Orthopedics for Physician Assistant and Nurse Practitioner Students: An Introductory Guide

Description

This practical introductory guide provides PA/NP students with the tools to recognize and begin treatment of the most common orthopedic problems, to avoid missing critical diagnoses, and to serve as a base of knowledge to which they can add depending on their chosen career path. Utilizing this concise text, PA/NP students will gain a basic familiarity with how to describe a problem (including imaging) to an orthopedic surgeon as well as how to begin treatment. In addition, the student should have no difficulty passing the orthopedic portion of the PA/NP credentialing exams.  The essentials of imaging, fracture description and operating room procedures are presented first. Then, proceeding anatomically from upper to lower extremity and the spine, chapters utilize a user-friendly chapter format covering fractures, dislocations and trauma as well as non-traumatic injury, focusing on pathophysiology, diagnosis and differential diagnosis, and brief treatment protocols. Since many PAs are office-based, only the highlights of surgery are presented, with an emphasis on what to look for regarding post-operative complications as well as the goals of the rehabilitation process (both non-operative and post-operative). Many books intended for orthopedic PA/NP students are written for those already in practice, usually providing far more information than the student can absorb in the usual 4-week orthopedic rotation, while others tend to skip important areas. This guide provides concise yet comprehensive coverage for a well-rounded presentation of everything orthopedic PA/NP students need to know to succeed.  Acknowledgments Contents 1: Introduction Reference 2: History, Physical Exam, and Diagnostic Testing 2.1 History Taking in Orthopedics 2.2 Physical Exam 2.3 Testing 2.3.1 Imaging Studies 2.3.1.1 Radiographs 2.3.1.2 CT Scans 2.3.1.3 Nuclear Imaging 2.3.1.4 MRI 2.3.1.5 Ultrasound 2.3.2 Lab Tests 2.3.3 EMG/NCS References 3: The Operating Room 3.1 Infection and Preoperative Evaluation 3.2 Positioning 3.3 Biomaterials 3.3.1 Polymethylmethacrylate 3.3.2 Hydroxyapatite (HA) References 4: The Hand and Wrist 4.1 Traumatic 4.1.1 Fractures 4.1.1.1 Scaphoid Fractures 4.1.1.2 Phalangeal Fractures 4.1.1.3 Thumb Fractures Bennett Fractures Rolando Fractures 4.1.1.4 Metacarpal Fracture (Digits 2–5) 4.1.2 Finger Dislocations 4.1.3 Tendon Injuries of the Hand 4.1.3.1 Flexor Tendon Lacerations 4.1.3.2 Extensor Tendon Injuries 4.1.3.3 Closed Tendon Injuries of the Hand 4.1.3.4 Sagittal Band Injuries 4.1.3.5 Mallet Finger 4.1.4 Nail Bed Injuries 4.2 Non-traumatic 4.2.1 Diseases 4.2.1.1 Trigger Fingers 4.2.1.2 Dupuytren’s Contracture Disease 4.2.1.3 Swan Neck 4.2.1.4 Boutonniere Deformity 4.2.1.5 Gamekeeper’s Thumb/Skier’s Thumb 4.2.1.6 Carpal Tunnel Syndrome (CTS) 4.2.1.7 Cubital Tunnel 4.2.1.8 De Quervain’s Disease (Tenosynovitis) 4.2.2 Hand Infections 4.2.2.1 Felons 4.2.2.2 Paronychia 4.2.2.3 Herpetic Whitlow 4.2.2.4 Metacarpophalangeal Joint Infections 4.2.2.5 Flexor Tenosynovitis Infection References 5: The Elbow and Forearm 5.1 Elbow Fractures and Dislocations 5.1.1 Supracondylar