complete or partial rupture, with an estimated incidence of 8 to 18 per 100,000 persons.1,3 With complete rupture, the

Endoscopic Treatment of Posterior Ankle Impingement through a Posterior Approach

DEFINITION Posterior ankle impingement syndrome is a clinical disorder characterized by posterior ankle pain that occurs in forced plantarflexion. It can be caused by an acute or chronic injury, with the os trigonum or trigonal process of the talus as the most offending

Treatment of Bone Loss, Avascular Necrosis, and Infection of the Talus with Circular Tensioned Wire Fixators

DEFINITION Talus fractures are high-energy fractures that can have traumatic bone loss, avascular necrosis (AVN), and infected nonunion as the outcome of the injury.1,3,15,23 Acute talar bone loss and subsequent AVN and infection will present a cascade of hindfoot reconstruction

Sesamoidectomy

DEFINITION Sesamoiditis is a general term that indicates an injury to the sesamoid bone. There are multiple possible causes, such as trauma (fracture, contusion, repetitive stress), infection, arthrosis, osteonecrosis, and osteochondritis dissecans.3,5,12,13,15 There are two sesamoid bones

First Metatarsophalangeal Joint Arthrodesis: Perspective 2

DEFINITION The term hallux rigidus refers to a painful condition of the first metatarsophalangeal (MTP) joint of the great toe that is characterized by restricted motion (mainly dorsiflexion) and periarticular bone formation. The basic pathologic entity is that of degenerative

First Metatarsophalangeal Joint Arthrodesis: Perspective 1

DEFINITION Arthrosis of the first metatarsophalangeal (MTP) joint is commonly seen in osteoarthritis (hallux rigidus), rheumatoid disease, and gout. The indication for surgical treatment of the first MTP joint is pain where conservative treatment has failed. Arthrodesis of the first MTP

First Metatarsophalangeal Total Joint Arthroplasty with Roto-Glide

DEFINITION The Roto-Glide (Implants International, Cleveland, United Kingdom; distributed by Intercus, Bad Blankenburg, Germany) is a noncemented TiCaP surfaced three-component device for total replacement of the first metatarsophalangeal (MTP-1) joint (FIG 1). It allows for normal mobility

Arthrosurface HemiCAP Resurfacing

DEFINITION Hallux rigidus is an arthritic condition of the first metatarsophalangeal (MTP) joint. It is the most common form of arthritis affecting the foot. An estimated 2% to 10% of the general population displays varying grades of hallux

Capsular Interpositional Arthroplasty

DEFINITION Hallux rigidus refers to degenerative arthritis of the first metatarsophalangeal (MTP) joint that is characterized by pain, decreased range of motion (ROM), and proliferative osteophyte formation.     ANATOMY   The first MTP joint is composed of the

Dorsal Cheilectomy, Extensive Plantar Release, and Microfracture Technique

DEFINITION Hallux rigidus, osteoarthrosis of the first metatarsophalangeal (MTP) joint, was first described by Cotterill8 and Davies-Colley12 in 1887. Pain and restriction in range of motion (ROM) in the first MTP joint are the major characteristics of hallux rigidus.41 After

Dorsal Cheilectomy for Hallux Rigidus

DEFINITION Hallux rigidus refers to limited dorsiflexion of the first metatarsophalangeal (MTP) joint as a result of dorsal osteophyte impingement. Plantarflexion is typically not limited but may be restricted if a large dorsal osteophyte is present. In advanced stages, global arthrosis of

Revision Hallux Valgus Correction

DEFINITION Recurrent hallux valgus is a partial or complete return of valgus deformity at the first metatarsophalangeal (MTP) joint after surgical correction. Metatarsus primus varus is an increase in the 1-2 intermetatarsal angle due to obliquity or hypermobility of the first tarsometatarsal

Ludloff Osteotomy

DEFINITION Symptomatic hallux valgus associated with a first intermetatarsal angle greater than 15 degrees is typically corrected with a proximal first metatarsal osteotomy and distal soft tissue procedure when nonoperative treatment fails. Multiple techniques for the hallux valgus deformity

