Words on paper
Based on one of the papers, this would be the expected outcome of a femur fracture 6 cm distal to the lesser trochanter treated with a retrograde nail.
Radiographic and clinical union with acceptable alignment
94% union after index surgery, 2% malunion (>10 degrees deformity)
After asking how a patient can WBAT on POD0, you intelligently say that an intramedullary nail is a ____-_______ device.
Load-Sharing
Also known as a narrow strip of land with sea on either side, this also determines the final reamer size
Isthmus
In general, this is the consequence of a starting point which is too lateral given a specific nail design/geometry
Varus
In the AO/OTA classification system, what is the designation given to the femur
3
In Tornetta et al.'s study, this percentage of patients with femoral shaft fractures had an associated femoral neck fracture.
7.5% (19/254)
When assessing a ventilator, these two settings are the primary drivers of oxygenation
PEEP & FiO2
Speaking of air conditioning, this technique used when reaming for a prophylactic nail decreases intramedullary pressures
Venting
These are 3 main deforming forces in a subtrochanteric femur fracture with responsible offenders
Abduction/ER - gluteal muscles
Varus - adductors
Flexion - IP
For the OITE, what is the age and weight in which you can consider rigid antegrade nailing compared to other methods for fixing pediatric/adolescent femur fractures
11-12yrs, >50kg (100lbs)
This was the most common reason for re-operation in each intramedullary nail article
Interlock screw removal
Nino et al: 7.8%
Ricci et al: 6.6%
When assessing ventilator settings, these two measurements/settings are the primary drivers of ventilation.
Tidal Volume & Respiratory Rate
Ventilation = removal of CO2
Name two challenges associated with under-reaming of the femoral canal
1. Difficulty advancing nail
2. Incarcerated nail (nail jail)
3. malunion, delayed union, nonunion
4. Distraction at fracture site
The english translation of Linea Aspera
Rough line
What is the AO/OTA Designation for a midshaft femur fracture with a wedge morphology?
32B
Tornetta et al's protocol included this work up.
AP internal rotation radiograph, fine cut (2 mm) CT, intraoperative lateral fluoroscopy prior to fixation, lateral radiographs of the hip prior to awakening the patient.
When asking if a patient is cleared, the internist sarcastically asks you if you've ever heard of the Cori cycle. Surmising the patient is not cleared, you astutely infer that:
The lactate is too high
Name 2 benefits (aside from autograft harvesting) or two risks/complications (aside from cost) related to using the RIA
Pros: Cools (reduces thermal necrosis) and reduces fat embolism. Also can remove cement, infection, and prevent extravasation of malignancies
Cons: cortical perforation and increased intraoperative blood loss
This measurement of the femur is typically 1-1.5m
Radius of Curvature
Compared to their geriatric counterparts, young, high energy femoral shaft fractures with associated femoral neck fractures are more likely this orientation (include classification designation)
Vertical, Pauwels III
According to Ricci et al, the use of a GT start point had this impact on operative time and this impact on fluoroscopy time.
This cell type is primarily responsible for secretion of this molecule, thought to be the most sensitive/specific indicator of resuscitation in recent literature
Macrophage (IL6)
IL6 mRNA is constitutively expressed, can be released by any cell type
Prior to solid nails, slotted nails were traditionally used. Compared to slotted nails, solid nails are more rigid in this type of loading/stress
This media giant published an article in 1945 titled "Amazing Thighbone" which detailed an American POW during WWII who was treated by German surgeons with a Küntscher nail for a femoral shaft fracture
Time Magazine
In the Windquist & Hansen classification of femoral shaft fracture, what separates Type II and Type III fracture patters?
Amount of cortical contact
Type II <50%
Type III >50%