HPI - Sustained open fracture of distal radius and ulna after he was injured by a heavy gate of a truck.
Underwent Irrigation/debridement and application of external fixator - distal radius and orif of distal ulna.
Patient is 2 weeks post op.
How would you have treated this open fracture on initial presentation?
HPI - THA after femoral neck fracture, pain following start of mobilization 5 days after surgery. No subsidence of the stem after WB
How would you treat this intraoperative peri-prosthetic fracture?
HPI - Child was born with one leg congenitally amputaed below knee and on other leg fixed knee at 60 degree flextion.
How to treat?
HPI - Two years ago, she had a car accident in another country. Was kept in a long leg cast for tibial plateau fracture during 45 days.
Now complains of pain and difficulties in daily activities (walking, prolonged standing position, stairs)
What would be your preferred treatment for this 28 years old active woman with posteromedial tibial plateau mal-union?
HPI - 2 days ago .. falling on both outstretched hands with pain at right wrist joint and left elbow joint .
How would you manage the scaphoid fracture?
HPI - Undergone surgery for #shaft of humerus ,4weeks ago
Post op X-ray 4 weeks show dislocation shoulder
When to go for dislocation reduction?
HPI - This gentleman had a FOOSH from 5 feet onto right side in December 2014. Presented in clinic after returning back to his home area in Feb 2015 with painful right clavicle despite cuff and collar treatment.
Came back in March with no improvement in symptoms and no progression of callous formation.
How do you treat the majority of displaced midshaft clavicle fractures in your practice?
HPI - Blast injury to both legs of 3 month duration treated initially with
Ex-fix, transfered to our hospital one week after her injury in which there was an ongoing infection.
radical attack on infection established, weeks after the infection subsided plastic was consulted for soft tissue coverage
What is the best choice of fixation to use right now?
HPI - Chronic pain lateral side of left leg of 3 years duration. No treatment for this problem taken to date.
what is the most likely diagnosis based on the radiographs provided?
HPI - 10 year old girl fall on ground 3 weeks ago. She was treated with closed reduction and long arm case in full pronation. She is now 3 weeks out and presents with the radiographs shown.
How would you treat this fracture now that it is 3 weeks out from the fracture.
HPI - 2 yo child with PFFD right leg and no femoral head and dysplastic acetabulum.
How would you classify this problem?
HPI - valgus hyperextension injury while wrestling. tender at medial epicondyle. good rom. pain with valgus of elbow.
what is the diagnosis on the right elbow
HPI - History of fall
How would you treat this patient?
HPI - RTA ... with right shoulder injury
HPI - Trapped his right leg in wheelchair while moving to bed - deformation, came to hospital after 2 days. Xray spiral distal femoral diaphysis fx 31A1.
What type of implant would you use for 1st operation?
HPI - 23-year-old male patient admitted to the emergency room s/p high-speed motor vehicle collision. X-rays reveal a femoral head fracture.
How would you treat this comminuted femoral head fracture
HPI - MVA
What is the initial treatment?
HPI - Female 78 years old, with a left TKA revised 3 years ago, tripped on a small stair and fell on her opperated left knee.
How would you treat
HPI - This man showed up in outpatient clinic complaining about neck and shoulder(right) pain. We conducted an AP & Lateral x-ray just to check his cervical spine. At the lateral view we noted a small long bone at the rear end of the cervical spine (at c6-c7). Never seen this before. We asked him if he put his hand or anyone else tried to help him, but he denied everything. He was alone in the x-ray room with his hands down.
What's this bone?
HPI - Sustained injury 02 months back ..on 03 May 2015
Optd at another center on 09 May 2015 with dorsolateral approach - Plating radius was done. No bone grafting done. Post op early movements was started by the surgeon.
Presently has restriction of forearm motion. Mild pain on load bearing
Management options ... do we need to do surgery now or wait till Myositis mass consolidates further
HPI - The patient was brought two days ago with GSW, the wound is infected and bone exposed, he was shot 10 days befor,
What would be your next step in management?
HPI - GSW since 2nd of July, through the left inguinal region, there injury to the bowl, colostomy was done, X-ray reveal fracture to both ischial rami, and right proximal femur
What are the possible fixation options?
HPI - 26 year old male presented with recurrent left ACL rupture a year ago. Prior left ACL reconstruction using allograft, with re-rupture 3-4 months after initial procedure. Pop with acute swelling while jogging during rehabilitation, with persistent pain and instability since then. Unable to jog or do any other activities.