Anterior Thoracic Corpectomy

DEFINITION Anterior thoracic approaches provide a means of decompression, stabilization, and fusion for a variety of spinal pathologies, such as deformity, trauma, infection, tumors, and disc herniations.     ANATOMY   The thoracic vertebral bodies are heart-shaped

Lumbar Disc Herniations: Comprehensive Guide to Diagnosis and Treatment

Learn about lumbar disc herniations, including definition, anatomy, pathogenesis, natural history, imaging, diagnostic studies, differential diagnosis, nonoperative management, and surgical management. Get the latest information on treatment options and outcomes.” Lumbar Disc Herniations:

Reduction Techniques for Cervical Fractures and Dislocations

BACKGROUND Cervical spine fractures are seen in approximately 5% of trauma patients being evaluated at level I trauma centers.   Dislocations and displaced fractures require reduction and frequently surgical stabilization.   This chapter focuses on the cervical fractures

Shoulder and Elbow Orthopedic MCQS online

(OBQ15.201) A 52-year-old, right hand dominant man comes for evaluation of right shoulder pain that has been intermittently bothering him for three months. The pain is worse with overhead activities. He denies any history of trauma. His range of forward elevation in the plane of the scapula is

Open Reduction and Internal Fixation of Fractures of the Proximal Ulna

DEFINITION Fracture of the olecranon process is common, usually displaced, and nearly always treated operatively. Important injury characteristics include displacement, comminution, and subluxation or dislocation of the elbow, and all are accounted for in the Mayo classification (FIG

Ulnar Collateral Ligament Reconstruction of the Elbow

DEFINITION The ulnar collateral ligament (UCL) is a primary stabilizer of the medial side of the elbow. A tear in this ligament can cause pain and disability, primarily in an overhead athlete. When reconstruction is performed, the anterior band of the ligament is

Distal Biceps Tendon Disruptions: Acute and Delayed Reconstruction and One- and Two-Incision Techniques

ANATOMY Matt Noyes Edwin E. Spencer, Jr.   Mean length of the distal biceps insertion is 22 to 24 mm and the mean width is 15 to 19 mm on the proximal radius.     The biceps tendon inserts like a ribbon on the ulnar aspect of radial tuberosity. Left tendon spirals

Open and Arthroscopic Treatment of Lateral Epicondylitis

DEFINITION Lateral epicondylitis involves tendinosis at the origin of the common wrist extensors. It is commonly referred to as tennis elbow and is likely more correctly termed lateral elbow tendinopathy.15     ANATOMY   The common extensor origin

Suprascapular Nerve Decompression

DEFINITION Originally described in 1936 by Thomas18 and further defined by Thompson and Kopell19 in 1959, suprascapular nerve (SSN) entrapment is an increasingly recognized cause for shoulder pain, weakness, and atrophy of the supraspinatus and infraspinatus muscle. SSN entrapment

Pectoralis Major Transfer for Long Thoracic Nerve Palsy

DEFINITION Long thoracic nerve palsy leads to classical medial scapular winging because of weakness of the serratus anterior muscle (FIG 1). Other types of winging include trapezius lateral winging and rhomboid winging. Lesions of the long thoracic nerve can range from paresis to

Pectoralis Major Repair

DEFINITION Pectoralis major ruptures are injuries to the one of the largest and strongest muscles of the shoulder girdle. Injuries can be categorized based on the location and size of the rupture. Location: Tears most commonly occur at the tendon-bone junction but can also occur anywhere

Intramedullary Fixation of Humeral Shaft Fractures

r       DEFINITION Incidence: 3% to 5% of all fractures12 The AO/ASIF classification of humeral shaft fractures is based on increasing fracture comminution and is divided into three types according to the contact between the two

Plate Fixation of Humeral Shaft Fractures

DEFINITION Humeral shaft fractures, which account for about 3% of adult fractures, usually result from a direct blow or indirect twisting injury to the brachium. These injuries are most commonly treated nonoperatively with a prefabricated fracture brace. The humerus is the most freely movable

Hemiarthroplasty for Proximal Humerus Fractures

DEFINITION Proximal humerus fractures involve isolated or combined injuries to the greater tuberosity, lesser tuberosity, articular segment, and proximal humeral shaft. Overall, proximal humerus fractures account for 4% to 5% of all

