trauma

Question 1

SIRS criteria

Answer 1

HR > 90, WBC <4 or >12, RR >20 w/ PaCO2<32, T <36 or >38

Question 2

antibiotics for GA III open fracture

Answer 2

cephalosporin and aminoglycoside (gent)

Question 3

antibiotic added for heavily contaminated wound or farm wound

Answer 3

penicillin

Question 4

antibiotics for freshwater wounds

Answer 4

fluoroquinolone (cipro or levo) or 3/4th generation cephalosporin (ceftazidime)

Question 5

antibiotics for saltwater wounds

Answer 5

doxy and ceftazidime or a fluoroquinolone

Question 6

flap and blood supply for middle third tibial wound

Answer 6

soleus flap, posterior tib artery

Question 7

radiation dose for HO ppx

Answer 7

600-700 cGy 24 hours before up to 72 hours after surgery

Question 8

main findings of LEAP study

Answer 8

absence of plantar sensation is not predictive of function, no difference in outcomes between limb salvage and amputation

Question 9

operative indications for scapula fracture

Answer 9

angulation > 40 degrees, glenopolar angle < 20 degrees

Question 9

Rockwood classification of AC injuries

Answer 9

1 - AC sprain, 2 - AC torn/CC sprain, 3 - AC and CC torn, 4 - clavicle through trap posteriorly, 5 - trap and deltoid detached (>100% displacement), 6 - clavicle beneath coracoid

Question 10

operative indication for greater tuberosity. fracture

Answer 10

> 5 mm displacement

Question 11

most common complication of periarticular locking plate for proximal humerus fracture

Answer 11

screw cutout

Question 12

most reliable landmark. for judging humeral height

Answer 12

superior border of pec major insertion

Question 13

acceptable alignment for non op treatment of humeral shaft fracture

Answer 13

<20 degrees anterior angulation, <30 degrees varus/valgus, <3 cm shortening

Question 14

which nerves are at risk with distal interlocks in humeral nail?

Answer 14

radial nerve with lateral to medial, musculocutaneous with AP

Question 15

first and last muscles to return in radial nerve injury

Answer 15

first - BR, ECRL. last - EPL and EIP

Question 16

radial fracture at what distance from the articular surface is suggestive of DRUJ injury?

Answer 16

DRUJ unstable in 55% when radial fracture <7.5 cm from articular surface

Question 17

most common cause of irreducible DRUJ

Answer 17

interposition of ECU tendon

Question 18

factors most predictive of loss of reduction in distal radius fractures

Answer 18

radial shortening, dorsal comminution

Question 19

APC 1

Answer 19

symphysis < 2.5 cm, anterior SI ligaments stretched

Question 20

APC 2

Answer 20

symphysis > 2.5 cm, rupture of anterior SI ligaments, sacrotuberous, sacrospinous

Question 21

APC 3

Answer 21

symphysis > 2.5 cm, rupture of anterior and posterior SI ligaments, sacrotuberous, and sacrospinous

Question 22

LC classification

Answer 22

all have pubic rami fracture, 1 - sacral compression fracture. 2 - posterior iliac wing fracture. 3 - contralateral APC

Question 23

main cause of death in LC injuries

Answer 23

brain injury

Question 24

strongest pins for pelvic ex fix

Answer 24

AIIS > iliac wing, but iliac wing tolerated better

Question 25

Denis classification

Answer 25

1 - lateral to foramen, 2 - involves foramen, 3 - medial to foramen

Question 26

best view to see S1 foramen for SI screw placement

Answer 26

outlet

Question 27

xray view to make sure anterior column screw doesn't penetrate joint

Answer 27

obturator oblique

Question 28

simple acetabulum fractures

Answer 28

posterior wall, posterior column, anterior wall, anterior column, transverse

Question 29

associated acetabulum fractures

Answer 29

posterior wall posterior column, transverse posterior wall, T-type, anterior column posterior hemitransverse, associated both column

Question 30

approach that provides best access to quadrilateral surface

Answer 30

modified stoppa

Question 31

what is the corona mortis

Answer 31

vascular communication between external iliac and obturator artery system

Question 32

which approach to the tab has the highest rate of HO

Answer 32

extended iliofemoral

Question 33

what is the spur sign and what view is it seen on

Answer 33

obturator oblique, represents intact portion of iliac wing in associated both column