Prior right ACL reconstruction with autograft hamstring eight years ago, no subsequent issues with that knee.
Graft choice (ie auto vs allo)?
HPI - Fall at home 01 week back
HPI - Mild renal failure,motorcycle accident before 5 years this catastrofic injury left untreated
what is the best choice of fixation-reconstruction?
HPI - She had a fall on rigth wrist one years ago. she had treatment in other hospital due to the fracture. However, she felt the wrist pain and deformity recent months.
HPI - h/o twisting injury going down stairs and fell
HPI - Otherwise healthy male s/p motorcycle accident
How would you classify this acetabular fracture?
HPI - 39 years old /Male (finance - manager ) admitted to emergency suit , he fell down from the height on his right wrist [cherry tree (3 meter)].
How would you have treated this fracture?
HPI - Sub trochanteric fracture treated by long gamma nail 1 year ago.
Patient lost of FU
Come to ER for right hip pain.
How would you manage this case ?
HPI - Progressive pain and deformity of knee
Reconstruction of medial tibial defect
HPI - MVA 2 days ago
Elbow Treatment options?
HPI - 55yo male with fall from height resulting in subtroch fracture. Treated with CMN and cerclage cabling. Non-compliant with initial WB status. 3 months postop had distal interlock screw breakage but no significant pain with WB. Follow up films showed decent callous and maintained alignment. Lost to follow up. 8 months post-op felt a pop and pain while walking. New films show breakage of proximal nail.
How would you treat this initial fracture?
HPI - Healthy woman, she received a tombstone on her rear leg and injured her left ankle. She was operated on 3 days later
Would you rather do ORIF to the fibula despite the intact syndesmosis
HPI - Patient started experiencing mild pain two years back.Later started Limping.Now pain has reduced in intensity.
What stage do you think it is using the Waldenstrom's classification system?
HPI - MVA 3 days ago
Best treatment possible
HPI - fall 3days ago from a ladder
How would you treat this injury?
HPI - Three days prior, patient was admitted due to a gunshot wound through the thorax. The pulmonary artery was transected while entering the spinal canal without damaging the vertebral body.
On imaging the T8 posterior structures are seen damaged with the bullet doing a traumatic laminectomy through the level. The disc material and vertebral body was spared, however the bullet trajectory can be seen crossing the spinal canal.
How would you treat this SCI given limited resources?
HPI - Fall from 2-3 meters from a tree, trauma to the elbow and wrist
How would you treat this fracture
HPI - Pain on loading right thumb fort 02 ys duration.
Gradually worsening, aggravated for 02 months
HPI - Sustained closed injury left ankle in a RTA on 18 Jun 2015.
What implant if any would you choose for the fibula fracture?
HPI - Patient had previous distal tibia fracture treated with a DCP.
Now presented with tibia shaft fracture at proximal end of the plate.
HPI - Parents notice limping ,after fatty boy fall on child rt hip .
What is the diagnosis?
HPI - painless limp in left hip started 1 yr back,which was insidious in onset without any history of trauma.he had difficulty in sitting cross legged now.
What is the most likely diagnosis?
HPI - Road traffic accident, fall from bike. no other injury. patient vitally and systemically stable.
HPI - 20M injured foot
How would you classify this fracture?
HPI - 13 months ago insidious onset of left hip pain which progressively become worse. Sudden deterioration after a sickle cell crisis. Now left hip is Ficat stage III. He started feeling discomfort with his right hip about two months ago. Now right hip is Ficat stage IIA (Precollapse stage)
What is the best combination of bearing surfaces for left THA
HPI - Had sustained the injury on 1-2 june. Since it was in a distant village didnt seek medical advice. Presented to trauma outpatient center on 6 june.
How would you manage this fracture?
HPI - Since a year ago and without any traumatic event patient had an insidious onset of discomfort over his right 2nd MTP joint.
Which is the best treatment plan?
HPI - On September 2013 right humerus fracture during seizure. Initial consrvative treatment with sarmiento splint. On March 2014 ORIF DCP 3.5 with 6 screws and iliac autografts. On September 2014 fixation failure. On November 2014 ORIF DCP 4.5 with 8 screws and iliac autografts. On May 2015 hardware failure.
Which is the best treatment plan for this patient?