Open Reduction and Internal Fixation of Proximal Humerus Fractures

DEFINITION Proximal humerus fractures may involve the surgical neck, the greater tuberosity, and/or the lesser tuberosity. The Neer classification, which is most commonly used, categorizes fractures based on the number of displaced parts (FIG 1). This classification system involves four

Intramedullary Fixation of Clavicle Fractures

DEFINITION The clavicle is one of the most commonly fractured bones. The site on the clavicle most often fractured is the middle third.10 The midclavicular region is the thinnest and narrowest portion of the bone. It is the only area not supported by ligament or muscle attachments. It

Intramedullary Fixation of Clavicle Fractures

Subscapularis Repair, Coracoid Recession, and Biceps Tenodesis

DEFINITION Subscapularis tears are less common than supraspinatus or infraspinatus tears. They occur in 2% to 8% of rotator cuff tears and are often missed.6,16 Subscapularis tears can be as follows: Isolated tears (partial or complete) Partial-thickness tears Anterosuperior (involving the

Treatment of Recurrent Posterior Shoulder Instability

DEFINITION Symptomatic recurrent posterior instability represents up to 12% of all cases of shoulder instability and is subdivided into two discrete entities.32,40 The first, true posterior dislocation is acute in nature and often related to trauma. It is readily managed with shoulder

Treatment of Periprosthetic Femoral Fractures above a Total Knee Arthroplasty

Introduction Periprosthetic fractures remain problematic complications after total knee arthroplasty. The number of knee arthroplasties performed worldwide continues to increase, and with the ever-growing elderly population, the number of periprosthetic fractures will continue to increase

Hip Resurfacing Arthroplasty

P ITFALLS Renal dysfunction: the lack of metal ion clearance by the impaired kidney may predispose these patients to the possible carcinogenic effects of increased serum metal ion concentrations.   Severe hip dysplasia (Crowe classes III and IV): bony acetabular

Total Knee Replacement in the Varus Knee

Indications End-stage arthritis associated with pain and dysfunction that has failed nonoperative treatment. Examination/Imaging Physical Examination Gait, alignment, range of motion, and stability are assessed, and a neurovascular exam is performed. Examination of

Revision Total Knee Arthroplasty with Femoral Bone Loss: Metal Augments

e       DEFINITION The number of revision total knee arthroplasty (TKA) procedures performed is projected to increase at an annual rate of 19.3%.13 Femoral bone defects are uncommon in primary TKA but are very common

Hip Arthroscopy

DEFINITION Hip arthroscopy is a minimally invasive technique to address a variety of painful hip conditions in the athletic and prearthritic population. A surge in technologic development since the mid-1990s has allowed surgeons to effectively and reliably treat a variety of painful hip

Uncemented Total Hip Arthroplasty

DEFINITION Total hip arthroplasty (THA) is the standard of care for symptomatic degenerative joint disease (DJD) of the hip that is unresponsive to nonoperative treatment. Cementless THA has demonstrated excellent mid- to longterm results. The acetabular component obtains initial fixation

Hip Arthroscopy

            DEFINITION     Hip arthroscopy is a minimally invasive technique to address a variety of painful hip conditions in the athletic and prearthritic

Release of Simple Syndactyly

    DEFINITION Syndactyly refers to the failure of separation between adjacent digits, resulting in “webbed” fingers. Congenital syndactyly is classified according to the extent of digital involvement and the character of the conjoined tissue. Complete

Release of Posttraumatic Metacarpophalangeal and Proximal Interphalangeal Joint Contractures

  DEFINITION Posttraumatic metacarpophalangeal (MCP) joint and proximal interphalangeal (PIP) contractures may develop directly as a result of injury to the joints and adjacent tissues or indirectly as a result of excessive immobilization or poor splinting of the hand. The

Surgical Treatment of Deep Space Infections of the Hand

    DEFINITION Deep space infections occur in one of three anatomically defined potential spaces within the hand. Thenar, midpalmar, and hypothenar spaces Interdigital subfacial web space Parona space—a potential forearm space Thenar space infections are the most

