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Which of the following processes relies on an exopolysaccharide glycocalyx?
Metastatic bone disease
Endochondral bone formation
Intramembranous bone formation
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A 22-year-old male presents 4 weeks following open reduction and internal fixation of his unstable ankle fracture. He has had three days of increasing pain, swelling and the new onset of purulent drainage from the mid-portion of the lateral incision. Laboratory values, including white blood cell count, sedimentation rate, and C-reactive protein are elevated. Current radiographs are seen in Figures A and B. On examination the wound probes deep and likely involves the lateral plate. What is the best step in management at this time?
Suppression with broad spectrum oral antibiotics until fracture healing
Suppression with broad spectrum intravenous antibiotics until fracture healing
Surgical debridement, removal of internal fixation, culture specific antibiotics, casting until fracture healing
Surgical debridement, maintenance of internal fixation, culture specific antibiotics until fracture healing
Wound culture in the office and suppression with culture specific antibiotics until fracture healing
After open reduction and internal fixation of long bone fractures, at what time period should C-reactive protein start to decrease?