4.0 of 129 Ratings
Technique guides are not considered high yield topics for orthopaedic standardized exams including ABOS, EBOT and RC.
Figure A is the radiographs of a 75-year-old female who sustained a fall from a step ladder while dusting. Her past medical history is significant for rheumatoid arthritis and hypertension. Which of the following is true of the most appropriate treatment for this patient’s injury?
Should be performed through an anterolateral approach
Stiffness is the most common postoperative complication
Plates should be placed in parallel
Patients are typically restricted to lifting no more than 5-10 lbs in the affected extremity for life after surgery
ORIF of the radial head or replacement is required for construct stability
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A 59-year-old patient presents with right elbow pain after a fall off a ladder. There is swelling of the elbow with a visible deformity. The patient is neurovascularly intact with decreased sensation in the ring and small fingers. The patient states that this has been present for several years. Figures A and B are radiographs of the right elbow. What is the most appropriate treatment that provides the greatest construct rigidity and appropriately addresses the patient's ulnar nerve symptoms?
Bicolumnar orthogonal plating with submuscular transposition
Bicolumnar parallel plating with all distal screws passing through a plate and in situ cubital tunnel release
Bicolumnar parallel plating with all distal screws passing through a plate and observation of ulnar neuropathy
Bicolumnar orthogonal plating with in situ cubital tunnel release
Interfragmentary screw fixation of the articular surface with neutralization plating and subcutaneous transposition of the ulnar nerve
A 27-year-old male motorcyclist suffers a crash sustaining an isolated right distal humerus fracture. He was treated non-operatively. Ten months later, he returns complaining of limited range of motion and continued pain. Physical examination reveals range of motion of 30-90 degrees on the right and 0-130 degrees on the left. Imaging of his elbow is shown in Figure A and B. What is the most appropriate treatment to improve flexion?
Heterotopic ossification excision with release of the posterior band of the ulnar collateral ligament
Heterotopic ossification excision with release of the anterior band of the ulnar collateral ligament
Which of the following patients is most appropriately treated with a total elbow arthroplasty?
42-year-old laborer with an open T-type supracondylar distal humerus fracture
90-year-old male with a comminuted transolecranon fracture-dislocation of the elbow
66-year old female with a coronal shear fracture of the distal humerus
50-year-old male with a nonunion of a supracondylar humerus fracture
86-year-old female with a comminuted bicolumnar distal humerus fracture
An 82-year-old right-hand dominant female presents to the ED after a fall from standing on her left arm. Figure A demonstrates her initial radiograph in the ED. She is neurovascularly intact with no other injuries. When discussing surgery with the patient, you review open reduction and internal fixation (ORIF) and total elbow arthroplasty (TEA). Which of the following statements regarding these treatments options is true?
Regaining range of motion is quicker after ORIF
Infection is the most common cause of reoperation for TEA
There is no difference in TEA longevity between genders
Reoperation rates are higher in TEA compared to ORIF
TEA survival rates are >75% at 10-years
A 33-year-old male sustains a distal humerus fracture and is treated with open reduction and internal fixation of the distal humerus with olecranon osteotomy. A postoperative radiograph is shown in Figure A. A new deficit of the anterior interosseous nerve is now noted in the recovery room. What physical exam finding would be expected with this nerve injury?
Inability to flex radiocarpal joint
Loss of sensation over palmar aspect of thumb
Loss of sensation over dorsal hand first webspace
Inability to abduct index finger
Inability to flex thumb interphalangeal joint
An 85-year-old woman falls and injures her elbow in her non-dominant arm. Radiographs are shown in Figure A and B. She also suffers from severe osteoporosis, lives independently, and is a low-level community ambulator. Which of the following is the most appropriate treatment?
Hinged elbow brace
Olecranon osteotomy, articular ORIF, locked lateral plating
Triceps-splitting approach with double plate fixation
Total elbow arthroplasty
Casting for 4 weeks then ROM
What is the most common complication of the fracture seen in figure A, if operatively treated as seen in figure B?
Decreased elbow range of motion
Wound healing complications
Iatrogenic ulnar nerve injury
Inadvertent intra-articular hardware penetration
Nonunion of the distal humerus fracture