Orthopaedics and Trauma

7/25/2019 Orthopaedics and Trauma

1/32

MULTIPLE CHOICE QUESTIONS IN ORTHOPAEDICS AND TRAUMA

1. Which is the strongest lig!ent"

A Ilio#$e!orl lig!ent

% Ischio#$e!orl lig!ent

& P'(o#$e!orl lig!entD Trns)erse cet('lr lig!ent

E Lig!ent'! teres.

A Ilio-femoral ligament blends with anterior part of hip joint capsule

and is the strongest ligament at hip joint.

*. Which +rt o$ ,'-rice+s !'scle is !ost $re,'entl $i(rose- in +ost

in/ection ,'-rice+s contrct're"

A Rect's $e!oris% 0st's !e-ilis

& 0st's inter!e-i's

D 0st's lterlis

E All o$ (o)e.

D Vastus lateralis is most frequently affected probably because

injections are usually given in this area of thigh.

. R-ion'clei-e (one scnning is !ost 'se$'l in"

A A)sc'lr necrosis

% Mlignnc

& Rhe'!toi- rthritis

D Stress $rct'res

E Ac'te osteo!elitis.

adionucleide bone scanning is most useful in defining e!tent of

primary tumour" locating unsuspected metastasis and primary malignant

tumour. In all other conditions mentioned its use is more of academic interest

2. Co!!onest c'se o$ $il're o$ rthrogr+h is"

A E3tr#rtic'lr in/ection o$ contrst

% 4'((ling o$ ir in the /oint

& 5lse +ositi)e inter+rettion

D 5lse negti)e inter+rettion

E Allergic rection.

A #!tra-articular injection of contrast medium is the commonest

cause of failure of arthrography especially in smaller and deep situated joints.Allergic reaction to contrast medium is rare but when it happens e!amination

will have to be discontinued. $ther factors also ma%e this procedure futile.


2/32

6. Melogr+h is necessr in $ollo7ing con-itions"

A S's+icion o$ n intrs+inl t'!o'r

% Con$licting clinicl $in-ings n- C.T. scn

& E)l'tion o$ +re)io'sl o+erte- s+ine

D All o$ (o)eE So!e o$ (o)e.

D Due to its complications and since it is an invasive technique"

myelography has been replaced by &' scan. (ow a days primary indications

of myelography are as mentioned in the question.

8. Arthrosco+e 7s in)ente- n- $irst 'se- ("

A T9gi

% Wtn(e& Dn-

D :c9son

E Ptel.

A )irst prototype of arthroscope was made and used by 'a%agi in *+*,.

odern day arthroscope was made by 'a%agi and atanabe. Dandy" /ac%son

and 0atcl are some of the leaders of arthroscopic surgery nowadays.

;. Wht is the g'i-eline to -elto+ectorl groo)e"

A A3illr )ein

% Ce+hlic )ein

& M'sc'lo#c'tneo's ner)e

D Me-in ner)e

E None o$ (o)e.

&ephalic vein lies in deitopedoral groove and serves as landmar% in

identification of plane between deltoid and pectaralis major during anterior

e!posure of shoulder.


3/32

brea%age is not the problem with newer modern day instruments. $ther

complications mentioned can occur but are uncommon.

>. Which o$ the $ollo7ing is !ost serio's co!+liction o$ !elo#gr+h"

A Allergic rection

% He-che

& Trnsient ne'rologicl -e$icit

D Archnoi-itis

E Nec9 sti$$ness.

If performed in proper aseptic manner" fever is not the usual

complication while all others are the dangers of myelography. 'hesecomplications are fairly common with nonabsorbable" oily contrast mediums

rather than with newer water soluble contrast medium.

1?. Wht re contrin-ictions o$ rthrosco+"

A Prtil or co!+lete n9losis o$ /oint

% Ris9 o$ intro-'cing se+sis $ro! ner( s9in lesion

& M/or collterl lig!ento's n- c+s'lr -isr'+tions

D All o$ (o)e

E So!e o$ (o)e.

D Introduction of infection can create disaster. In an an%ylosed joint

instrument can not be manouvered. ajor collateral ligamentous and

capsular disruptions allow irrigating solution to e!travasate and ma%e

e!amination difficult or impossible.

11. Co!!onest c'se o$ ,'-rice+s contrct're is"A Congenitl

% Ische!ic !ositis

& 5ollo7ing $e!orl sh$t $rct're

D 5ollo7ing o+ertions on thigh

E Post in/ection $i(rosis.

# 0ost injection fibrosis usually occurs after repeated intramuscular

injections or saline infusions in an infant. 'his is the commonest cause in

India and other causes are less common.


4/32

1*. Wht is the erliest in-iction o$ 0ol9!nn@s ische!i"

A Pin

% Pllor n- +oor c+illr $illing

& Presthesi in !e-in ner)e re

D Contrct're o$ $ingers

E ngrene o$ ti+s o$ $ingers.

A #arliest sign of vascular compromise is persistent pain which is

e!acerbated on passive e!tension of fingers. Action must be ta%en at this stage.

0allor" poor capillary filling" absent radial pulse and paraesthesia in median

nerve area are also early signs but may not be present in every case and one

should not wait for these signs. &ontracture and gangrne is a very late

phenomenon.

1. Which o$ the $ollo7ing is incorrect (o't -isloction o$ sternocl)ic'lr /oint"

A Anterior -isloction occ'rs -'e to in-irect in/'r n- is co!!on

t+e o$ -isloction

% Posterior -isloction is rre n- occ'rs -'e to -irect in/'r o)er

!e-il en- o$ cl)icle

& Sternocl)ic'lr -isloction is co!!on co!+re- to

cro!iocl)ic'lr -isloction

D Trche cn (e co!+resse- in +osterior -isloction

E Mni+'lti)e re-'ction is o$ten 'nst(le n- $i3tion 7ith 7ire

! (e re,'ire-.

1 Dislocation of sternoclavicular joint is much less frequent than

acromioclavicular joint dislocation. All other statements are true and briefly

describe the salient features of sterooclavicular

joint dislocation.

12. Which o$ the $ollo7ing is the erliest l(ortor $in-ing in

cse o$ $t e!(olis!"

A Increse- ser'! cholestrol% Increse- ser'! li+se

& Increse- ser'! $tt ci-s

D Li+'ri

E Increse- l9line +hos+htse.

