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96 Cards in this Set
- Front
- Back
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Which type of bone ar staples designed for, corticcal or cancellous?
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cancellous
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Do you typically find callous formation with rigid internal fixation?
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No theis generally indicates motion at he fractur /osteotomy sie.
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For xiation of an oblique fracture should the screw fixation be perpendicular ot the long axis of the bone of the ot he fractue line/
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to the bone (cortex this will prevent movemnt slid ng of the fragments on each other during axial loading.
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What is the speical design of a herbert bone screw
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It has no head and the pitch of hte threads on either end of hte screw is differnt formeach other.
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Should plate fixation lie on the compression side or onthe tension side?
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tension
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When utilizing plate fixation on a fractue, the screw should be lcoated whre o the screw hole?
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eccentrically, away form the racture site.
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Name antoherfixation method, which provides compression acreossa fracture line.
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tensionband wire.
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What is the fixationdeviceo fchoice for a fractrue with soft tissu loss?
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extenal fixation.
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Why is hte proximal cortex over drilled whenusing lag technique?
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to prevent distraction fo the osteotomy and lllow for compression.
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What ifference beteen cortical nad cancellous screws?
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the pitch o fhte screw (cortical is 1.25 mm and cancellous is 1.75 mm)
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Lag technique is necessary when using a cannualted, partially threaded , cancellous scre . T or F?
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False. Becaue this is a partially threaded screw, only the trheads ( which are hte distal to the fracrue/oseotomy_ will purhcae he bone and ompression weill still be acheivedd.
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During palcement of a 2.7 mm corticla screw with lag technque, yo accidnetally over drill the far side of boen i nralatin to your ostotomy. What is your next best option?
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go up to the next larger size screw
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The Ilizarove bone lengthening ostoetomyu requeis how ong of a period fo compression befor ecallous distraction begins?
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three weeks
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What is the maximum documented amound of callous distraction that can be achieved in one dayh with the iLizarove bone lengthenign proceure
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1 mm
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What is the first step in proper lag technique?
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REduce the fracture / osttoomy with a bone clamp
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What is the nubmer one complicatoin of an external fxator
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infection.
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What should yo do if you breake the suture off of a MItek bone achor
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top shouting , tpine onut the anchor , or leave it, nd inset a new anchor in a different location.
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Is secondary bone healing (gap heling0 a principle of standard internal fixatin?
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No, rigid internal fixation allows for primary boen healing (contact healing0.
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According to internal fixation technique, hwo any cortices msut a single trns-syndesmotic screw crsos swhen the tre is disrutipion of the distal tibial - fbualr syndesmosi
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4 cortices
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What is the most apprporiate form o fixation used for an end to end arthrodesis of a PIPJ?
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a k-wire retrograded fromdistal to proximal
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What is the mosst apprpriated metod of fixation for as salter harris type IV fracture of the idstal tibia?
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smooth K-wire
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The weakest segment of a screw is?
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the run out, whih is whre the shaft meetsthe core. The core of the screw is the poriton fo th eshaft that extens into the thread patter. THe shaft of the screw is poriton without a trhead pattern.
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Why is it important to countersink when usign screw fixation?
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Countersinking reduces the promiennce of the screw head. It also increases the surface area betweenthe cortex and the screw head, hwich serves to prevent stress risers. it also creates a concentric relationship wiht the thread hole, which prevents lateral movmenet of the head of hte screw as it iengagtes the cortex.
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Which type of fixation casues the best coprression
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screw fixation.
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Which method of fixation would be most advantageous i nopening wedge osteotomies?
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staples becasue they maintatin the size of the osteotomy when bone grapft is being resorbed.
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The term "cutting cone" refers to ?
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osteons, which cress the fracture line. EAch remodeling steon is composed of leading osteoclasts which create a resorption canals htat is then invaded by vscualr buds. cicumferentialy oriented osteoblast then gve riese o new osteon.
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What would you expect ot be the casue, if you observed a radiograph with callu formatio aobut the osteotomy site, with fixtation in place?
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motion a the site
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List two reason that a delaye dunion may occur?
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iandequate aligment and appostion of thre fracture framents at hte time of reduciton.
Motion athe the soteotomy site |
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A malunion is defiene as
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inadequate postional healing of an ostoetomy or fractrue site.
