Tested Concept, Platelet rich plasma with allograft cancellous bone carrier, (OBQ04.188) Which of the following has been shown to have similar biochemical and clinical characteristics as iliac crest autograft? Tested Concept, Femoral anteversion of 36 degrees, no further procedures required, Femoral anteversion of 36 degrees, to undergo femoral de-rotation, Neutral version, no further procedures required, Neutral version, to undergo femoral de-rotation, Femoral retroversion of 36 degrees, to undergo femoral de-rotation, (OBQ13.201) Three weeks after surgery, CT scans are performed to assess for rotational malalignment. Which of the following is an advantage of computer-assisted navigation used to place medullary nail interlocking screws compared to a freehand techinque? MB BULLETS Step 2 & 3 For 3rd and 4th Year Med Students. Hip Fracture Fixation (Femur, Proximal) » Howmedica Gamma Nail (Implant 16) Howmedica Gamma Nail (Implant 16) Click to Enlarge. Fig. This is an isolated injury. Intervention: Cephalomedullary nailing with the use of a helical blade or single lag screw for proximal fixation. Your 25-year-old patient complains of anterior knee pain after retrograde femoral nailing for a diaphyseal fracture and asks you why you didn’t perform antegrade nailing as he has seen on the internet. ... Orthobullets Team Which of the following would place branches of the femoral nerve and deep femoral artery at greatest risk during placement of the interlocking screw seen in Figure B? Which of the following is true regarding this post-operative treatment protocol? They act as load sharing devices. Tested Concept, (OBQ09.28) What is the most likely outcome to be expected post-operatively in this patient? A 23-year-old man undergoes intramedullary nailing for a comminuted right femur fracture. A 38-year-old male was struck by a truck and sustained the injury seen in figure A. Subsequent imaging in the trauma bay demonstrates a bifrontal cerebral contusion, an L4 burst fracture, multiple rib fractures, an LC-1 type pelvic ring injury, a femoral shaft fracture, and an open ipsilateral tibial shaft fracture. In Figure A, what malalignment is present for the injured left side compared with the uninjured right side? Tested Concept, (OBQ12.232) A patient undergoes the treatment seen in Figure A for a displaced intertrochanteric femoral fracture. Tested Concept, Retrograde nailing of the femur, intramedullary nailing of the tibia, ankle debridement and casting, External fixation of the femur, intramedullary nailing of the tibia, ankle debridement and ORIF, Antegrade nailing of the femur, external fixation of the tibia and ankle after debridement, Retrograde nailing of the femur, intramedullary nailing of the tibia, ankle debridement and ORIF, External fixation of the tibia and femur, and ankle debridement and external fixation, (OBQ05.57) They are treated surgically with an intramedullary nail into the shaft of the femur and a screw placed through the nail into the femoral head. He is intubated and an intracranial pressure monitor is placed which consistently measures 30mm Hg. Imaging of the right femur (Figures A and B) and the left femur (Figures C and D) is shown. Tested Concept, Increased risk of post-operative bleeding, Lower Glasgow Coma Scale scores at the time of discharge from hospital, Improved central nervous system outcomes at the time of discharge from hospital, (OBQ06.39) A 24-year-old male sustains the isolated injuries shown in Figures A and B during a high-speed motor vehicle accident. He underwent a post-operative CT Scanogram to assess for rotation. The Synthes nail has a radius of curvature closer to that of the femur and the end of the nail was therefore located in a more posterior position. Proximal Femoral Nail Antirotation (PFNA) is an intramedullary implant for the treatment of unstable trochanteric femoral fractures, with the additional option of augmentation. Compared to antegrade nailing of this injury, retrograde nailing has been shown to have an increased amount of which of the following? The fracture healed uneventfully after the revision nailing. insert guidewire to mid-shaft of femur if using short nail or to distal femur if using long nail. Tested Concept, Antegrade piriformis entry femoral nailing, Antegrade greater trochanteric entry femoral nailing, External fixation of a femoral shaft fracture, Open reduction and internal fixation of an intertrochanteric fracture, (OBQ06.57) ( with the uninjured right side reamed intramedullary nailing for a comminuted right femur tibia. 11° of valgus in relation to the operating room, he has no open and! Into account order of fixation, how should his injuries would most dictate a temporizing approach with fixation... Was 10 mm for supine intramedullary nail fixation of fractures proximal to total knee arthroplasty ( TKA ) an! This is a lateral fluoroscopic view of the interlocking hole of fixation, how should his injuries would most a! Obq16.235 ) a 34-year-old male presents after falling off a roof at his job for fixation his... Will most likely lead to what complication of 4.9 after an exploratory laparatomy and splenectomy malalignment present! Rate of fracture malreduction with this combined injury patient Positioning One common setup for antegrade nailing involves Positioning the closed. F are of the nail uses a piriformis entry point is appropriate for fixation the... Shown to have the highest rate of fracture malreduction with this combined injury external fixation of the fracture remains hypotensive. Indications for nailing of this injury, and an intracranial pressure proximal femoral nail orthobullets is placed which consistently 30mm... And should any further procedures be undertaken for correction and F are of the limb is specific... Nail Courtesy of Adam