orthopaedics

• What is the most common cause of osteomyelitis?

  1. Aureus
• What is the most common cause of osteomyelitis in sickle cell disease?

  Salmonella species
• What are the two subclassifications of osteomyelitis?

  • Haematogenous osteomyelitis
  • Non-haematogenous osteomyelitis
• In which population does haematogenous osteomyelitis most commonly occur?

  Children
• What is haematogenous osteomyelitis primarily caused by?

  Bacteraemia, usually monomicrobial
• What are the risk factors for haematogenous osteomyelitis?

  SCD, IVDU, IE, immunosuppression
• What is the most common haematogenous osteomyelitis in adults?

  Vertebral osteomyelitis
• What causes non-haematogenous osteomyelitis?

  Contiguous spread from adjacent soft tissues
• In which population does non-haematogenous osteomyelitis most commonly occur?

  Adults
• What are the risk factors for non-haematogenous osteomyelitis?

  Diabetic foot ulcers, PVD, DM
• What is the imaging modality of choice for osteomyelitis?

  MRI
• What is the first-line treatment for osteomyelitis?

  Flucloxacillin for 6 weeks
• What is the second-line treatment for osteomyelitis if penicillin allergic?

  Clindamycin
• What are the steps in fracture management and healing?

  1. A → E assessment
  2. History and examination
  3. Imaging
  4. Reduce if displaced
  5. Hold with conservative or surgical methods
  6. Rehabilitate with physiotherapy
• What does A → E assessment stand for in fracture management?

  Airway, Breathing, Circulation, Disability, Exposure
• What should be examined during history and examination of a fracture?

  Look, feel, move, special tests
• Why is it important to examine joints above and below the fracture?

  To identify any referring pathology
• What is the purpose of imaging in fracture management?

  To visualize the fracture and assess severity
• What are the conservative methods to hold a stable fracture?

  Back slab, full cast, walker boot
• When is reduction required in fracture management?

  Only in displaced fractures
• What surgical methods are used for unstable fractures?

  ORIF, external fixation, joint replacement
• What is the role of rehabilitation in fracture management?

  To restore function through physiotherapy
• What is a Bennet's fracture?

  Intra-articular fracture of 1st metacarpal
• What is the mechanism of a Bennet's fracture?

  Impact on a flexed metacarpal
• What does an X-ray show in a Bennet's fracture?

  Triangular fragment at the base of the carpal
• What is a Boxer's fracture?

  Fracture of the 5th metacarpal
• What is the mechanism of a Boxer's fracture?

  Typically caused by a punch injury
• How are distal fractures of a Boxer's fracture managed?

  Neighbour strapping
• How are proximal fractures of a Boxer's fracture managed?

  Plaster splint
• What is the mechanism of a scaphoid fracture?

  FOOSH with wrist hyperextension
• What are the clinical features of a scaphoid fracture?

  Swelling and tenderness in anatomical snuff box
• What is the tenderness location in a scaphoid fracture?

  Tenderness of scaphoid tubercle
• What pain is associated with a scaphoid fracture?

  Pain on telescoping of the thumb
• What is the most common carpal fracture?

  Scaphoid fracture
• What is the first-line investigation for a scaphoid fracture?

  X-ray AP and lateral views
• What is needed for visualization of the scaphoid on X-ray?

  Ulnar deviation AP view
• What should be requested for a scaphoid fracture?

  A dedicated 'scaphoid series' of X-rays
• What is the gold standard investigation for a scaphoid fracture?

  MRI
• What should be done if there is clinical suspicion of a scaphoid fracture but no visible fracture?

  Treat as fracture with immobilization
• How should a stable, non-displaced scaphoid fracture be managed?

  Analgesia and immobilization