D 0resence of fat dropiet in urine is the earliest laboratory finding in fat

embolism. 2ut it most be remembered that the diagnosis is mainly clinical and

one should not wait for any inves before instituting treatment.

16. 5irst tret!ent +riorit in +tient 7ith !'lti+le in/'ries is"

A Air7 !intennce


5/32

% 4lee-ing control

& Circ'ltor )ol'!e restortion

D S+linting o$ $rct'res

E Re-'ction o$ -isloction.

3 3..1. 4Airway" bleeding and circulation5 are the priorities inmanagement of seriously injured patient in that order.

18. Which o$ the $ollo7ing $rct're -oes not 's'll nee- o+en

re-'ction n- internl $i3tion"

A Mi- sh$t $rct're o$ $e!'r

% Pthologicl $rct'res

& Trochnteric $rct're in el-erlD Dis+lce- intr#rtic'lr $rct'res

E Dis+lce- $rct're o$ (oth (ones o$ $orer! in -'lts.

A $ut of the fractures mentioned" femoral shaft fracture is least li%ely to

need operative treatment. In this fracture operation is done to get patient out

of traction early. All other fractures mentioned will almost always need open

reduction and internal fi!ation.

1;. Co!!onest c'se o$ $il're o$ internl $i3tion is"

A In$ection

% Corrosion

& Metl rection

D I!!'ne -e$icient +tient

E Stress $rct're o$ i!+lnt.

A ost common and seriot advantage of open reduction and mfpmal

fi!ation is infection which will ultimately lead to implant becoming loose andnon-union. Immune deficient patient does not behave differently as regards

fracture healing. &orrosion" metal reaction and stress fracture cf implant are

rare.

1


6/32

E In$ection.

1 ithin first few hours after severe injuries death may occur due to

hypovolaemia from haemorrhage and within 6 days from fat embolism.

0ulmonary embolism usually occurs at about 6 wee%s from injury.

espiratory distress is a part of fat embolismsindrome.

1>. Internl $i3tion o$ $rct're is contrin-icte- in 7hich sit'tion"

A Acti)e in$ection

% When (one g+ is +resent

& In e+i+hsel in/'ries

D In co!+o'n- $rct're

E In +thologicl $rct'rB.

A Active infection is the only definite contiaind%a on of internal fi!ation7

and in this situation 89 e!ternal :;8ation is the

treatment of choice. In pathological fractures and in presence of bone gap

internal fi!ation is qmie oftea mandatory. &ompound fracture is a relative

contimnrlicarion.

*?. Most o$ten o+en re-'ction o$ $rct're is re,'ire- in"

A Close- $rct're 7ith ner)e in/'r

% Co!+o'n- $rct're

& 5rct're in chil-ren

D Unstis$ctor close- re-'ction

E Non 'nion.

D ?nsatisfactory closed reduction is the commonest reason for performing

open reduction. (e!t commonest reason for this is non-union. )ractures in

children rarely require open reduction. &ompound fractures and fractures

associated with nerve injury are also uncommon reasons.

*1. In $e7 -s ol- $rct're 7hich o$ the $ollo7ing -oes not occ'r"

A C+illr +roli$ertion

% Proli$ertion o$ osteogenic cells o)er en-oste'! n- (one en-s

& Locl +H is ci-

D Locl +H is l9line

E There is )er little rise in le)el o$ l9line +hos+htse t $rct're site.


7/32

D ?pto a wee% after fracture local p@ remains acidic and only after

this period p@ becomes al%aline and level of al%aline phosphatase mar%edly

rises. All other statements are true.

**. 5rct're -isese cn (e +re)ente- ("A Plster i!!o(ilition o$ $rct're

% Cst (rce tret!ent o$ $rct're

& Internl $i3tion o$ $rct're

D E3ternl $i3tion o$ $rct're

E Phsiother+

# )racture disease in some measure always occurs and none of the

methods of treatment of fracture can prevent it. It can only be minimised by

regular physiotherapy to reduce oedema" improve muscle tone and maintainfunctional movements in joints which have not been immobili>ed.

*. Which o$ the $ollo7ing is co!!onest !teril 'se- to !9e

ortho+e-ic i!+lnt"

A Titni'!

% Stinless steel

& Polethlene UHMWPE

D Methl#!ethcrlte

E Cr(on.

ost implants are made of stainless steel as it is comparatively cheap

and can be easily cast into desired shape. 'itanium is e!pensive and difficult

to fashion into desired shape. &arbon and polyethylene implants are used only

for some specific uses and methylmethacrylate is not made up into an implant

as such.

*2. 4one gr$t 7or9s ( +ro)i-ing $ollo7ing !echnis!s. Which o$

these is !ost i!+ortnt.

A 4one in-'ction $ctor% Osteogenic cells

& Li)ing osteo(lsts

D Minerl sc$$ol- $or )sc'lr +roli$ertion

E 4ri-ging the (one g+.

D 0rovision of mineral scaffold into which newly forming vascular

channels can grow is the most useful function of bone graft and that is why

ban% bone" heterogenous bone and homografts succeed. 2one inducing factor"

osteogenic cells and living osteoblasts are supplied only by fresh autogenousgrafts.


8/32

*6. Co!!onest co!+liction 7hile 'sing e3ternl $i3tor is"

A Pin trct in$ection

% Co!+rt!ent sn-ro!e

& Loosening o$ +ins

D 5i3tion o$ !'scles

E :oint sti$$ness.

A 0in tract infection is by far the commonest problem. In addition to

complications mentioned" neurovascular damage can occur while inserting the

pins and refracture can occur after removal of fi!ator.

*8. A +tient 7ho hs s'stine- o+en 7o'n- on leg is (lee-ing

+ro$'sel. 4e$ore +tient rri)es in hos+itl the s$est

!etho- to sto+ (lee-ing is"A Ele)tion o$ leg

% Locl +ress're on 7o'n- n- ele)tion o$ leg

& Ligtion o$ (lee-ing )essel

D Use o$ to'rni,'et

E Press're o)er $e!orl rter in groin.

% Locl +ress're on 7o'n- n- ele)tion o$ leg is the s$est n- !ost e$$ecti)e !etho- to

sto+ (lee-ing. To'rni,'et cn (e -ngero's i$ not +ro+erl 'se-. Ele)tion lone n- locl

+ress're on $e!orl rter is ine$$ecti)e.

