SOAS Exam 3 UPDATED ACTUAL Exam
Questions and CORRECT Answers
What are the four regions of physeal anatomy? Describe them - CORRECT ANSWER -
Reserved - metabolically active, small
Proliferation - increase in number
Hypertrophy - increase in size
Calcification - maturation phase when cartilage turns into bone
What is the weakest point of physeal transition zones? - CORRECT ANSWER - Hypertrophy
Salter Harris fractures: type one - CORRECT ANSWER - Straight across
--> separation through the physis
Where is the most common location for a Salter-Harris type I fracture? - CORRECT
ANSWER - Slipped capital physis of femur
Salter Harris fractures: type two - CORRECT ANSWER - above
Separation through physis and metaphysis
Where is the most common location for a Salter-Harris type II fracture? - CORRECT
ANSWER - Distal femur
Salter Harris fractures: type three - CORRECT ANSWER - lower
Articular fracture caused by separation through the epiphysis and physis
Where are salter-harris type III fractures usually found? - CORRECT ANSWER - Distal
humerus
,What is the least common type of salter-Harris fracture? - CORRECT ANSWER - Salter-
harris III
Salter Harris fractures: type four - CORRECT ANSWER - through everything
Separation from epiphysis, physis, and metaphysis causing an articular fracture as well
Where are you most likely to see a Salter-Harris type IV fracture? - CORRECT ANSWER -
Distal humerus
Salter Harris fractures: type five - CORRECT ANSWER - crush - physeal crushing injury
Where are you most likely to see a Salter-Harris type 5 fracture? - CORRECT ANSWER -
Distal radius and ulna
Why is the most common site for physeal injury the radius and the ulna? - CORRECT
ANSWER - Because its a paired set of bones
Cone shape of distal ulnar physis
rapid growth rate
After a physeal fracture, what factors affect the degree of growth alteration - CORRECT
ANSWER - Degree of growth alteration depends on blood supply to the affected area,
mechanical disruption, and growth potential remaining
What is the Thurston-Holland sign? - CORRECT ANSWER - It is when the epiphysis is
separated from the physis with the fracture extending into the metaphysis. It makes a triangular
fracture fragment.
In which type of Salter Harris fractures do you see a Thurston-Holland sign? - CORRECT
ANSWER - Two and four
,How do you minimize surgical trauma during the repair of a Salter-Harris fracture? - CORRECT
ANSWER - Use pins instead of things like screws as this limits the trauma
Adaption osteosynthesis - CORRECT ANSWER - ?? Ask Gina
Proximal humerus SH fractures are usually what type? - CORRECT ANSWER - type I
What are the surgical repairs for a salter-harris fracture of the proximal humerus? The prognosis?
- CORRECT ANSWER - repair with screws and maybe tension bands if necessary
Good prognosis
How do you repair a proximal humerus SH fracture if the humeral head is completely fractures
off? - CORRECT ANSWER - Add Lag screw
Salter-Harris fractures of the distal humerus are typically where in it? What type of SH fracture
are they? - CORRECT ANSWER - Lateral aspect of the distal humeral condyle
IV
Why are spaniel breeds pre-disposed to having SH type 4 fractures of the distal humerus? -
CORRECT ANSWER - Cartilage defect in which they have incomplete ossification
How does jumping/ falling cause a fracture of the distal humerus? - CORRECT ANSWER -
There is a transfer of energy trough the radial head, this pushes on the condyle, causing the
fracture
The radial head transmits ______% of weight to the distal humerus - CORRECT ANSWER -
85%
, What are the surgical repairs for a salter-Harris fracture of the distal humerus? The prognosis? -
CORRECT ANSWER - Reduce w/ clamp or bone reduction forceps...
Stabilize with transcondylar screw across epiphysis
Add in anti-rotational K wire
What are the surgical repairs for a salter-harris type I fracture of the distal radius? The prognosis?
