2020 Q's

Question 1

<div>Orthopaedic surgeons deal with a lot of polytrauma patients and often do the tertiary survey….which is False?</div>

<ol><li><div>High energy mechanism with head injury and unconscious patients easier to miss injuries.</div></li><li><div>Missed hip and pelvic fractures are not frequent</div></li><li><div>Missed fractures at night higher than daytime</div></li><li><div>Hand and feet are more commonly missed</div></li></ol>

Answer 1

Answer: 3<div><div><br></br></div><div>JBJS 2018: Commonly Missed Injuries in the Patient with Polytrauma and the Orthopaedists Role in the Tertiary Survey.</div><div><br></br></div><div>RF for missed injuries</div><div>- ISS >15, altered mental status, ICU stay, emergent surgery</div><br></br><div>Highest incidence of missed injuries in hands/feet/clavicle</div><br></br><div>- <b>Missed Pelvic and hip injuries has significantly decreased over past 3 decades</b>, likely due to implementation of stand AP pelvis x rays during primary survey and multislice CT pelvis as part of emergency workup with CT C/A/P </div><div> >10% to now <10% since 2000… not sure what constitutes as “frequent”</div><br></br><div><b>No difference in missed injuries during day vs night</b> (Zamboni et al. 2014 - Injury), there always have high index of suspicion regardless of time</div></div>

Question 2

In a meta-analysis what is true about heterogeneity?<div><ol><li><div>Chi-square is the only way to test for heterogeneity</div></li><li><div>I²tells you the source of the heterogeneity</div></li><li><div>I²of 75-100% is considerable amount of heterogeneity</div></li><li><div>It is not necessary to measure heterogeneity.</div></li></ol></div>

Answer 2

<div>Answer: 3</div>

<div><br></br></div>

<div>Statistics</div>

<div>Thresholds for the interpretation of I²can be misleading, since the importance of inconsistency depends on several factors. A rough guide to interpretation is as follows:</div>

<ul><li><div>0% to 40%: might not be important;</div></li><li><div>30% to 60%: moderate heterogeneity*;</div></li><li><div>50% to 90%: substantial heterogeneity*;</div></li><li><div>75% to 100%: considerable heterogeneity*.</div></li></ul>