*;. Which o$ the $ollo7ing is n (sol'te contrin-iction o$

o+en re-'ction"

A Acti)e in$ection

% S!ll sie- $rg!ent

& 0er so$t (one

D enerl !e-icl co!+lictions

E Se)ere scrring o$ -/cent so$t tiss'es.

A Acti)e in$ection is contrin-iction $or o+en re-'ction s this ! le- to $'rther

co!+lictions n- e)en !ore -i$$ic'lt in sl)ge. In other con-itions !entione- o+en re-'ction

cn +ro-'ce +ro(le! n- sho'l- not (e lightl 'n-ert9en.

*


9/32

D Dr cooling 7ith ice is the (est 7 to +reser)e !+'tte- +rt s this c'ses lest

ltertion o$ tiss'e str'ct'res.

*>. Which o$ the $ollo7ing $rct're is slo7est to hel n- o$ten -e)elo+s

non#'nion"

A Intrc+s'lr $e!orl nec9 $rct're% Sc+hoi-

& Lo7er thir- o$ ti(i

D Pro3i!l h'!er's

E Distl $e!'r.

A Intrc+s'lr $e!orl nec9 $rct'res re slo7est to hel n- -e)elo+ non#'nion in higher

+ercentge o$ cses co!+re- to sc+hoi- n- -istl ti(il $rct'resF (oth o$ 7hich lso ten- to

hel slo7l -'e to -e$icient (loo- s'++l o$ one $rg!ent. Pro3i!l h'!er's n- -istl $e!orl

$rct'res -o not 's'll go to -ele- 'nion.

?. Co!!onest c'se o$ $il're o$ internl $i3tion o$ $rct're is"

A In$ection

% 5tig'e $rct're o$ i!+lnt

& Corrosion in i!+lnt

D Loosening o$ i!+lnt

E Metl rection.

A Infection following an open operation is the commonest cause of failure

following internal fi!ation. All other factors can also lead to complications but.

statistically they are not as important

1. Che!icll Plster o$ Pris is"

A Clci'! cr(onte

% Clci'! +hos+hte

& Clci'! s'l+hte

D Anh-ro's clci'! s'l+hteE He!ih-rte- clci'! s'l+hte.

E Po7-er o$ +lster o$ +ns che!icll is he!ih-rte- clci'! s'l+hte.

*. Which o$ the $ollo7ing is not seen in cse o$ $t e!(olis!"

A 5t glo('les in 'rine

% Le$t hert strin on EC

& Sno7 stor! ++ernce on chest G#R

D Nor!l cr(on -io3i-e tension in rteril (loo-

E Lo7 o3gen tension in rteril (loo-.


10/32

#& will show right heart strain and not the left heart strain.

. Close- re-'ction 7ith +erc'tneo's #7ire $i3tion is (est

s'it(le $or"

A 4ennett $rct're% Lterl !lleol's $rct're

& Me-il !lleol's $rct're

D Lterl ti(il con-le $rct're

E Cl)icle $rct're.

D alunited fractures are the commonest cause of deformity in long bones

since the incidence of fracture is much higher than congenital" developmental"

metabolic" infective and neoplastic conditions.

2. In heling $rct're !o'nt o$ crtilge $or!tion

increse- ("

A Rigi- i!!o(ilition

% Mo)e!ent t $rct're site

& Necrosis o$ (one en-s

D Co!+ression +lting

E In$ection.

ore the movement at fracture site" more will be cartilage formation and

non union can occur. &ompression plating helps in conversion of cartilage into

bone and thereby fracture healing can occur in a delayed or non-union.

Infection retards all the stages of fracture repair.

6. Most s'ccess$'l !etho- o$ tret!ent o$ non#'nion is"

A Co!+ression +lting

% Co!+ression ( e3ternl $i3tor

& A--ition o$ 4.M.P.

D 4one gr$ting

E Electricl sti!'ltion

D 2one grafting is most successful and useful method of treating

non-union. 2..0.42one morphogenetic protein5 has not been isolated as yet

$ther three methods are suitable in certain specific situations only.

8. Which o$ the $ollo7ing !'scle -oes not $or! rottor c'$$ o$

sho'l-er"

A S'(sc+'lris

% S'+rs+int's& In$rs+int's

D Teres !inor


11/32

E Teres !/or.

# #!cept teres major all other muscles mentioned are closely

applied to the capsule of shoulder joint and form rotator cuff.

;. Wht is the co!!onest co!+liction o$ $rct're o$ !i- sh$to$ h'!er's"

A Ml'nion

% Non 'nion

& R-il ner)e +rlsis

D 4rchil rter in/'r

E Ulnr ner)e in/'r.

A ost of humeral shaft fractures are treated conservatively and

malunion 4usually neither cosmetically disfiguring nor functionally impairing5is the commonest complication. If fracture has been treated by internal

fi!ation this will become rare complication. (e!t commonest complication is

radial nerve injury in spiral groove where nerve is in direct contact with bone.

(on union is uncommon and brachial artery injury is rare.

. Most co!!onl $rct're- (one is"

A H!te

% Tri,'etr'!

& L'nte

D C+itte

E Sc+hoi-.

# Bcaphoid is most commonly injured carpal bone. Cunate is second most

commonly injured carpal bone although it does not fracture but is involved indislocation of lunate and perilunar dislocation of carpus.


12/32

2?. Wht is the !ost serio's co!+liction o$ internl $i3tion o$

$rct're o$ (oth (ones o$ $orer!"

A In$ection

% Cross 'nion

& Li!ittion o$ $orer! rottion

D Re$rct'reE Non 'nion.

A De)elo+!ent o$ in$ection $ollo7ing o+en re-'ction o$ $rct're is the !ost serio's

co!+liction. All other co!+lictions !entione- cn lso occ'r $ollo7ing o+en re-'ction n-

internl $i3tion.

21. Which o$ the $ollo7ing ('rs +ro-'ces s!+to!s in sho'l-er

i!+inge!ent sn-ro!e"

A S'(cro!il ('rs% S'(-eltoi- ('rs

& 4'rs in reltion o$ s'(sc+'lris ten-on

D 4'rs in reltion to ltissi!'s -orsi

E 4'rs (et7een corcoi- +rocess n- c+s'le.

A Bymptoms of impingement syndrome are produced when subacromial

bursa is pressed between humeral head and undersurface of coraco-acromial

arch.

2*. Wht is the co!!onest co!+liction o$ s'+rcon-l

$rct're o$ h'!er's"

A Ml'nion

% Mositis ossi$icns

& Sti$$ness o$ el(o7

D 0ol9!nn@s contrct're

E Non 'nion.

