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A 22-year-old male sustains the closed injury seen in figure A. The injury is best treated with which of the following methods?
Flexible intramedullary nailing
Open reduction and internal fixation with acute bone grafting
Open reduction and internal fixation
Closed reduction and functional bracing
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All of the following have been shown to increase the risk of refracture following removal of forearm plates used for internal fixation EXCEPT:
initial fracture comminution
initial fracture displacement
use of 3.5 mm dynamic compression plate
plate removal before 12 months
immediate activity as tolerated following removal
Treatment of an atrophic nonunion of the radial diaphysis should include which of the following?
Ultrasound bone stimulator
Plate exchange with autogenous cancellous grafting
Plate exchange with ulnar shortening osteotomy
A 25-year-old female sustains the isolated fracture seen in Figure A. The patient elects to have nonoperative management. When compared to operative treatment, which of the following is true of the clinical outcome following nonoperative management?
Long arm cast immobilization is necessary with nonoperative management
Twenty degree loss of forearm rotation is expected with nonoperative management
Loss of wrist motion is expected with nonoperative management
Loss of elbow motion is expected with nonoperative management
Equivalent clinical outcomes
A 42-year-old male sustains a closed, isolated ulna shaft fracture with 2mm displacement and 3 degrees valgus angulation. He is treated conservatively with early range of motion but presents at one year with a painful atrophic nonunion. What treatment is indicated at this time?
Open autogenous cancellous bone grafting
Open reduction internal fixation with autogenous bone grafting
Closed reduction and percutaneous pinning
Use of an implantable ultrasound device
A 27-year-old male sustains a type I open both bone forearm fracture as seen in Figure A. During irrigation and debridement a 1 cm of cortex is removed leaving a segmental gap. Which of the following adjuvants is recommended to supplement your internal fixation?
Longitudinal radioulnar dissociation, including Essex Lopresti fractures, requires disruption of the interosseous membrane (IOM). The interosseous membrane (IOM) consists of all of the following ligaments EXCEPT?
Central band ligament
Accessory band ligament
Dorsal oblique accessory cord ligament
Distal oblique bundle ligament
During open reduction and internal fixation of a both bone forearm fracture, restoration of the radial bow has been most associated with which of the following?
Improvement in wrist extension strength
Improvement in wrist flexion strength
Restoration of forearm rotation
Restoration of elbow range of motion
Decreased incidence of synostosis
Excision of heterotopic bone about the forearm or elbow can be done with limited recurrence rates as early as which of the following after initial injury?
Once ankylosis of the forearm or elbow occurs
An otherwise healthy 30-year-old male sustains a left forearm injury as a result of a fall from a ladder. Initial examination in the emergency room reveals a clean 2 centimeter laceration over the volar forearm associated with the radiographs shown in Figures A and B. Treatment should consist of irrigation and debridement of the wound followed by which of the following?
Closed reduction and casting of left radius and ulna
Temporary external fixation of the left radius and ulna
Definitive external fixation of the left radius and ulna
Open reduction and internal fixation of the left radius and ulna with delayed skin closure
Open reduction and internal fixation of the left radius and ulna with immediate skin closure
What is the primary advantage of two incisions compared to one for open reduction internal fixation of a both bones forearm fracture?
lower risk of synostosis
lower risk of wound complications
lower rate of radial neuritis
less pronator teres denervation
lower malunion rate
Proximal Ulna Fractures – Jeffrey Smith, M.D.(COA 2017, 6.4)
Title: Forearm Fractures - What Approaches? Presenter: Robert J. Strauch, MDColu...
HPI - Machine twist and injury right forearm
How would you manage this patient at this point?
HPI - Patient underwent surgery 2 years ago after falling while playing soccer. He suffered a comminuted diaphyseal radial shaft fracture, treated with open reduction and internal fixation with 2 K-wires.
How would you manage this patient?
HPI - Pain and swelling in LEFT wrist - patient cannot remember any history of trauma
What is the best treatment of this injury?