Open Achilles Tendon Repair

Open Reduction and Internal Fixation of the Distal Femur

DEFINITION Distal femur fractures are difficult, complex injuries that can result in devastating outcomes. The distal part of the femur is considered the most distal 9 to 15 cm of the femur and can involve the articular surface. The intra-articular injury can vary from a simple split to

Arthroscopically Assisted Triangular Fibrocartilage Complex Débridement and Ulnar Shortening

  DEFINITION The triangular fibrocartilage complex (TFCC) is a homogenous anatomic structure located on the ulnar aspect of the wrist that is responsible for distal radioulnar joint (DRUJ) stability and transfers load across the wrist from the ulnar carpus to the distal

Retrograde Intramedullary Nailing of the Femur

DEFINITION Retrograde femoral nailing can be defined as any femoral nailing technique with a distal entry from the condyles or through an intercondylar, intra-articular starting point. For this chapter, retrograde femoral nailing will refer to nails with an intercondylar starting

Open Reduction and Internal Fixation of the Symphysis

DEFINITION The pubic symphysis comprises a fibrocartilaginous disc between the bodies of the two pubic bones. A diastasis of the pubic symphysis indicates a disruption of the pelvic ring and an unstable pelvis. The symphysis is disrupted in anterior-posterior compression (APC) injuries as

Open Reduction and Internal Fixation of Monteggia Fractures in Adults

DEFINITION This injury was initially reported by Giovanni Monteggia in 1814 as a fracture of the ulna associated with an anterior dislocation of the radial head.6 The term “Monteggia lesions” was coined by Bado to describe any fracture of the ulna associated with a dislocation of

Operative Treatment of Radius and Ulna Diaphyseal Nonunions

DEFINITION A diaphyseal forearm fracture should be treated as a nonunion if there is either no likelihood that the fracture will go on to union (ie, large segmental defect) or if the fracture has ceased to demonstrate any progression of healing. Secondary to the advent of compression plating,

Open Reduction and Internal Fixation of Scaphoid Fractures

DEFINITION The scaphoid is the most commonly fractured carpal bone, accounting for 1 in every 100,000 emergency department visits.15 Scaphoid fractures typically result from a fall on an outstretched hand or less commonly following forced palmar flexion of the wrist20 or axial loading of

Intramedullary and Dorsal Plate Fixation of Distal Radius Fractures

DEFINITION Distal radius fractures typically originate in the radial metaphysis and occasionally enter the radiocarpal joint and distal radioulnar joint (DRUJ). These fractures may be stable or unstable, intra-articular or extra-articular, and have significant incidences of associated bony

Intramedullary and Dorsal Plate Fixation of Distal Radius Fractures

Reconstruction of Tibialis Anterior Tendon Ruptures

Open Achilles Tendon Repair

Endoscopic Treatment of Posterior Ankle Impingement through a Posterior Approach

Acute Patellar and Chronic Patellar Instability

DEFINITION Patellar instability in children and adolescents usually involves an episode of complete dislocation of the patella from the trochlear groove. Occasionally, there can be episodes of patellar subluxation without gross dislocation. There are two main types of patellar

Arthroscopic Drilling and Fixation of Osteochondritis Dissecans

DEFINITION Osteochondritis dissecans (OCD) is described as a focal, idiopathic alteration of subchondral bone with risk for instability and disruption of adjacent articular cartilage that may result in premature osteoarthritis.25     ANATOMY   The most common

Management of the Multiple Ligament-Injured Knee

DEFINITION Multiligament knee injuries result from both high-energy (eg, motor vehicle collisions) and low-energy (eg, athletic injuries, falls) events. Ultra-low velocity dislocations are those described in obese patients with minimal trauma. Dislocation of the tibiofemoral joint is common,

Osteochondritis Dissecans and Avascular Necrosis

DEFINITION Osteochondritis dissecans (OCD), avascular necrosis (AVN), spontaneous osteonecrosis of the knee, and chondral and osteochondral lesions all occur at or beneath the articular surface of a weight-bearing joint and are easily confused (FIG 1). OCD lesions occur when a segment of