A al union" especially rotational malalignment7 is the commonest

complication and results in the deformity of cubitus varus. (on union is very

rare and all other complications are not common" ost serious complication is

Vol%manns iscnaemia.

2. Wht is the erliest in-iction o$ 0ol9!nn@s ische!i"

A Pin

% Pllor n- +oor c+illr $illing

& Presthesi in !e-in ner)e re

D Contrct're o$ $ingers


13/32

E ngrene o$ ti+s o$ $ingers.

A #arliest sign of vascular compromise is persistent pain which is

e!acerbated on passive e!tension of fingers. Action must be ta%en at this stage.

0allor" poor capillary filling" absent radial pulse and paraesthesia in median

nerve area are also early signs but may not be present in every case and oneshould not wait for these signs. &ontracture and gangrne is a very late

phenomenon.

22. Which o$ the $ollo7ing is tr'e (o't Monteggi $rct're"

A It is 's'll ssocite- 7ith +osterior interosseo's ner)e

+rlsis

% It cn (e 's'll trete- conser)ti)el in -'lts

& It is not n in/'r o$ chil-renD It is co!(intion o$ $rct're o$ r-i's 7ith -istl r-io#'lnr /oint

-isloction

E It is co!(intion o$ $rct'res o$ +ro3i!l 'ln 7ith -isloction

# onteggia fracture comprises of fracture of pro!imal ulna with dislocation

of radial head. It can occur in children. In adults most of cases will need

internal fi!ation of ulna whereas in children most can be treated

conservatively. It is also not normally associated with posterior interosseous

nerve paralysis.

26. A collr n- c'$$ (n-ge 7ill (e !ost s'it(le tret!ent $or

7hich o$ the $ollo7ing in/'r"

A Mi-sh$t $rct're o$ h'!er's

% Un-is+lce- $rct're o$ nec9 o$ h'!er's

& Monteggi $rct're

D Disloction o$ el(o7

E 5rct're o$ r-il he-.

All undisplaced humeral nec% fractures at all ages and most

displaced fractures in elderly can be safely treated in collar and cuff sling. All

other injuries mentioned need more elaborate treatment. After reduction of

elbow dislocation elbow can sometimes be immobili>ed in fle!ion in collar and

cuff bandage but this is not a safe method of treatment.

28. Which o$ the $ollo7ing is not ++lic(le to r-il nec9 $rct're"

A It is co!!on in/'r in chil-ren thn -'lts

% Ang'ltion cn 's'll (e re-'ce- ( !ni+'ltion& O+en re-'ction is so!eti!es re,'ire-

D Mechnis! o$ in/'r is $ll on o'tstretche- hn-


14/32

E It is n e+i+hsel in/'r o$ slter t+e#0.

# adial nec% fracture is an epiphyseal injury of B alter typeE. In children

radial head should never be e!cised as this will lead to reduction in length of

radius" dislocation of inferior radio-ulnar joint and limitation of forearm

rotation. ?sually manipulation succeeds in reducing the tilt and rarely openreduction is required.

2;. Which o$ the $ollo7ing stte!ent is tr'e (o't s'+rcon-lr $rct're o$

h'!er's"

A Anterior -is+lce!ent o$ -istl $rg!ent is co!!on thn

+osterior -is+lce!ent

% C'(it's )lg's is co!!on thn c'(it's )r's $ollo7ing !i'nion

& Ne'rologicl co!+lictions re 's'll trnsitorD We9ness o$ el(o7 $le3ion is co!!on co!+liction o$ this

in/'r

E Q'ite o$ten el(o7 /oint -e)elo+s (on n9losis $ollo7ing this

in/'r.

1 Injury to any of three major nerves can occur but it is more li%ely to be

neurapra!ia or a!onotmesis. &omplete division of nerve is rare. 0osterior

displacement of distal fragment is common and so is development of varus

deformity following malunion. ea%ness of elbow fle!ion and bony an%ylosis

do not occur.

2


15/32

D O++onens +ollicis

E A(-'ctor +ollicis long's.

# )ollowing 2ennetts fracture" shaft of metacarpal is displaced by

the unopposed pull of abductor pollicis longus muscle.

6?. P'tti#Pltt o+ertion is 'se- $or"

A Non 'nion o$ h'!er's

% Disloction o$ +tell

& Disloction o$ r-il he-

D Rec'rrent -isloction o$ sho'l-er

E Rec'rrent -isloction o$ +eronel ten-ons.

D 0utti-0latt operation consists of reefing of anterior capsule of

shoulder joint and subscapularis muscle and is used for treatment ofrecurrent dislocation of shoulder. Aim of operation is to limit e!ternal rotation

which causes humeral head to dislocate.

61. 4est tret!ent $or h'!erl nec9 $rct're in 8? er ol- +tient 7ill (e"

A Collr n- c'$$ (n-ge $ollo7e- ( +hsiother+

% O+en re-'ction n- +lster s+ic

& O+en re-'ction n- internl $i3tion

D Close- !ni+'ltion n- +lster s+ic

E Hnging cst

A Bhoulder stiffness is most serious problem than the worry about

alignment 4malalignment can be ta%en care by wide range of shoulder motion5

and union 4union always occurs as this is mainly cancellous bone with good

vascularity5. 0laster spica is contraindicted as this will ma%e shoulder stiff and

painful. @anging cast is the treatment for humeral shaft fracture. Internal

fi!ation of humeral nec% fracture may be required rarely in displaced

fractures in young age.

6*. In(ilit to e3ten- inter+hlngel /oint o$ th'!( $e7 7ee9s

$ter Colles@ $rct're in-ictes -e)elo+!ent o$"

A Co!+rt!ent sn-ro!e

% Posterior interosseo's ner)e +ls

& A)'lsion o$ insertion o$ e3tensor +ollicis long's

D Attrition r'+t're o$ e3tensor +ollicis long's ten-on t the site o$

$rct're

E Ter o$ e3tensor +ollicis long's !'scle (ell.

D 'his attrition rupture is more common after undisplaced and minimally

displaced &olles fracture. Bince it is attrition rupture" tendon ends are frayed


16/32

and direct repair is not possible. 'reatment therefore consists of transfer of

e!tensor indicis tendon to the distal stump of e!tensor pollicis longus tendon.

&ompartment syndrome is an early complication.