Fractures in Children 5.1.2 Supracondylar Elbow Fractures in Adults 5.1.3 Monteggia Fracture/Dislocation 5.1.4 Olecranon Fractures 5.1.5 Essex-Lopresti Lesions 5.1.6 Radial Head and Neck Fractures 5.1.7 Elbow Dislocations 5.1.8 Radial Head Subluxation “Nursemaid Elbow” 5.2 Forearm Fractures 5.2.1 Radial Shaft Fractures 5.2.2 Ulnar Shaft Fractures 5.2.3 Two-Bone Forearm Fractures 5.2.4 Complications of Forearm Fractures 5.3 Distal Radius Fractures 5.3.1 Colles Fracture 5.3.2 Smith Fracture 5.3.3 Barton Fracture 5.3.4 Chauffeur’s Fracture 5.3.5 Galeazzi Fracture/Dislocations 5.3.6 Ulnar Styloid Fractures 5.4 Biceps and Triceps Rupture: Distal 5.5 Elbow and Forearm: Non-traumatic 5.5.1 Lateral Epicondylitis 5.5.2 Medial Epicondylitis 5.5.3 Olecranon Bursitis References 6: The Shoulder and Humerus 6.1 Traumatic 6.1.1 Clavicle Fractures 6.1.1.1 Midshaft Clavicle Fractures 6.1.1.2 Fractures of the Distal Third of the Clavicle 6.1.2 Scapular Fractures 6.1.3 Humerus Fractures 6.1.3.1 Proximal Humerus Fracture 6.1.3.2 Humeral Shaft Fractures 6.1.4 Dislocations 6.1.4.1 Sternoclavicular Dislocation 6.1.4.2 Acromioclavicular Dislocations 6.1.4.3 Glenohumeral Dislocations 6.1.5 Complications of Dislocations 6.1.5.1 Hill-Sachs Lesion 6.1.5.2 Bankart Lesion 6.1.6 Other Common Shoulder Pathology 6.1.6.1 Labral Tears and Long Head Biceps 6.2 Non-traumatic 6.2.1 Glenohumeral Arthritis 6.2.2 Acromioclavicular Arthritis 6.2.3 Rotator Cuff Disease 6.2.4 Adhesive Capsulitis References 7: The Foot and Ankle 7.1 Introduction to Ankle Fractures 7.2 Traumatic 7.2.1 Specific Foot and Ankle Fractures 7.2.1.1 Triplane and juvenile Tillaux 7.2.1.2 Calcaneus Fractures 7.2.1.3 Tibial Pilon 7.2.1.4 Syndesmosis Injury 7.2.1.5 Phalangeal Fractures and Dislocations 7.2.1.6 Metatarsal Fractures 7.2.1.7 Avulsion Fractures 7.2.1.8 “Jones” Fractures 7.2.1.9 Tarsometatarsal Dislocations and Midfoot Fractures 7.2.2 Stress Fractures 7.2.3 Ankle Sprains 7.2.4 Achilles Tendon Ruptures 7.2.5 Puncture Wounds 7.3 Non-traumatic Foot and Ankle Conditions 7.3.1 Ankle Arthritis 7.3.2 Plantar Fasciitis 7.3.3 Deformities of the Midfoot 7.3.3.1 Flexible Flatfoot 7.3.3.2 Tarsal Coalition 7.3.3.3 Acquired Flatfoot 7.3.3.4 Cavovarus Foot (High Arch) 7.3.4 Charcot Foot 7.3.5 Neurologic Disorders 7.3.5.1 Tarsal Tunnel Syndrome 7.3.5.2 Interdigital Neuroma (aka Morton’s Neuroma) 7.3.6 Pediatric Deformities 7.3.6.1 Clubfoot (Equinovarus Foot) 7.3.6.2 Metatarsus Adductus 7.3.7 Deformities of the Forefoot 7.3.7.1 Bunions (aka Hallux Valgus) 7.3.7.2 Bunionette (aka Tailor’s Bunion) 7.3.7.3 Hammertoes and Claw Toes 7.3.7.4 Corns References 8: The Knee and Leg 8.1 Fractures 8.1.1 Patella Fractures 8.1.2 Tibial Plateau Fractures 8.2 Tendon Injuries 8.2.1 Quadriceps Tendon Injuries 8.2.2 Patella Tendon Ruptures 8.2.3 Patellar Dislocations 8.3 Ligamentous Injuries About the Knee 8.3.1 MCL 8.3.2 ACL 8.3.3 PCL and LCL 8.4 Meniscal Tears 8.5 Non-traumatic Knee Problems 8.5.1 Prepatellar Bursitis 8.5.2 Patellofemoral Pain aka Anterior Knee Pain Syndrome 8.5.3 Baker’s Cyst 8.5.4 Osteoarthritis of the Knee 8.5.5 Septic Arthritis 8.5.6 Osteochondritis Dissecans (OCD) 8.5.7 Osgood-Schlatter Disease 8.5.8 Shin Splints References 