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Howlong should a petint remain non-weight bearing flloweing a base ostetomy of the first metatrarsal
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six to eight weks.
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What is the mos inherently stable fractrue pattern?
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transverse type
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What is the complication fo not over drilling the proximal fragment i nstatndard AO screw fixation?
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It cause distraction rathr than compressionl.
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The correct sequnce fo the insertionfo a 3.5 mm cortical screw
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2.5mm threaded hole, coutnersing, 3.5 mm gliding hole, depth gauge, tap 3.5 mm, apply screw
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When fixating a fracture ,is the "load screw" perpendiculr to the obne or is perpendicular to the fracture?
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perpendicular ot the bone
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When using single screw technique to fixatea closing b ase wedge ostetoomy describe the orientation of the screw.
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Equal distance between the perepndicualr to th long axis of the bone and hte perpendicular to the fracture line.
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A 27 y/o man develops a foot infection threee weeks after open reduciton and internal fixation of a pilon ankle fracture with interfragmentary scres and amedial buttresss plate. The woudn is debreided to boen; in this case shold the hardwar e be left inplace or removed
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removed
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What is the pitch of a cancellous screw
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1.75
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How many threads of hte scrw should extend beyond the far cortex?
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Two
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Theoretically, afixation palte used o a transvers midshaft fraxture of a metatarsa shoudl be palced where?
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On the plantar aspect of he metarsa whic his the sid eof tension.
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A contraindication to Grafton (alogenic bone grafting gel) would be?
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a history of a bacitracin allergy.
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How long will and orhtosSorb (polydiaxanone) pin reatin it's strenght?
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4-8 weeks, absrobed in 9-12 weeks
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Name the three forces affecting stability fo fracture reduction?
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beding, shera, torsion.
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In terms of scres, the "land" refers to what part of the screw?
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undersuface of the scerw head
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What type of screw, cancellous or cortical , is genreally accepted for use in the cacaneous?
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cancellous
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When cn screw be used alone for interanl fixation of a fracture?
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When the fractue is at leas twiced as logn as the diameter of the bone at hte level of the fracture.
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The tension band principle is an exampel of what type of compression?
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dynamic compression
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The best type of fixation for pseudoarthrosis, following bone debreidement and graft palcement is?
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neutralization paltes
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pneumatic surgical instruments use which type of gas?
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nitrogen
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Which clinical sympotm indicaties a possibl malunion?
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prolonged swelling, anguation at the fracture/ostoetomy site, pain and stiffnes.
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Which type of screw fixation allows for percuatneous palcement acrossa fracture ste?
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cannulated.
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The most common complicaton when usign external K-wires is ?
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infection (pin tract)
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What is the minimum number of K-wire needed to achieve frontal plane stabiity of a distal metaphyseal osteotomy?
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Two, unless th osteotomy hs inerent frontal palne stability (an austin ostetomy for insances in which case ne k-wire may suffice
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What is the purpose of a jones cast?
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reduction fo edema through compression.
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One of the primary reasons to use external fiation is:
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immediate weight bearing
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Prebending of a plae provides for?
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uniform covression at the osteotomy site.
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Contraindiacations to open reduction ineternal fixation (ORIF) include?
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perpheral vascualr disedae, infection open contaminated injureis, extnesive soft tissue damage, significant bone loss.
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(Tor F) a neutralization plate produces interframentary compression
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False
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Which fracture pattern is least stable
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comminuted
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According ot Pauwes principal, a long bone eccentrically loaded is subjected ot tension forces on the convex side nd what force on the concave side?
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compression forces
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Which effect is prodced, when using two different type sof metlas in close proximity ot each other within ghe body.
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galvanic corrosion (a battery effect)
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The basic techniques of internalfixation are?
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splinting, neutralization, buttressing, ingterfagmentary compression
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Which trehad diameter is alrger ngernaal, a cortical or cancellous screw?
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cancellous
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(T of F) The use of plates and scres allows for the posteoperative paiet to ambulae in a weight bberaign attitude
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False, AO fixatin is meant to tallow joint movmemnt (preventscast disea) but is not meant ot wethstand wieht bearing forces
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What is a transfixation screw used for?
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used ot apprxiamte the fubula to the tibia when n interossious ligament ruture (diastasis) occurs
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If a pateint relates a nickel allergy, what would be the best choice to fixate a closin base wdge osteotomy?