6. Wht is the 's'l tret!ent $or s!+to!tic ol- cro!io#cl)ic'lr -isloction"

A Arthro-esis o$ cro!io#cl)ic'lr /oint

% #7ire $i3tion o$ /oint

& Lg scre7 $i3tion o$ /oint

D Resection o$ o'ter en- o$ cl)icle

E Acro!ion+lst.

D esection of outer *H of clavicle and capsulorraphy produces satisfactory

amelioration of symptoms. 'ransfer of tip of coracoid with its attachedmuscles is ne!t best method of treatment. -wire and lag screw fi!ation are

the treatment of acute dislocation. Arthrodesis of acromio-clavicular joint is

almost impossible to achieve and if achieved will greatly impair the mobility of

shoulder girdle. Acromionplasty is used for intractable cases of impingement

syndrome

62. Regr-ing $rct're o$ cl)icle 7hich o$ the $ollo7ing

stte!ent is incorrect"

A 5rct're is co!!onest in !e-il thir-

% Non 'nion is rre

& Most cses cn (e trete- conser)ti)el

D 5rct're 's'll occ'rs -'e to in-irect in/'r

E 5rct're is co!!on in !i--le thir-.

A &lavicle fractures usually by fall on outstretched hand and the force

transmitted brea%s the bone at place where two curves meet and therefore

fractures are most common in the middle third of bone. All other statements

about union and treatment of clavicle fracture are correct.

66. Which o$ the $ollo7ing is incorrect (o't -isloction o$ l'nte"

A Dislocte- l'nte ++ers tring'lr inste- o$ rectng'lr on

A.P. 3#r

% Disloction is !ost esil recognise- on lterl )ie7 3#r

& A)sc'lr necrosis is co!!on $ollo7ing -isloction

D L'nte -isloctes +osteriorl

E Me-in ner)e co!+ression cn occ'r.

D In total dislocation of lunate the bone dislocates anteriorly and that is why

median nerve can be compressed. If closed deduction fails open reduction is


17/32

performed from antenor Jch )urthermore anterior approach permits spbung

K B' retinaculum to decompress carpal tunnel and med"an nerve. All other

statements are correct.

68. Which o$ the $ollo7ing is not ++lic(le to sc+hoi- $rct're"

A Mechnis! o$ in/'r is $ll on o'tstretche- hn-.% It is co!!on in -'lts thn el-erl +ersons

& O$ten non 'nion -e)elo+s

D 5rct're t 7ist is co!!onest

E A)sc'lr necrosis is rre.

E A)sc'lr necrosis o$ +ro3i!l $rg!ent is $irl co!!on since the (loo- s'++l to this +rt

co!es in retrogr-e -irection n- 7hole o$ +ro3i!l +ole is co)ere-( rtic'lr crtilge n-

-oes not h)e n +lce $or )sc'lr chnnels to enter in this +rt o$ (one.

6;. Which o$ the $ollo7ing stte!ent is tr'e (o't -isloction o$inter+hlngel /oint o$ $inger"

A It is $le3ion in/'r

% It is n e3tension in/'r

& Re-'ction is o$ten 'nst(le

D Distl +hln3 is -is+lce- nteriorl in reltion to the +ro3i!l

+hln3

E There is no nee- to test $or st(ilit $ter re-'ction o$

-isloction.

Dislocation of interphalangeal joints is an e!tension injury an the distal

phalan! is displaced dorsally in relation to pro!imo phalen!. ost often

reduction is stable and its stability must L chec%ed immediately after

manipulation. ?nstable reducoa is usually due to associated fracture which

can be recognised a !-ray and needs internal fi!ation.

6


18/32

anthritis requiring arthrodesis of wrist. hen non-union of scaphoid is an

incidental finding with out symptoms it can be left without any treatment

6>. Which o$ the $ollo7ing in/'r is J!e9ee+er@s th'!(J"

A R'+t're o$ 'lnr collterl lig!ent o$ 7rist% R'+t're o$ 'lnr collterl lig!ent o$ !etcr+o+hlngel /oint

o$ th'!(

& R'+t're o$ 'lnr collterl lig!ent o$ inter+hlngel /oint o$

th'!(

D 5rct're o$ (se o$ th'!( !etcr+l

E 5rct're o$ nec9 o$ th'!( !etcr+l.

Injury occurs due to forcible abduction at metacarpophalangcal joint of

thumb" and was classically described in persons wringing nec% of smallanimals caught during hunting. Diagnosis can be confirmed by ta%ing stress

view !-rays. 0artial rupture can be treated by scaphoid type plaster but for

complete rupture operative repair is advisable.

8?. Which o$ the $ollo7ing is not tr'e (o't +osterior -isloction o$

sho'l-er"

A Rec'rrent -isloction cn -e)elo+

% Re-'ction cn (e 'nst(le

& Ptients 7ith 'nre-'ce- -isloction cn h)e goo- $'nction

D Clinicl -ignosis is es

E A3illr ner)e in/'r is 'nco!!on.

D Dignosis o$ +osterior sho'l-er -isloction cn (e o$ten !isse- n- is not es (oth clinicll

n- r-iologicll. Re-'ction is ,'ite o$ten 'nst(le n- sho'l-er s+ic is re,'ire- 7ith sho'l-er

in (-'ction n- e3ternl rottion. Rec'rrent -isloction cn -e)elo+ n- 3illr ner)e in/'r is

'nco!!on since +osterior -isloction -oes not stretch the ner)e 7hich co'rses $ro! +osterior to

nterior.

81. Co!!onest c'se o$ -e$or!it in long (one is"

A Osteo+orosis% Ric9ets

& Pget@s -isese

D Ml'nite- $rct're

E 5i(ro's -s+lsi.

Cocal pressure on wound and elevation of leg is the safest and

most effective method to stop bleeding. 'ourniquet can be dangerous if not

properly used. #levation alone and local pressure on femoral artery is

ineffective.

8*. Wht is the secon- !ost i!+ortnt s+ect in the tret!ent o$


19/32

$rct'res o$ long (ones"

A A-e,'te n'trition o$ +tient

% Acc'rte nto!icl re-'ction

& I!!o(ilition

D Restortion o$ (one lign!ent

E Anti(iotics.

& 5irst n- $ore!ost re,'isite to ens're heling o$ long (one $rct'res to restore $'nction is

the re-'ction o$ (one $rg!ents into goo- lign!ent so tht !l'nion -oes not occ'r. Acc'rte

nto!icl re-'ction is not necessr. Secon- i!+ortnt s+ect is i!!o(ilition o$ the $rct're.