Allograft Cartilage Transplantation

DEFINITION Articular cartilage lesions are focal, usually isolated, cartilage defects that may be either symptomatic or incidentally found. Osteochondritis dissecans is an osteochondral lesion that occurs in adolescents and, therefore, may have different management ramifications from lesions

Arthroscopic Meniscectomy

DEFINITION Irreparable meniscal tears are those for which no healing response is possible. This may include all or part of a meniscus, prompting partial, subtotal, or total meniscectomy. Meniscal injuries in the “white zone” (central avascular portion; FIG 1) most

Radial Nerve Decompression

    DEFINITION Radial tunnel syndrome was first described by Michele and Krueger7 in 1956 as radial pronator syndrome. It was described as a compression neuropathy involving primarily the posterior interosseous nerve (PIN), associated with a predominant symptom of

Carpal Tunnel Release: Endoscopic, Open, and Revision

      DEFINITION Carpal tunnel syndrome (CTS) is a compressive neuropathy of the median nerve at the wrist. CTS is the most common nerve compression condition in the upper extremity. Carpal tunnel release (CTR) is one of the most commonly performed procedures in the

Surgical Treatment of Cubital Tunnel Syndrome

    DEFINITION Cubital tunnel syndrome is a compression neuropathy of the ulnar nerve that occurs at or around the level of the elbow (cubis is Latin for “elbow”). Cubital tunnel syndrome is the second most common compression neuropathy of the upper limb

A1 Pulley Release for Trigger Finger with and without Flexor Digitorum Superficialis Ulnar Slip Excision

      DEFINITION Trigger finger is an entrapment of the digital flexor tendon(s) by the flexor tendon sheath. Trigger finger progressively causes inflammation, pain, catching, locking, and reduced range of motion (ROM).     ANATOMY   The

ORTHOPEDIC MCQS BANK HAND AND WRIST 1B

145) A 32-year-old carpenter complains of progressively worsening wrist pain for the last 2 months. He denies any recent history of trauma to the wrist or hand. An MRI is obtained and a representative image is provided in Figure A. Which of the following surgical interventions is thought to be

ORTHOPEDIC MCQS BANK HAND AND WRIST 1C

  A 22-year-old college quarterback is tackled and sustains a reducible first carpometacarpal dislocation. What is the recommended treatment? Closed reduction and casting Closed reduction and percutaneous pinning First carpometacarpal

ORTHOPEDIC MCQS BANK Hand and wrist 1A

A 35-year-old woman reports wrist pain after a fall onto an outstretched hand. On exam, she has focal tenderness over the wrist snuffbox. A radiograph and CT image are shown in Figures A and B. What is the proper treatment of her

Lateral Epicondylitis (Tennis Elbow) Arthroscopic Treatment

DEFINITION Lateral epicondylitis (LE) is a common musculoskeletal disorder that is characterized by lateral epicondylar pain and tenderness over the origin of the extensor carpi radialis brevis (ECRB) slightly distal and anterior to lateral epicondyle with exacerbated pain at the resisted

Treatment of Recurrent Posterior Shoulder Instability

Treatment of Recurrent Posterior Shoulder Instability DEFINITION Symptomatic recurrent posterior instability represents up to 12% of all cases of shoulder instability and is subdivided into two discrete entities.32,40 The first, true posterior dislocation is acute in nature and often

Operative Treatment of Thumb Carpometacarpal Joint Fractures

  Operative Treatment of Thumb Carpometacarpal Joint Fractures       DEFINITION The first carpometacarpal (CMC) joint comprises the thumb metacarpal base and the trapezium. The thumb CMC joint is vital to the function of the hand, and injuries can result in

Open Reduction and Internal Fixation of Scaphoid Fractures

  Open Reduction and Internal Fixation of Scaphoid Fractures       DEFINITION The scaphoid is the most commonly fractured carpal bone, accounting for 1 in every 100,000 emergency department visits.15 Scaphoid fractures typically result from a fall on an

Open Reduction and Internal Fixation of Scaphoid Fractures

Arthroscopic Capsular Releases for Loss of Motion

Arthroscopic Capsular Releases for Loss of Motion           DEFINITION Shoulder stiffness can be a function of soft tissue scarring and contracture or osseous changes. The stiff or frozen shoulder has been given the

