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Which of the following techniques used to treat pediatric femur fractures has been associated with the greatest risk of damage to the deep branch of the medial femoral circumflex artery?
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An 11-year-old male falls and sustains the injury shown in Figure A. Which of the following treatment options carries the greatest risk of injury to the medial femoral circumflex artery (MFCA)?
Femoral nail with piriformis starting point
Femoral nail with trochanteric starting point
Intramedullary flexible nails
Retrograde intramedullary nailing
External fixation with trochanteric fixation proximal
Which of the following patients would be the BEST candidate for submuscular bridge plating?
A 4-year-old boy with a spiral diaphyseal femur fracture
A 9-year-old, 75-lb girl with a length stable distal one-third femur fracture
A 10-year-old, 120-lb boy with a long spiral, comminuted midshaft femur fracture
A 17-year-old girl with an open, transverse midshaft femur fracture
An 18-year-old female with a proximal third, wedge-shaped femur fracture
An 11-year-old female sustains an open right femoral shaft fracture and closed left both-bone forearm fracture after being struck by a motor vehicle. She is 5'1'' and weighs 146 lbs. No neurovascular deficits are noted in any of her extremities. Which of the following is a contraindication to elastic intramedullary nail fixation of her femur fracture?
Multiple extremity fractures
Open femur fracture
Figure 22 shows the radiograph of a 7-year-old boy who underwent retrograde elastic nailing of a femoral shaft fracture. What is the most common problem following this procedure?
Osteonecrosis of the femoral head
Persistent pain and irritation at the nail insertion site
A 14-year-old boy sustains a femoral shaft fracture while waterskiing. He is treated with a piriformis fossa entry antegrade intramedullary nail. Six months post-operatively the patient complains of persistent groin pain. What is the most likely complication he has sustained?
iatrogenic femoral neck fracture
femoral head osteonecrosis
femoral shaft non-union
proximal locking screw cutout
A 4-year-old boy sustains a midshaft femur fracture with less than 2 cm of shortening that was treated with immediate closed reduction and hip-spica casting. Of the following listed potential complications, which is the most common requiring revision treatment in this age group?
loss of reduction
A 7-year-old boy sustains an isolated, closed injury shown in Figure A. He weighs 55lbs and is otherwise healthy. What is the best treatment option for this patient?
Closed reduction and hip spica casting
Closed reduction and flexible intramedullary nailing
Closed reduction and antegrade rigid femoral intramedullary nailing
Skeletal traction and hip spica casting
A 13-year-old male is involved in motor vehicle accident. He has a GCS of 6 and is intubated at the scene. He has a splenic laceration that will require an emergent exploratory laparotomy and he has a left hemothorax requiring a chest tube. His femur fracture is shown in Figure A. What is the next best step in management of this fracture?
Balanced skeletal traction
Intramedullary nail with trochanteric starting point
Intramedullary nail with pirifomis starting point