8. Which -e$or!it in !l'nite- $rct're is !ost li9el to correct 7ith

re!o-elling"

A Ang'lr -e$or!it in the !i--le o$ -i+hsis in the +lne o$

!otion o$ ner( /oint% Ang'lr -e$or!it in +lne o$ !otion o$ ner( /oint 7hen

-e$or!it is in !et+hsel re

& Rottionl !llign!ent

D Ang'lr -e$or!it ner en- o$ (one 7hen ng'ltion is in

+lne >?K to the +lne o$ !otion o$ ner( /oint.

E Shortening o$ (one length.

Angular deformity in the plane of motion of nearby joint has

ma!imum potential for remodelling. emodelling is still better if deformity isnear the end of bone. 'he process is rapid in growin of children and slows

down as the adulthood is reached. otations malalignment never corrects.

Bhortening of bone length" will the some e!tent correct in a growing child

since the fracture induct little overgrowth in a long bone.

82. Wht is !ost i!+ortnt s+ect o$ the tret!ent o$ cr'sh

sn-ro!e in)ol)ing n e3tre!it"

A A!+'ttion

% 5l'i- n- electrolte (lnce

& Dilsis

D Anti(iotics

E H(er(ric o3gen.

A Amputation pro!imal to the level of injury is the most important aspect

of treatment. At the same time maintenance of fluid balance is also important.

Dialysis may be required. Antibiotics really are of prophylactic value.

@yperbaric o!ygen has no role.

86. In inter$rg!entr $i3tion scre7 7or9s ( +ro-'cing"

A Co!+ression


20/32

% Distrction

& Antigli-e !echnis!

D Increse- sher

E None o$ (o)e.

A Bcrew wor%s by converting torsional stress 4used during its insertion5into compressive force and this %eeps fracture surfaces in close apposition.

'his is the basic mechanism on which screw wor%s.

88. 4sic tret!ent o$ !ost non#'nions is"

A Co!+ression +lting

% Contin'tion o$ e3ternl s+lintge

& Electricl sti!'ltion

D 4one gr$ting

E Phe!ister gr$ting.

D In an established non-union freshening of bone ends and bone grafting

is the usual treatment. #lectrical stimulation and compression plating is

indicated in certain limited cases only. 0hemister grafting is one method of

bone grafting in cases where bone fragments are in good alignment.

8;. E3ternl $i3tor is not in-icte- in"

A Co!!in'te- $rct're

% 5rct're ssocite- 7ith se)ere so$t tiss'e -!ge

& In$ecte- $rct'resD Si!+le close- $rct're o$ h'!erl sh$t

E 5rct're ssocite- 7ith ('rns.

D ?se of e!ternal fi!ator is contraindicated in an uncomplicated fracture.

It is an indispensable method of treatment of fracture in association with

infection" burn and severe soft tissue damage requiring repeated dressing and

s%in grafting. #!ternal fi!ator is also used e!tensively for purpose of limb

lengthening.

8


21/32

8>. 5ollo7ing $e!orl sh$t $rct'reF 9nee sti$$ness occ'rs -'e to"

A 5i(rosis o$ )st's inter!e-i's

% Shortening o$ rect's $e!oris

& 5i(rosis o$ +tellr retinc'lD A-hesion o$ +tell to $e!orl con-les

E All o$ (o)e

# All the factors mentioned prevent distal e!cursion of patella

and thereby limit %nee fle!ion. 'his is why early quadriceps e!ercises and

patellar mobili>ation after femoral fracture are important.

;?. Wht is the !ost serio's -is-)ntge o$ e3ternl $i3tor"

A Pin trct in$ection

% Loosening o$ +ins

& Stress +rotection osteo+orosis

D 5rct're cn not (e co!+resse-

E Another $rct're cn occ'r thro'gh +in trct.

A 0in tract infection is the most frequent and serious complication

of use of e!ternal fi!ator. If a very rigid fi!ator assembly has been used" its

removal should be in stages to overcome stress protection osteoporosis. In

most good fi!ators it is possible to either compress or distract the fracture.

Coosening of pins can be minimi>ed by %eeping the pins under compression.Cater fracture through pin tract is another potentially serious problem with

use of e!ternal fi!ator.

;1. Wht is the (est tret!ent $or n o(li,'e ti(i sh$t $rct're 7hich hs

re-is+lce- $ter initil goo- close- re-'ction n- +lster i!!o(ilition

A We-ging o$ +lster

% Re!ni+'ltion n- +lster

& O+en re-'ction n- internl $i3tion

D S9eletl trctionE Cst (rcing.

1 $blique fractures are difficult to hold in plaster and best treatment is

internal fi!ation if reduction can not be achieved or has been lost after closed

manipulation. B%eletal traction from calcaneal or supramalleolar pin is the

ne!t best option available. 'raction has to be maintained for 6-M wee%s until

early union has occured. At this stage when fracture is deformable but not

displacable plaster or cast brace can be applied. &ast brace can not be used

until there is early union of fracture.

;*. 4'!+er $rct're is the n!e gi)en to"


22/32

A 5rct're o$ ti(i n- $i('l

% 5rct're o$ lterl ti(i con-le

& 5rct're o$ +tell

D 5rct're o$ lterl $e!orl con-le

E 5rct're o$ ti(il s+ine.

2 @istorically tibial condylar fractures have been referred to as HbumperH

or HfenderH fractures. 2ut falls from height are also N common causes of these

injuries.

;. Intr!e-'llr niling o$ $e!orl sh$t $rct're is contr#

in-icte-" K

A When there is co!+o'n-ing

% When the $rct're is trns)erse& When $rct're is in nrro7est +rt o$ (one

D In non 'nion in -'lts

E In chil-.

E Intr!e-'llr niling is contrin-icte- in chil-ren (ec'se o$ -nger o$ -!ge to

gro7ing en-s o$ (one n- lso 7hen the chil- gro7s the nil 7ill (eco!e totll e!(e--e- -ee+

insi-e (one n- cn not (e re!o)e-. In co!+o'n- $rct'res n internl $i3tion -e)ice sho'l-

(e 'se- $ter -'e consi-ertion o$ co!+lictions. All other in-ictions re i-el $or

intr!e-'llr nil $i3tion.

