Please rate topic.
Average 3.7 of 3 Ratings
Thank you for rating! Please vote below and help us build the most advanced adaptive learning platform in medicine
Figure A is a radiograph of an 80-year-old woman who sustained a closed injury to her left arm 10 months ago. She presents to office today complaining of persistent pain in her arm. What is the most likely metabolic or endocrine abnormality contributing to this patients presentation?
Vitamin D deficiency
Parathyroid hormone disorder
Select Answer to see Preferred Response
A 42-year-old man reports persistent arm pain after undergoing intramedullary nailing of a humeral shaft fracture 13 months ago. Physical exam shows near normal shoulder and elbow range-of-motion. Infection work-up is normal. A radiograph is shown in Figure A. What is the next most appropriate step in treatment?
Manipulation under anesthesia
Nail removal and plate fixation
Percutaneous locked plating
A patient sustained a transverse humeral shaft fracture 6 months ago and presently complains of pain and instability at the area of injury. A plain radiograph is shown in Figure A and on exam there is gross motion at the fracture site. What is the most appropriate definitive treatment?
ultrasound therapy to nonunion site
open reduction internal fixation with autologous bone graft
antegrade intramedullary nail
retrograde intramedullary nail
A 33-year-old male presents 7 months after a fall from 15 feet. He complains of continued pain over his left arm and you elicit pain and gross movement with palpation of his humerus. Infectious workup is negative and a radiograph is shown in Figure A. What is the most appropriate next step in his management?
Reassurance and appropriate followup
Use of a bone stimulator
Exchange humeral nailing
IM nail removal, open reduction internal fixation with bone grafting
HPI - Patient fractured his left humeral shaft and saw an outside surgeon, undergoing IM fixation. Fracture site initially looked promising, but soon went on to nonunion. One of the distal screws never seated properly and began to back out soon after his initial surgery.
At 3 months post-op, the patient returned to the outside facility and was pronounced healed by the PA.
3 years later, he presented to my clinic with significant pain and dysfunction.
Would you recommend surgery in this patient?