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bio-absorbable screw
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What is the primary advantage of a screwhas over a k-wiere , hwenfixating an ostoetomy site?
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the screw provides compresson.
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What is no expected to be seen radographically, ant an ostotomy site, with scrw fiation, 5seeks postop?
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callos formation.
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When observing a radiogarph at 5 weeks out, scerosis is noted ad the ostetomy site wht woudl be a likely possible expalnatin?
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the beginnign of ano0n-union.
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What woudl be apprporiate to use when reattachign the achilles tendon back onto the calcaneus?
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a Bone anhorsytem.
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When reducign an boblique midshaft fractue on the second metarsa, which woudl be a better screw to use, a corticla or a cancellos ?
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Cortical
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Do lagscres provide dynamic interfragmental compression
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No, they provide static interfragmental compression
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How is dynameic interfragmental compression achived? Give an example of its use int hte foot.
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Dynamic interframental compression is achieved by thuse of tension bnad fixation. Tnesion bands harness forces genrated at he level of hte fracture hen the skeleton come under phyisiological laod. 5th metatarsal, styloid fractrues can be fixated in this way.
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What is the core diamter of a 4.0 mm cancellous screw?
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1.9 mm
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What is the size of the pilot hle needed to apply a 4.0 mm cancellous scrw?
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2.5mm
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What is the size of the tap need to apply a 4.0 mm cancellous screw
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3.5 mm
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What is the size of the pilot hle needed to apply a 2.7 mm cortical screw?
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2.0 mm
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What i sth esize of hte tap needed to apply a 2.7 mm cortical scre?
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2.7 mm tap
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What is the size of the drill bit used to "over-drill" the proximal cortex when applying a 2.7 mm cortex
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2.7 mm drill
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When ar emetal or ceramic washers possibly indicated?
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When utiliziang screw fixation on soft, osteopenic bone or when reattaching avulsed soft tissue structures such as ligmaent or tendon to bone.
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What is the primary funciton fo neutralization plante?
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To protect interfragmental compression lag screw rom bending, shearing, and torsional forces.
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What is th primary puropose fa buttress palte?
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To prevent axial deformity form bending, sheraing and torsional forces.
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What is th purpose of a poster 1/3 semi-tubular plate in a distal oblique fibular fracture?
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This anti-glid plate prevents proxiaml migration fo the distal fractruer fragment.
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What is fracture diesease?
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A clinicla state, which is manifested by chronic edem, soft tissue atrophy, osteoporosis, and joint siffness.
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What is the principle of hte lagscrew?
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The thread must not cross the fracture line.
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What is the principle of the tension band
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The implant absorbs gthe tnesion and the bone the compression
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What is the screw fixation principle?
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Two small scres obtain a better fixation thatn one large screw
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What is the 'vassal ruel"
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Where thre is mechanicaldependence between two fracure, the domiantn fracture should be reduced first, after which the vassal fracture will reduce spnatneously or can be reduce easily. Only the dominat fracture requreis a plate.
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What is the average time interval between intrnal fixation and removal of a scrw forma maetartsalor hllux assuming normal healing has occurred
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Screw, shold generally be removed with 4-6 months.
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What are the prerequisites from promary bone healin?
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excellent antomic alignemnt with riegid internal compression, complete immobiliztioon, along wiht adquate vaculrit.
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Whatare the common sizes of K-wires/
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0.035 in, 0.045 in, 0.054 in, 0.062 in
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What is themost common size of stainless teel monofilament wire used in podiatric surgery?
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26 or 28 guage
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What are the common sizes of steinmann pins used in podiatric srgery?
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5/64 - 3/16 inches
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which is stronger, a 0.045 inch smooth k-wire or a 0.045 threaded k-wire
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The smooth k-wire is stronger. The threaded k-wire has a thinner core is hterfore weaker.
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When applying bone screws, shuld the depth gauge bue used pior ot atapping or subseguentot tappong , why?
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always prior to tappping. Once threats are tapped , the use of a depth gauge could dirupt th ethreads.
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What is the shape of hte recess in 1.5mm and 2.0 mm Syntes mini cortex screw heads?
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cruciate
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Wha tis the shape of the reces in the 2.7 mm Syntes cortical nd 4.0 mm Sytes cancellous scrw heads?
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hexagonal
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