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We’ve moved

Just a short post to say that Dundee Bones is now closed on this site and we’ve closed down comments.

If you are a student or staff member in the Medical School at Dundee please visit our new site to keep up to date with news and access learning resources in the musculoskeletal system.

2010 in review

The stats helper monkeys at WordPress.com mulled over how this blog did in 2010, and here’s a high level summary of its overall blog health:

Healthy blog!

The Blog-Health-o-Meter™ reads Wow.

Crunchy numbers

Featured image

A Boeing 747-400 passenger jet can hold 416 passengers. This blog was viewed about 9,400 times in 2010. That’s about 23 full 747s.

 

In 2010, there were 50 new posts, not bad for the first year! There were 87 pictures uploaded, taking up a total of 38mb. That’s about 2 pictures per week.

The busiest day of the year was February 17th with 213 views. The most popular post that day was More bones for Thursday.

Where did they come from?

The top referring sites in 2010 were Private networks, dundeeprn.com, dundeechest.com, en.wordpress.com, and michael-jackson-secret-exposed.xpac.info.

Some visitors came searching, mostly for dundee bones, dundeebones, dundee bones blog, carpal bones, and dundeebones.com.

Attractions in 2010

These are the posts and pages that got the most views in 2010.

1

More bones for Thursday February 2010
6 comments

2

Ask DundeeBones February 2010
33 comments

3

About DundeeBones December 2009
5 comments

4

Mnemonics In Orthopaedics February 2010
7 comments

5

Test yersel February 2010
2 comments

DundeeBones is starting up again after the summer break and is ready for this year’s 4th year students for revision.
The posts contain info on core clinical problems, anatomy, x-ray interpretation and SAQs.  So…take the chance to look a round the Blog to find topics of interest for revision.
The Blog will be undergoing a substantial overhaul shortly as we migrate to a site within BlackBoard. This will give us the chance to post videos of joint examination technique as well as recently produced virtual patient scenarios.
Don’t forget if you have any orthopaedic questions, just ask DundeeBones! 

Topic: Complications of Fractures

1 B – compartment syndrome
2 A – ulnar nerve injury
3 G – osteomyelitis
4 E – avascular necrosis
5 D – deep venous thrombosis
6 I – pneumothorax

Topic: Treatment options in Fracture Management

1 D – dynamic hip screw
2 K – hemiarthoplasty
3 A – collar & cuff
4 B – open reduction & internal fixation
5 G – tension band wiring
6 E – intramedullar nailing
7 J – below elbow cast

Topic: Common Disorders of the Hand

1 F – trigger finger
2 B – dupuytren’s contracture
3 C – ganglion
4 A – carpal tunnel syndrome
5 E – pulp space infection

Topic: The Painful Knee

1 C – anterior cruciate injury
2 F – pre-patellar bursitis
3 H – rheumatoid arthritis
4 E – medial meniscal tear

Topic: Childhood Disorders

1 A – SUFE
2 G – perthe’s disease
3 F – transient synovitis
4 B – septic arthritis
5 D – developmental dysplasia of the hip

From feedback, most of you wanted to see more SAQs so here are some single best answer questions to help with your revision. Answers will be given in a separate post.

Topic: Complications of Fractures

A Associated Nerve injury
B Compartment Syndrome
C Non-Union
D Deep Venous Thrombosis
E Avascular Necrosis
F Delayed Union
G Osteomyelitis
H Fat Embolism
I Pneumothorax
J Pulmonary Embolism

1. An 18 year old footballer sustained a closed spiral fracture to his right tibia. He was placed in an above knee backslab. Overnight, he asks for more and more analgesia and complains of increasing pain with numbness in the first web space. His toes are well perfused and pedal pulses are present

2. A 29 year old gymnast with a fracture dislocation of her left elbow has the dislocation reduced under sedation. Afterwards, she complains of numbness and tingling in her little and ring fingers.

3. A 60 year old diabetic with an open fracture dislocation of the ankle has a post-operative wound binfection, treated with antibiotics. 6 months post-op X-rays show lucency around the screws and periosteal reaction. CRP is mildly elevated.

4. A 40 year old lady who fell onto an outstretched hand is treated in a scaphoid cast for 6 weeks. at 6 months, she continues to have pain in her wrist and her X-rays show increased density at the proximal pole of the scaphoid.

5. A 30 year old lady with anti-phospholipid syndrome is treated conservatively in a below knee cast for a distal fibular fracture. 2 weeks later she complains of a painful, tender calf.

6. A 45 year old man who came off a motorbike, sustaining a clavicle fracture and 2 rib fractures, complains of shortness of breath in A&E. Saturations are 85% and his respiratory rate is 38.