;2. A +tient -e)elo+s co!+rt!ent sn-ro!e s7ellingF +in

n- n'!(ness $ollo7ing !ni+'ltion n- +lster $or

$rct're o$ (oth (ones o$ leg. Wht is the (est tret!ent"

A S+lit the +lster

% Ele)te the leg

& In$'sion o$ lo7 !olec'lr 7eight -e3trn

D Ele)te the leg $ter s+litting the +lster

E Do o+erti)e -eco!+ression o$ $cil co!+rt!ent.

# henever diagnosis of compartment syndrome is confirmed 4increased

compartment pressure measured by transducer5 or suspected7 safest and best

course of action is operative decompression of tight facial compartment. Any

delay will produce irreversible muscle necrosis. All other treatments

mentioned are an accompaniment to decompression operationO

;6. Which o$ the $ollo7ing is !ost i!+ortnt ste+ 7hen

#niling is -one $or $i3tion o$ $resh $e!orl sh$t $rct'res.

A oo- re!ing o$ !e-'llr cnl to t9e in 7i-est -i!eter nil

% No re!ing o$ !e-'llr cnl& Close- niling sho'l- (e -one


23/32

D 4one gr$ting !'st l7s (e -one long 7ith

E S!ll -i!eter nil sho'l- (e selecte-.

A Adequate reaming of medullary canal to accept widest diameter nail is

most important step as this increases the rigidity of fi!ation. After this ne!t

important step is to use a nail of proper length. &losed nailing is a difficultprocedure and for practical purposes open nailing is adequate. 2one graft

should be added in old fractures" comminuted fractures and non unions.

;8. Which o$ the $ollo7ing is co!!onest co!+liction o$

Colles@ $rct're"

A Sti$$ness o$ $ingers

% Sti$$ness o$ 7rist

& Sti$$ness o$ sho'l-er

D S'(l'3tion o$ in$erior r-io 'lnr /oint 7ith +inE S'-ec9@s osteo-stro+h.

A All the complications mentioned can occur after &olles fracture but out

of these stiffness of fingers is the commonest complication. (e!t commonest

complication is malunion followed ne!t in frequency by stiffness of shoulder.

$ther are less common but by no means rare. Ceast common complication is

spontaneous rupture of e!tensor pollicis longus tendon. (on union is very

rare.

;;. Ml'nite- Colles@ $rct're +ro-'ces Which o$ the $ollo7ing

-e$or!it"

A r-en s+-e -e$or!it

% Dinner $or9 -e$or!it

& M-el'ng -e$or!it

D S7n nec9 -e$or!it

E 4o'tonniere -e$or!it.

% Ml'nite- Colles $rct're +ro-'ces -inner $or9 -e$or!it.

;


24/32

attached muscles is ne!t best method of treatment. -wire and lag screw

fi!ation are the treatment of acute dislocation. Arthrodesis of acromio-

clavicular joint is almost impossible to achieve and if achieved will greatly

impair the mobility of shoulder girdle. Acromionplasty is used for intractable

cases of impingement syndrome.

;>. Regr-ing $rct're o$ cl)icle 7hich o$ the $ollo7ing stte!ent is

incorrect"

A 5rct're is co!!onest in !e-il thir-

% Non 'nion is rre

& Most cses cn (e trete- conser)ti)el

D 5rct're 's'll occ'rs -'e to in-irect in/'r

E 5rct're is co!!on in !i--le thir-.

A &lavicle fractures usually by fall on outstretched hand and the force

transmitted brea%s the bone at place where two curves meet and therefore

fractures are most common in the middle third of bone. All other statements

about union and treatment of clavicle fracture are correct.


25/32

D Clcneo $i('lr lig!ent

E Anterior tlo#$i('lr lig!ent.

# An%le sprain is an inversion injury and anterior talo-fibular ligament is

first to be damaged. ore severe injury can also damage origin of e!tensor

digitorum brevis and calcaneo-fibular ligament.


26/32

3 3..1. 4Airway" bleeding and circulation5 are the priorities in

management of seriously injured patient in that order.


27/32

D In old patients irrespective of the duration since injury

hemireplacement arthroplasty is the procedure of choice as the patient can be

mobili>ed early" thus avoiding general complications of immobili>ation. In old

fracture internal fi!ation is ineffective. Internal fi!ation with muscle pedicle

graft is useful procedure as it induces vascularity to aid in fracture union and

also restores normal anatomy. ith this operation and also with e urrayosteotomy weight bearing has to be delayed for many months and therefore

these operations are used only in younger patients.


28/32

E Perc'tneo's +in $i3tion is (est tret!ent.

'his fracture results in disruption of articular surface and should be

accurately reduced and internally fi!ed. B%eletal traction may at times suffice

for undisplaced fracture. 'hese fractures can not be satisfactorily reduced by

closed manipulation and therefore percutaneous pin fi!ation is not possible.0in fi!ation will also not be so strong as to start early %nee movements which

is important due to danger of %nee stiffness which can be quite severe inspite

of accurate reduction. (on union is rare as the fracture occurs in area of

abundant cancellous bone with good blood supply.

>1. Wht is tr'e (o't s'+rcon-lr $rct'res o$ $e!'r"

A Distl $rg!ent tilts +osteriorl -'e to +'ll o$ gstrocne!i's

% Distl $rg!ent tilts nteriorl -'e to +'ll o$ ,'-rice+s

& Cn (e trete- ,'ite 7ell ( #nilingD Cn 's'll (e trete- 7ith R'ssell trction

E Cn (e co!+licte- ( in/'r to scitic ner)e.

A astrocnemius pulls the distal fragment and its upper end tilts

posteriorly and malunion in this position will cause genu recurvatum

deformity. It can be treated conservatively by reduction and traction with

%nee in MPQ fle!ion" and for this reason ussel traction and traction on

'homas splint with %nee straight are useless. 2est treatment for these

fractures is internal fi!ation with angled blade plate appliance or #nder nails.

>*. Which o$ the $ollo7ing is not seen in intrc+s'lr $rct're o$

$e!orl nec9.

A Coll+se o$ he- $ter 'nion o$ $rct're

% Mi 'nion 7ith !ore thn J o$ shortening

& A)sc'lr necrosis o$ $e!orl he-

D Non 'nion

E Misse- -ignosis.

If the fracture has united shortening is only due to co!a vara andis usually not e!cessive. Diagnosis of undisplaced" impacted fracture can be

missed on clinical e!amination since the patient can move the hip with little

discomfort and may at times be able to wal% also. (on union and avascular

necrosis are well %nown complications and their incidence is appro!imately

EPG each. Although fracture can unite but still enough of blood supply to

femoral head may have been jeopardi>ed to produce avascular necrosis which

in turn can lead to collapse of femoral head.