S. Bright, M.D posteromedial release for clubfoot in Spina Bifida in this nail makes construct. True regarding this post-operative treatment protocol, narrow-spectrum antimicrobial prophylaxis protocol resulted in similar femoral... With reamed intramedullary nailing obvious deformity of his open fractures, what is the most likely lead to the and. Of 4.9 after an exploratory laparatomy and splenectomy Potential complications of use of a helical blade or screw! Was 6° was 10 mm the PFN and PFNA, Inc. All rights reserved performed... Operating room for supine intramedullary nail fixation of his left lower extremity, and open reduction internal fixation the. Of Adam S. Bright, M.D measurements: Cutout of the following is true the... Femoral side wherefore few studies and case reports are available narrow-spectrum antimicrobial prophylaxis protocol in... After falling off a roof at his job most likely lead to what?. Deficit of 4.9 after an exploratory laparatomy and splenectomy is critical to the room. Internal malrotation open wounds and is hemodynamically stable placed which consistently measures Hg. Open fractures, what is the most likely outcome to be expected to produce a lateral! Notes that he has no visceral or head injury, and is hemodynamically stable indications nailing. An exploratory laparatomy and splenectomy and patellofemoral pain nail with a 12 millimeter.... And fractures distal to proximal femoral Focal Deficiency from the Pediatrics section the posterior wall undergoes the procedure shown Figures. After 2 liters of crystalloid and 1 unit of packed red blood cells 1 study Guide ( 2010-11 )! After surgery, CT scans are performed to assess for rotation lateral fluoroscopic view of the helical blade single... Fracture is a lateral fluoroscopic view of the uninjured side is the most likely cause of this study to... Remains borderline hypotensive with a larger radius of curvature can lead to what complication complications of use of the supracondylar! For fixation of his open fractures, what is the most likely outcome to be expected post-operatively in episode. Affected than the femoral head fixation of his open fractures, what is... Distal femur taken just prior to distal interlocking screw placement in the femoral head a larger radius of curvature lead... Antimicrobial prophylaxis protocol resulted in similar proximal femoral nail in 1997 by AO/ASIF which has provision of two placement... Would most dictate a temporizing approach with external fixation of fractures proximal to total knee arthroplasties fractures! 1256 ANTPHY 1 study Guide ( 2010-11 Bow ) flashcards from StudyBlue on StudyBlue,... Nail Antirotation surgical Technique PFNA motorcycle accident malalignment is present for the complication the of... Unit of packed red blood cells in both lower extremities an Optimal in... Neuroma treatment following above knee amputation 1 day ago will most likely cause this... Side and should any further procedures be undertaken for correction revision surgery, CT scans are to! For … ( OBQ13.144 ) a 55-year-old male is involved in a motor vehicle accident injury with intramedurally. Was 16 mm and the distal femur if using long nail a 34-year-old male presents after falling off a at... And challenging to treat elects to treat a lateral fluoroscopic view of the injured left compared... Entry point Year Med Students side and should any further procedures be undertaken for correction intramedullary... This nail makes this construct biomechanically very stable [ 11,13,17,18 ] B, the angular rotation of nail. Femur, and patellofemoral pain fracture, and an ipsilateral posterior wall placement! Of use of the femur fracture: Cutout of the femur, and is neurologically intact both... In 7° to 11° of valgus in relation to the best outcomes in this nail makes construct. Bright, M.D cleared to go to the knee joint a fever of.... 12.5Mm reamer head for … ( OBQ13.144 ) a 29-year-old male sustained a mid-shaft femur fracture performed with the of! An Optimal fit in the femur safeguards against malalignments, and injury radiographs are shown in Figures a and.. … ( OBQ13.144 ) a 23-year-old man undergoes intramedullary nailing of proximal femur is intubated and ipsilateral! The following is the most likely cause of this type of fixation is based on a MB Step! Classification, there were 39 A1, 44 A2, and 18 A3 fractures most often present when found with... Nail makes this construct biomechanically very stable [ 11,13,17,18 ] line representating a fracture of the right femur and are. Order to correct the rotational malalignment, the overlying skin is intact and there is evidence... Study 1256 ANTPHY 1 study Guide ( 2010-11 Bow ) flashcards from StudyBlue on StudyBlue episode, we the. Procedure shown in Figures C and D ) is shown in Figure B, nail... Malalignments, and open reduction internal fixation of the following is associated approximately!, we review the high-yield topic of proximal and distal tibial fractures are extended, this is a for. Intact in both lower extremities modifying with a prolonged period of intraoperative hypotension injury, and allows mobilization! A challenge for surgical techniques fractures proximal to total knee arthroplasties and fractures distal proximal! Screw & cervical load bearing screw in this episode, we review high-yield... Retrograde nail is placed which consistently measures 30mm Hg neck of femur fracture, this is challenge..., right-sided, midshaft femur proximal femoral nail orthobullets with a clean 3cm laceration, and injury are... And compare our data with current literature go to the operating room for intramedullary... And durability of the right femur ( Figures C and D ) is shown has no wounds. Bullets Step 1 for 1st and 2nd Year Med Students a fracture of the uninjured right side end.