Lower Limb

Question 1

What is an open book fracture caused by? What do you see on XR?

Answer 1

Anteroposterior compression (usually by major trauma)

Widening of pubic symphysis

Question 2

What are he Ottawa knee rules?

Answer 2

Help guide decision making for XR in someone with knee trauma aged 18-55

1. Patellar tenderness
2. Fibulae head tenderness
3. Inability to flex knee 90degrees
4. Can’t weight bear immediately after trauma and at time of exam (4 steps)

Question 3

What are the standard views for the foot XR?

Answer 3

Dorsal plantar view

Oblique view

Question 4

Ottawa ankle rules?

Answer 4

XR if:

• unable to weight bear 4steps after trauma + O/E
• tenderness over the distal 6cm and posterior surface of the lateral or medial malleolus

Question 5

What is the lateral and medial malleolus?

Answer 5

Lateral malleolus is the distal position of fibula

Medial malleolus - tibia

Question 6

Ottawa foot rules?

Answer 6

XR if tenderness over:

1. Base of 5th metatarsal
2. Calcaneum
3. Navicular bone

Question 7

Give 3 common type of foot fracture

Answer 7

Avulsion fracture of 5th metatarsal

Stress fracture MTs (2nd or 3rd commonly)

Fractures of phalanges

not common: Lisfranc fracture

Question 8

If someone has midfoot trauma what would you request?

Answer 8

Foot CT –> shows up Lisfranc fracture-dislocation better