9: The Hip and Thigh 9.1 Fractures 9.1.1 Pelvic Fractures 9.1.2 Acetabular Fractures 9.1.3 Hip Fractures: Proximal Femur 9.1.3.1 Femoral Neck and Subcapital Hip Fractures 9.1.3.2 Intertrochanteric Hip Fractures 9.1.3.3 Subtrochanteric Fracture 9.1.4 Femoral Shaft Fractures 9.1.5 Supracondylar Femur Fractures 9.2 Hip Dislocations 9.3 Hip and Thigh: Non-traumatic 9.3.1 Hip Arthritis 9.3.2 Trochanteric Bursitis 9.3.3 Osteonecrosis 9.3.4 Femoral Acetabular Impingement 9.3.4.1 Cam Impingement 9.3.4.2 Pincer FAI 9.4 Pediatric 9.4.1 Slipped Capital Femoral Epiphysis 9.4.2 Legg-Calvé-Perthes Disease (LCPD) 9.4.3 Developmental Dysplasia References 10: The Spine 10.1 Spine: Traumatic 10.1.1 Cervical Spine 10.1.2 Thoracolumbar Spine Fractures 10.1.3 Compression Fractures 10.1.4 Burst Fractures 10.1.5 Chance Fractures 10.2 Spine: Non-traumatic 10.2.1 Cervical Spine 10.2.1.1 Cervical Stenosis 10.2.1.2 Cervical Myelopathy 10.2.1.3 Cervical Radiculopathy 10.2.2 Lumbar Spine 10.2.2.1 Background 10.2.2.2 Low Back Pain 10.2.2.3 Lumbar Stenosis 10.2.2.4 Lumbar Spondylolisthesis 10.2.2.5 Lumbar Radiculopathy 10.3 Diseases of the Spine 10.3.1 Arnold-Chiari 10.3.2 Ankylosing Spondylitis (AS) 10.3.3 Scoliosis 10.3.4 Idiopathic Scoliosis 10.3.5 Scheuermann’s Disease References 11: Tumors 11.1 Background 11.2 Benign Bone Tumors 11.2.1 Osteoid Osteoma 11.2.2 Bone Islands 11.2.3 Osteochondroma 11.2.4 Fibrous Tumors 11.2.5 Unicameral Bone Cyst 11.2.6 Enchondroma 11.2.7 Aneurysmal Bone Cysts (ABC) 11.2.8 Giant Cell Tumor 11.3 Malignant Bone Tumors 11.3.1 Osteosarcoma 11.3.2 Chondrosarcomas 11.3.3 Ewing’s Sarcoma 11.3.4 Adamantinoma 11.4 Metastatic Cancer to the Bone 11.5 Benign Soft Tissue Tumors 11.5.1 Ganglion Cyst 11.5.2 Lipoma References 12: Pediatric Orthopedics 12.1 Physeal Injuries: Salter-Harris Fractures 12.2 Developmental and Genetic Conditions 12.2.1 Cerebral Palsy 12.2.2 Charcot-Marie-Tooth Disease (CMT) 12.2.3 Down Syndrome 12.2.4 Dwarfism 12.3 Child Abuse 12.4 Connective Tissue Disorders 12.4.1 Ehlers-Danlos 12.4.2 Marfan 12.4.3 Fibrous Dysplasia 12.4.4 Muscular Dystrophy 12.4.5 Duchenne Muscular Dystrophy 12.5 Neural Tube Defects 12.5.1 Myelomeningocele 12.6 Neurofibromatosis 12.7 Metabolic Disorders of the Bone 12.7.1 Osteogenesis Imperfecta (OI) 12.7.2 Osteopetrosis 12.7.3 Rickets 12.7.4 Scurvy 12.7.5 Paget’s Disease 12.8 Sickle Cell Disease 12.9 Infection 12.9.1 Transient Synovitis of the Hip 12.9.2 Hip Infections in Children References 13: Rheumatological Disorders 13.1 Bone 13.1.1 Osteoporosis 13.1.2 FRAX Score 13.2 Crystal Disease 13.2.1 Gout 13.2.2 Pseudogout 13.3 Autoimmune Disease 13.3.1 Rheumatoid Arthritis 13.3.2 Juvenile Idiopathic Arthritis (JIA) 13.3.3 Reiter’s Syndrome 13.3.4 Psoriatic Arthritis 13.3.5 Systemic Lupus Erythematosus 13.3.6 Raynaud Phenomenon 13.3.7 Scleroderma (Systemic Sclerosis) 13.3.8 Sjogren’s Syndrome 13.3.9 Polymyositis 13.3.10 Polymyalgia Rheumatica 13.3.11 Polyarteritis Nodosa 13.4 Vasculitis 13.4.1 Large Artery Vasculitis 13.4.2 Medium Cell Arteritis 13.4.3 Small Cell Arteritis 13.5 Pain Syndromes 13.5.1 Complex Regional Pain Syndrome 13.5.2 Fibromyalgia References 14: Compartment Syndrome 14.1 Compartment Syndrome References Index