Treatment Options in Fracture Management

A Collar and Cuff
B Open reduction & internal fixation
C External Fixator
D Dynamic hip Screw
E Intramedullary Nailing
F Screw fixation
G Tension Band Wiring
H Traction
I Above elbow cast
J Below below cast
K Hemiarthroplasty

1. An intertrochanteric 2 part fractured neck of femur in a 95 year old lady which is minimally displaced.

2. A displaced intra-capsular fractured neck of femur in an 85 year old man who is house bound.

3. A 2 part fractured neck of humerus with minimal displacement in a 75 year old lady on her dominant side

4. A fracture dislocation of an ankle in a 21 year old rugby player

5. A displaced 2 part fracture of the patella which is displaced in an active 40 year old man

6. An isolated transverse femoral shaft fracture in an 18 year old

7. A minimally displaced, extra-articular fractured distal radius in a 70 year old lady on her non-dominant side.

Topic: Common Disorders of the Hand

A Carpal Tunnel Syndrome
B Dupuytren’s Contracture
C Ganglion
D Mallet Finger
E Pulp Space Infection
F Trigger Finger
G Paronychia
H Rheumatoid arthritis
I Game Keeper’s thumb
J Heberden’s nodes

1. A 46 year old man complaining of his finger sticking in a flexed position and then clicking upon straightening it.

2. A 60 year old alcoholic with progressive flexion of his MCP and PIP joints. His father had a similar problem.

3. A 30 year old man with a cystic swelling over the dorsum of the wrist, limiting wrist extenison.

4. A 20 year old pregnant woman with numbness and tingling of her thumb, index and middle fingers.

5. A 30 year old worker with a minor abrason over his left index finger. 1 week later, he presents with erythema and swelling affecting the palmar surface of the distal aspect of his left index finger.

Topic: The Painful Knee

A. Medial Collateral Ligament Sprain
B. Postero-lateral corner injury
C. Anterior Cruciate Injury
D. Posterior Cruciate Injury
E. Medial Meniscal Tear
F. Pre-patellar Bursitis
G. Osteoarthritis
H. Rheumatoid Arthritis
I. Septic arthritis

1. An 18 year old with a twisting injury and audible pop whilst skiing. Immediately afterwards, a large haemarthrosis developed.

2. A 30 year old joiner who sustained a minor cut to the front of his knee. 7 days later he develped erythema, pain and swelling.

3. A 40 year old lady with a chronic history of pain and swelling of her knee. Examination revealed decreased flexion and extension along with a valgus deformity, most marked on weight bearing.

4. A 22 year old footballer with a twisting injury to his knee. He presented to the A&E department being unable to fully straighten his knee.

Topic: Childhood Disorders

A SUFE
B Septic Arthritis
C Still’s disease
D Developmental dysplasia of the hip
E Osgood-Schlatter’s disease
F Transient Synovitis
G Perthe’s disease
H Tuberculous synovitis

1. An overweight 14 year old boy who presents with a 6 month history of a painful knee. He fell 3 days ago and limps now. Examinaton reveals that his leg is shorter and he has reduced rotations.

2. A 6 year old boy with groin pain and a limp presents to paediatrics. Initially, his symptoms were severe but subsequently resolved with bed rest. He has limited abduction and internal rotation of his hip.

3. A 3 year old toddler is admitted with a limp and temperature of 37.9 after an upper respiratory tract infection. He has mild tenderness of his hip joint, but a good range of movement.

4. A 4 year old girl with fever for 3 days presents with inability to weight bear and a grossly decreased range of movement of her hip. Her peripheries are cool to touch.

5. A young girl is brought to her GP by her mother who is concerned that her left leg is shorter than the other. She seems to limp slightly. Her mother had a “clicky” hip at birth.

Mr DundeeBones is taking a break for a few days but the Blog will still be here.

I’d  like to take up some of the suggestions you made today but it will take a while to get more SAQs together.  There’s also a chance that the platform for DundeeBones will be changing and that should make posting to the site easier.

Thanks to  everyone who has commented, contributed or asked questions – –and especially for all the feedback after today’s  lecture.

More X-rays after the weekend.

Have your say during the 12MD summing up  lecture tomorrow.  Audience response system will be used to see what you all think as a class. 

Also time for your individual personal responses and opinions.

Would an on-going, constantly growing, regularly updated DundeeBones be of any  use later in the year?/ next year? / when you are on  4th year orthopaedic placements? / if you are lonely?

Come along to  tell us what Mr DundeeBones mean to you tomorrow.