Question 34

ilioinguinal medial window

Answer 34

medial to external iliac artery and vein

Question 35

ilioinguinal middle window

Answer 35

between external iliac vessels and iliopsoas

Question 36

ilioinguinal lateral window

Answer 36

lateral to iliopsoas (iliopectineal fascia)

Question 37

pipkin classification

Answer 37

femoral head. 1 - below fovea, 2 - above fovea, 3 - +femoral neck fracture, 4 - +acetabular fracture

Question 38

garden classification

Answer 38

femoral neck. 1 - valgus impacted. 2 - complete, nondisplaced. 3 - complete, partially displaced. 4 - complete, displaced

Question 39

what factor correlates most with satisfactory clinical outcome in tibial plateau fractures

Answer 39

maintenance of mechanical axis

Question 40

what bone void filler used for plateaus has highest compressive strength

Answer 40

calcium phosphate cement

Question 41

what factor has the highest impact on need for amputation in tibial shaft fractures

Answer 41

severity of muscle injury

Question 42

which BMP is approved in acute tibial shaft fractures? nonunion?

Answer 42

BMP-2 in acute with IMN, BMP-7 in nonunion

Question 43

angulation common in proximal third tibia fractures

Answer 43

valgus and apex anterior

Question 44

starting point for tibial nail

Answer 44

medial border of lateral spine

Question 45

preferred treatment for midshaft tibial nonunions

Answer 45

reamed exchange nailing

Question 46

zone of physis damage in physeal fracture

Answer 46

zone of provisional calcification within zone of hypertrophy

Question 47

pediatric blood volume

Answer 47

75-80 ml/kg

Question 48

order of elbow ossification centers

Answer 48

CRI(M)TOE(L) - 1, 3, 5, 7, 9, 11

Question 49

xray view for lateral condyle

Answer 49

internal oblique

Question 50

bado classification

Answer 50

Monteggia. 1 - anterior. 2 - posterior. 3 - lateral. 4 - radial head fracture dislocation + proximal ulna fx

Question 51

acceptable angulation in peds distal radius fracture with >5 years growth remaining

Answer 51

30 degrees sagittal plane, 10-15 degrees coronal plane

Question 52

ASIS avulsion

Answer 52

sartorius

Question 53

AIIS avulsion

Answer 53

rectus

Question 54

iliac crest avulsion

Answer 54

abdominals and TFL

Question 55

delbet classification

Answer 55

peds fem neck. 1 - transphyseal (almost 100% risk AVN). 2 - transcervical. 3 - basicervical. 4 - IT (10-15% risk of AVN)

Question 56

Meyers and McKeever tibial spine fx classification

Answer 56

1 - nondisplaced. 2 - minimally displaced w/ intact posterior hinge. 3 - completely displaced. 4 - completely displaced and rotated

Question 57

tibial plateau and tubercle physis closure

Answer 57

posterior to anterior, medial to lateral, proximal to distal

Question 58

tillaux fracture

Answer 58

SH 3 avulsion of AITFL

Question 59

distal tibial physis order of closure

Answer 59

central -> anteromedial -> posteromedial -> lateral

Question 60

triplane fracture

Answer 60

SH 4. sagittal plane through epiphysis. axial plane through physis. coronal plane through metaphysis (SH 2 on lateral, SH 3 on coronal)

Question 61

what is the ISS

Answer 61

sum of square of 3 highest AIS scores. correlates w/ morbidity, mortality, LOS

Question 62

what structure travels with the round ligament or spermatic cord through superficial inguinal ring

Answer 62

ilioinguinal nerve

Question 63

best imaging to view U-type sacral fracture

Answer 63

lateral of sacrum or sagittal reformatted CT

Question 64

border between middle and lateral windows

Answer 64

iliopectineal fascia

Question 65

common nerve injured in hindfoot nail

Answer 65

lateral plantar nerve (numbness over lateral plantar midfoot)

Question 66

last muscle to recover with a peroneal nerve injury at fibular neck

Answer 66

EHL