Arthroscopic Treatment of Subscapularis Tears, Including Subcoracoid Impingement

Arthroscopic Treatment of Subscapularis Tears, Including Subcoracoid Impingement       DEFINITION A subscapularis tendon tear typically occurs at its insertion into the lesser tuberosity of the proximal humerus. Although the subscapularis is the largest of the

Arthroscopic Treatment of Subscapularis Tears, Including Subcoracoid Impingement

Arthroscopic Treatment of Rotator Cuff Tears

Arthroscopic Treatment of Rotator Cuff Tears           DEFINITION Rotator cuff disease encompasses a spectrum of disorders ranging from tendinitis to partial and fullthickness tendon tears. It is the most common shoulder disorder treated by an

Throwing Shoulder

Throwing Shoulder         DEFINITION The repetitive acceleration and deceleration of the arm during the throwing motion places the thrower's shoulder in extreme positions and under significant stresses, which can lead to chronic overuse-type injuries as

Arthroscopic Treatment of Biceps Tendinopathy

  Arthroscopic Treatment of Biceps Tendinopathy         DEFINITION The long head of the biceps tendon has long been recognized as a potential source of pain and cause of shoulder impairment.1,20,21,35 Although biceps tendon pathology can occur in

Intramedullary and Dorsal Plate Fixation of Distal Radius Fractures

  Intramedullary and Dorsal Plate Fixation of Distal Radius Fractures         DEFINITION Distal radius fractures typically originate in the radial metaphysis and occasionally enter the radiocarpal joint and distal radioulnar joint (DRUJ). These

Operative Treatment of Radius and Ulna Diaphyseal Nonunions

  Operative Treatment of Radius and Ulna Diaphyseal Nonunions       DEFINITION A diaphyseal forearm fracture should be treated as a nonunion if there is either no likelihood that the fracture will go on to union (ie, large segmental defect) or if the fracture

Fractures of the Proximal Ulna

Fractures of the Proximal Ulna   Open Reduction and Internal Fixation of Fractures of the Proximal Ulna         DEFINITION Fracture of the olecranon process is common, usually displaced, and nearly always treated operatively. Important injury

Open Reduction and Internal Fixation of Pediatric T-Condylar Fractures

  Open Reduction and Internal Fixation of Pediatric T-Condylar Fractures           DEFINITION T-condylar fractures of the distal humerus in children and adolescents are relatively rare occurrences. They are

Open Reduction and Internal Fixation of Pediatric T-Condylar Fractures

Open Reduction and Internal Fixation of Displaced Lateral Condyle Fractures of the Humerus

  Open Reduction and Internal Fixation of Displaced Lateral Condyle Fractures of the Humerus       DEFINITION Lateral condyle fractures refer to fractures of the outer (lateral) aspect of the distal humerus and may involve any or all of the following:

Open Reduction and Internal Fixation of Fractures of the Medial Epicondyle

  Open Reduction and Internal Fixation of Fractures of the Medial Epicondyle       DEFINITION Trauma to the medial aspect of the elbow may cause a medial epicondyle fracture, which is an injury to the apophysis of the medial

Open Lengthening of the Achilles Tendon

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Hip Arthroscopy

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ORTHOPEDIC MCQS ONLINE QUESTION BANK H3C

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ORTHOPEDIC MCQS ONLINE QUESTION BANK H2E

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ORTHOPEDIC MCQS ONLINE QUESTION BANK H2D

ORTHOPEDIC MCQS ONLINE QUESTION BANK H2D 2685. (3157) Q6-3976: Which of the following serves as the best landmark for proper screw entry into the lumbar pedicle:   1) The junction of the transverse process and inferior facet 3) The articulating interface of the superior and

ORTHOPEDIC MCQS ONLINE QUESTION BANK H2C

ORTHOPEDIC MCQS ONLINE QUESTION BANK H2C 2379. (3838) Q5-7621: An 18-month-old patient is suspected of X-linked hypophosphatemic rickets. The clinical findings are most likely to include all of the following except:   1) Below average stature 3) Dental abscesses or caries 2)

