Trauma
2018
,1*A 36-year-old man has right shoulder pain after a fall from a bicycle. What is the most likely
complication of nonsurgical treatment of the injury shown in Figure 1?
1- Nonunion
2- Symptomatic malunion
3-Skin breakdown
4-Acromioclavicular joint arthrosis
Correct answer :1
The patient has a Neer type II distal clavicle fracture with radiographic evidence of coracoclavicular
ligament disruption. With non-surgical treatment, the most commonly reported complication is
nonunion, with rates reported to be as high as 44%. However, many patients with distal clavicular
nonunion remain asymptomatic. Symptomatic malunion and skin breakdown over the fracture site are
certainly possible, but are less common than nonunion. Because the fracture does not extend into the
acromioclavicular joint, post-traumatic arthrosis would not be expected.
,2*A 99-year-old woman sustains the injury shown in Figure 1 after falling from a standing position. What
is the most cost-effective treatment?
1- Three cannulated screws
2- Long intramedullary nail
3- Sliding hip screw
4- Short intramedullary nail
Correct answer : 3
Intertrochanteric hip fractures remain a common injury that orthopaedic surgeons manage. The optimal
form of surgical stabilization for these injuries has been a topic of debate over the years. Recent studies
have demonstrated equivalent outcomes between the use of sliding hip screws and intramedullary nails
for stable fracture patterns. Recent guidelines have suggested that the use of sliding hip screws for
stable fracture patterns can have a significant reduction in cost per case.
, Figure for question 3+4+5