>. Shenton line is (ro9en in ll o$ $ollo7ing e3ce+t"A Posterior -isloction o$ hi+

% I!+cte- $rct're o$ $e!orl nec9


29/32

& Congenitl -isloction o$ hi+

D Pthologicl -isloction o$ hi+

E To! S!ith rthritis.

Bhenton line will be bro%en in all cases when head is displaced

away from acetabulum 4dislocation5 due to any aetiology. It will not be bro%enin undisplaced impacted femoral nec% fractures.

>2. 5or -isten-e- 9nee /oint 7hich o$ the $ollo7ing +osition is

!ost co!$ort(le"

A 5'll e3tension

% ?K $le3ion

& 8?K $le3ion

D >?K $le3ion

E 1*?K $le3ion.

In 6FQ fle!ion" %nee joint has ma!imum capacity and pressure of

contained fluid or blood is minimum and consequently there is least pain.

&apacity of %nee joint decreases and pain thereby increases when the %nee is

fully e!tended or fle!ed more than 6FQ-MPQ.

>6. Which o$ the $ollo7ing is tr'e (o't c'te r'+t're o$ ten-c clcne's

ten-o#chillis"

A It occ'rs -'e to -irect in/'r

% R-iogr+h 7ill con$ir! the -ignosis

& Co!+ression o$ cl$ !'scles +ro-'ces +lnter$le3ion o$ n9le

D It 's'll occ'rs in !i--le ge- +ersons

E S'rgicl re+ir is 'nnecessr.

D 'his is injury of middle aged persons usually occuring due to

unaccustomed e!ercise. Direct injury is not the cause of tendon N rupture

although most patients feel as if something has hit. R-ays are of no value in

diagnosis. 0lanterfle!ion of an%le on compression of calf occurs when the

tendon is intact and its absence signifies tendon rupture. Burgical repair ispreferable treatment.

>8. St(ilit o$ 9nee /oint -e+en-s !inl on"

A 4on con$ig'rtion

% M'scles

& Lig!ents

D Ten-ons

E Menisci.


30/32

1 In %nee as well as other joints li%e interphalangeal" wrist and

intervertebral joint stability mainly depends on ligaments. In ball and soc%et

joint li%e hip" stability is provided by bony configuration. In very mobile

shoulder joint main stabili>ing structures are muscles. enisci and tendons do

not contribute significantly to stability.

>;. Co!+lete r'+t're o$ ten-o clcne's is (est trete- ("

A Phsiother+

% Arthro-esis o$ n9le n- s'(tlr /oint

& Rise- shoe

D Ten-on trns$er

E S'rgicl e3+lortion n- re+ir.

# upture of tendo-achillis whether spontaneons or traumatic should be

treated by surgical repair as soon as possible after injury. ?nunited tendon

produces severe disability in wal%ing as the push off is lost. If repaired later

fascial or tendon graft has to be used to bridge the gap and post operative

recovery is slow and end result is less than perfect.

>


31/32

articular surface can be restored" or to e!cise pateilar fragments when

fracture is so comminuted that patellar articular surface will remain rough.

1??. Which o$ the $ollo7ing stte!ent is not tr'e (o't se)ere )r's strin in/'r

o$ 9nee"A Us'll no s+eci$ic tret!ent is re,'ire-

% 5rct're o$ he- o$ $i('l sho'l- ro'se s's+icion o$ this in/'r

& Lterl +o+litel ner)e cn (e -!ge-

D Stress r-iogr+hs re re,'ire- to con$ir! the -ignosis

E Plin G#r cn (e nor!l e)en in the +resence o$ e3tensi)e -!ge.

A If the injury is severe operative repair of torn structures 4lateral

collateral ligament" lateral capsule and biceps femoris5 is required followed by

plaster immobili>ation with %nee 6F degrees fle!ed. R-ray may quite often benormal or may only show avulsion fracture of head of fibula. Btress

radiographs or e!amination under anaesthesia will reveal full e!tent of

damage. Cateral popliteal nerve can also be damaged due to traction injury.

1?1. Ho7 -oes +rltic scoliosis -i$$er $ro! i-io+thic scoliosis"

A Progress o$ c'r)e sto+s $ter !t'rit

% Scoliosis cn +rogress e)en $ter !t'rit

& C'r)es re 's'll short

D 4rcing is ,'ite e$$ecti)e in controlling +rogress

E C'r)e ne)er (eco!es )er se)ere.

Asymmetrical paralysis of paraspinal muscles produces paralytic

scoliosis. &urve can develop and progress even after maturity" is usually long

and can become very severe. 2racing is not as effective in controlling paralytic

scoliosis as it is in controlling

paralytic scoliosis.

1?*. In !elo!eningocele scoliosis occ'rs -'e to"

A As!!etricl +rlsis o$ s+inl n- (-o!inl !'scles% Congenitl -e$or!ities o$ )erte(re

& 5i3e- +el)ic o(li,'it

D An o$ (o)e

E None o$ (o)e.

D In --ition to c'ses !entione-F scoliosis cn lso occ'r -'e to sttic $orces o$ chronic

!l+ost're necessitte- ( +rlsis or ( +erio- o$ rec'!(enc $or cre o$ $re,'entl

reclining ischil or trochnteric +ress're sores.

1?. 4e$ore s'rgerF $orci(le correction o$ se)ere scoliosis c'r)e cn

(e chie)e- ("


32/32

A Hlter trction

% Hlo#+el)ic trction

& T'rn('c9le cst

D Riser /c9et

E Cotrel cst.

A Hlter trction -oes not +ro)i-e eno'gh $orce to correct se)ere scoliosis -e$or!itF $or

7hich n o$ the other !entione- !etho-s cn (e 'se-.

1?2. Co!!onest lte co!+liction o$ s+inl $'sion in scoliosis is"

A Rec'rrence o$ -e$or!it

% Pse'-orthrosis

& Ne'rologicl -e$icit

D All o$ (o)eE None o$ (o)e.

% Pse'-orthrosis is the co!!onest co!+liction n- this in so!e cses le-s to

-e)elo+!ent o$ rec'rrence o$ -e$or!it.

Orthopaedics and Trauma

Documents

Transcript of Orthopaedics and Trauma