ORTHOPEDIC MCQS ONLINE QUESTION BANK H1D

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ORTHOPEDIC MCQS ONLINE QUESTION BANK H1D

ORTHOPEDIC MCQS ONLINE QUESTION BANK H1D Which of the following is a significant risk factor for a motor nerve palsy following a primary hip replacement:   1) Age <50 years 3) Prior hip surgery 2) Female sex 5) Developmental dysplasia 4) Body mass index

Labral Support (Shelf) Procedure for Perthes Disease

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Release of Simple Syndactyly

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Syme and Boyd Amputations for Fibular Deficiency

  Syme and Boyd Amputations for Fibular Deficiency           DEFINITION Fibular deficiency, previously known as fibular hemimelia, is a longitudinal deficiency of the fibula. It is

ORTHOPEDIC MCQS ONLINE BANK

(OBQ04.118) What muscles are responsible for the most common deformity after antegrade intramedullary nailing for a subtrochanteric femur fracture?           Hip

Arthroscopic Drilling and Fixation of Osteochondritis Dissecans

  Arthroscopic Drilling and Fixation of Osteochondritis Dissecans       DEFINITION Osteochondritis dissecans (OCD) is described as a focal, idiopathic alteration of subchondral bone with risk for instability and disruption of adjacent articular cartilage that

Acute Patellar and Chronic Patellar Instability

Chapter 41 Acute Patellar and Chronic Patellar Instability   Eric J. Wall Jay C. Albright Sarah R. Steward     DEFINITION Patellar instability in children and adolescents usually involves an episode of complete dislocation of the patella from the trochlear

Open Reduction and Internal Fixation of the Distal Femur

Chapter 29 Open Reduction and Internal Fixation of the Distal Femur   Animesh Agarwal     DEFINITION Distal femur fractures are difficult, complex injuries that can result in devastating outcomes. The distal part of the femur is considered the most distal 9 to

Open Reduction and Internal Fixation of Proximal Humerus Fractures

Chapter 19 Open Reduction and Internal Fixation of Proximal Humerus Fractures   Mark T. Dillon Stephen Torres Mohit Gilotra David L. Glaser     DEFINITION Proximal humerus fractures may involve the surgical neck, the greater tuberosity, and/or the lesser

Plate Fixation of Humeral Shaft Fractures

Chapter 17 Plate Fixation of Humeral Shaft Fractures   Matthew J. Garberina Charles L. Getz     DEFINITION Humeral shaft fractures, which account for about 3% of adult fractures, usually result from a direct blow or indirect twisting injury to the

Humeral Shaft Fracture Stabilization with Elastic Nails

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Open Reduction and Internal Fixation of Pediatric T-Condylar Fractures

Chapter 13 Open Reduction and Internal Fixation of Pediatric T-Condylar Fractures   Keith D. Baldwin John M. Flynn       DEFINITION T-condylar fractures of the distal humerus in children and adolescents are relatively

Open Reduction and Internal Fixation of Fractures of the Medial Epicondyle

Chapter 6 Open Reduction and Internal Fixation of Fractures of the Medial Epicondyle   Brian G. Smith Kristan A. Pierz   DEFINITION Trauma to the medial aspect of the elbow may cause a medial epicondyle fracture, which is an injury to the apophysis of the medial

Open Reduction and Internal Fixation of Displaced Lateral Condyle Fractures of the Humerus

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Open Reduction and Internal Fixation of Scaphoid Fractures

Chapter 2 Open Reduction and Internal Fixation of Scaphoid Fractures   Asheesh Bedi Peter J.L. Jebson Levi Hinkelman   DEFINITION The scaphoid is the most commonly fractured carpal bone, accounting for 1 in every 100,000 emergency department visits.15 Scaphoid

Open Reduction and Internal Fixation of Scaphoid Fractures

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ORTHOPEDIC MCQS ONLINE BANK OITE 14A

1.04 A 32-year old man sustained a closed tarsometatarsal fracture-dislocation, and a closed reduction is performed. Postreduction radiographs reveal a 3 mm offset at the first metatarsocuneiform joint. Management should not consist of: A light dressing and immediate range of