- CORRECT ANSWER - cross pinning
Good
What type of SH fracture of the proximal femur are you most likely to see? - CORRECT
ANSWER - SH type I
What are the surgical repairs for a salter-Harris fracture of the proximal femur? The prognosis? -
CORRECT ANSWER - Use divergent pinning, K wires, and pin placement
Fair to good due to blood supply considerations. Blood supply of the prox. femur comes from the
outside in and comes in around the neck of the femur
In which salter-harris fracture do you see apple coring of the femoral neck? - CORRECT
ANSWER - SH type I Proximal femur neck
What kind of salter-Harris fractures usually affect the distal femur - CORRECT ANSWER -I
or II
Discuss interdigitation in SH fractures of the distal femur - CORRECT ANSWER - Natural
interdigitation between segments due to 4 metaphyseal projections which fit into corresponding
depressions in the epiphysis
How do you repair a SH fracture of the distal femur? - CORRECT ANSWER - Reduction
with leverage and traction AKA reduce the epiphysis over top of the metaphysis
Questions and CORRECT Answers
What are the four regions of physeal anatomy? Describe them - CORRECT ANSWER -
Reserved - metabolically active, small
Proliferation - increase in number
Hypertrophy - increase in size
Calcification - maturation phase when cartilage turns into bone
What is the weakest point of physeal transition zones? - CORRECT ANSWER - Hypertrophy
Salter Harris fractures: type one - CORRECT ANSWER - Straight across
--> separation through the physis
Where is the most common location for a Salter-Harris type I fracture? - CORRECT
ANSWER - Slipped capital physis of femur
Salter Harris fractures: type two - CORRECT ANSWER - above
Separation through physis and metaphysis
Where is the most common location for a Salter-Harris type II fracture? - CORRECT
ANSWER - Distal femur
Salter Harris fractures: type three - CORRECT ANSWER - lower
Articular fracture caused by separation through the epiphysis and physis
Where are salter-harris type III fractures usually found? - CORRECT ANSWER - Distal
humerus
,What is the least common type of salter-Harris fracture? - CORRECT ANSWER - Salter-
harris III
Salter Harris fractures: type four - CORRECT ANSWER - through everything
Separation from epiphysis, physis, and metaphysis causing an articular fracture as well
Where are you most likely to see a Salter-Harris type IV fracture? - CORRECT ANSWER -
Distal humerus
Salter Harris fractures: type five - CORRECT ANSWER - crush - physeal crushing injury
Where are you most likely to see a Salter-Harris type 5 fracture? - CORRECT ANSWER -
Distal radius and ulna
Why is the most common site for physeal injury the radius and the ulna? - CORRECT
ANSWER - Because its a paired set of bones
Cone shape of distal ulnar physis
rapid growth rate
After a physeal fracture, what factors affect the degree of growth alteration - CORRECT
ANSWER - Degree of growth alteration depends on blood supply to the affected area,
mechanical disruption, and growth potential remaining
What is the Thurston-Holland sign? - CORRECT ANSWER - It is when the epiphysis is
separated from the physis with the fracture extending into the metaphysis. It makes a triangular
fracture fragment.
In which type of Salter Harris fractures do you see a Thurston-Holland sign? - CORRECT
ANSWER - Two and four
,How do you minimize surgical trauma during the repair of a Salter-Harris fracture? - CORRECT
ANSWER - Use pins instead of things like screws as this limits the trauma
Adaption osteosynthesis - CORRECT ANSWER - ?? Ask Gina
Proximal humerus SH fractures are usually what type? - CORRECT ANSWER - type I
What are the surgical repairs for a salter-harris fracture of the proximal humerus? The prognosis?
- CORRECT ANSWER - repair with screws and maybe tension bands if necessary
Good prognosis
How do you repair a proximal humerus SH fracture if the humeral head is completely fractures
off? - CORRECT ANSWER - Add Lag screw
Salter-Harris fractures of the distal humerus are typically where in it? What type of SH fracture
are they? - CORRECT ANSWER - Lateral aspect of the distal humeral condyle
IV
Why are spaniel breeds pre-disposed to having SH type 4 fractures of the distal humerus? -
CORRECT ANSWER - Cartilage defect in which they have incomplete ossification
How does jumping/ falling cause a fracture of the distal humerus? - CORRECT ANSWER -
There is a transfer of energy trough the radial head, this pushes on the condyle, causing the
fracture
The radial head transmits ______% of weight to the distal humerus - CORRECT ANSWER -
85%
, What are the surgical repairs for a salter-Harris fracture of the distal humerus? The prognosis? -
CORRECT ANSWER - Reduce w/ clamp or bone reduction forceps...
Stabilize with transcondylar screw across epiphysis
Add in anti-rotational K wire
What are the surgical repairs for a salter-harris type I fracture of the distal radius? The prognosis?
- CORRECT ANSWER - cross pinning
Good
What type of SH fracture of the proximal femur are you most likely to see? - CORRECT
ANSWER - SH type I
What are the surgical repairs for a salter-Harris fracture of the proximal femur? The prognosis? -
CORRECT ANSWER - Use divergent pinning, K wires, and pin placement
Fair to good due to blood supply considerations. Blood supply of the prox. femur comes from the
outside in and comes in around the neck of the femur
In which salter-harris fracture do you see apple coring of the femoral neck? - CORRECT
ANSWER - SH type I Proximal femur neck
What kind of salter-Harris fractures usually affect the distal femur - CORRECT ANSWER -I
or II
Discuss interdigitation in SH fractures of the distal femur - CORRECT ANSWER - Natural
interdigitation between segments due to 4 metaphyseal projections which fit into corresponding
depressions in the epiphysis
How do you repair a SH fracture of the distal femur? - CORRECT ANSWER - Reduction
with leverage and traction AKA reduce the epiphysis over top of the metaphysis