ORTHOPEDIC MCQS ONLINE BANK OITE 22

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ORTHOPEDIC MCQS BANK OITE 96

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ORTHOPEDIC MCQS BANK OITE 99

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ORTHOPEDIC MCQS ONLINE OB SPINE

SPINE A 79-year old man falls sustaining a hyperextension injury to his neck. A lateral radiograph, CT scan and MRI are seen in Figures A through C. On motor examination, he has 3/5 strength in his deltoids, elbow and wrist flexors and extensors. He has 4/5 strength in his hip flexors,

Triple Innominate Osteotomy

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Labral Support (Shelf) Procedure for Perthes Disease

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Posterolateral Arthrodesis for Spondylolisthesis

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ORTHOPEDIC MCQS ONLINE OB SHOULDER AND ELBOW 1B

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HIP EXAMINATION SPECIAL TESTS

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Release of Simple Syndactyly

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Arthroscopic Drilling of Osteochondritis Dissecans

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Proximal Patellar Realignment

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Patellar Instability

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Open Reduction and Internal Fixation of Fractures of the Medial Epicondyle

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Open Reduction and Internal Fixation of Displaced Lateral Condyle Fractures of the Humerus

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ORTHOPEDIC MCQS ONLINE OB HAND 1A

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Revision Total Knee Arthroplasty With Femoral Bone Loss: Metal Augments

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Uncemented Total Hip Arthroplasty

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Open Reduction and Internal Fixation of Jones Fracture

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Surgical Treatment of Calcaneal Fractures

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Open Reduction and Internal Fixation of the Pilon

      DEFINITION In orthopedic surgery, the terms pilon and plafond have been loosely translated and interchangeably used to describe the weight-bearing portion of the distal tibial articular surface. These injuries account for about 1%

Open Reduction and Internal Fixation of the Distal Femur

  Chapter 11 Open Reduction and Internal Fixation of the Distal Femur   Animesh Agarwal   DEFINITION Distal femur fractures are difficult, complex injuries that can result in devastating outcomes. The distal part of the femur is considered

Retrograde Intramedullary Nailing of the Femur

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Open Reduction and Internal Fixation of the Symphysis

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Management of the Multiple Ligament–Injured Knee

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Osteochondritis Dissecans and Avascular Necrosis

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Allograft Cartilage Transplantation

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Arthroscopic Meniscectomy

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Adductor Longus–Related Groin Pain

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Arthroscopic Capsular Releases for Loss of Motion

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Open Reduction and Internal Fixation of the Distal Femur

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Arthroscopic Treatment of Subscapularis Tears, Including Coracoid Impingement

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Arthroscopic Treatment of Rotator Cuff Tears

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ORTHOPEDIC MCQS ADULT RECONSTRUCTIVE OB 20 1C

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ORTHOPEDIC MCQS ONLINE OB 20 TRAUMA  2B CT angiography and admit the patient for hourly neurovascular checks Interventional radiology consult for formal angiography and stenting Corrent answer: 2 This patient has a posterior knee dislocation with an ischemic limb

ORTHOPEDIC MCQS 20 OB TRAUMA 1C

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ORTHOPEDIC MCQS 20 OB TRAUMA 1B

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ORTHOPEDIC MCQS 20OB TRAUMA 1A

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Orthopedic MCQS Trauma 0018

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Orthopedic Mcqs Sport 0019

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ORTHOPEDIC MCQS OB 20 TRAUMA1

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ORTHOPEDIC MCQS OB 20 SHOULDER AND ELBOW4

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ORTHOPEDIC MCQS OB 20 SHOULDER AND ELBOW3

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ORTHOPEDIC MCQS OB 20 SHOULDER AND ELBOW 2

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ORTHOPEDIC MCQS WITH ANSWER TRAUMA 03

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1) What percentage of patients will complain of knee pain at the time of union of a tibial shaft fracture treated with a reamed intramedullary nail?  1. <10%  2. 10-33%  3. 33-50%  4. 50-75%  5. >75%  Corrent answer:

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DEFINITIONChapter2   Open Reduction and Internal Fixation of the Symphysis         Michael S. H. Kain and Paul Tornetta