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FRACS True / False Quiz > Imperium Im Imperio JAAOS 2019 > Flashcards

Imperium Im Imperio JAAOS 2019 Flashcards

1
Q

20% of Primary ACLs have co-existing chondral or meniscal pathology

A

False

50%

JAAOS Jan 2019

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2
Q

90% of Revision ACLs have co-existing pathology

A

True

JAAOS Jan 2019

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3
Q

A delay in surgical reconstruction of ACL of 12 weeks will increase the risk of chondral or meniscal injury by 12%

A

False

3%

JAAOS Jan 2019

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4
Q

Males have a consistently higher rate of meniscal tears with ACL injuries than females

A

True

JAAOS Jan 2019

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5
Q

Total medial meniscectomy has no appreciable bearing on examination findings during Lachmanns manoeuvre

A

False

Increase from 5mm to 11mm

JAAOS Jan 2019

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6
Q

Total lateral meniscectomy has no appreciable bearing on examination findings during Lachmanns manoeuvre

A

True

But does increase AP translation during pivot shift

JAAOS Jan 2019

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7
Q

By far the majority of tears involve the posterior horns of medial and lateral meniscus

A

True

95% Medial and 77% Lateral are posterior horns

JAAOS Jan 2019

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8
Q

“Benign neglect” of stable meniscal tears found during ACL reconstruction have a low rate ~ 5% of requiring revision surgery

A

True

5.4% (with 9% medial and 3% lateral

JAAOS Jan 2019

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9
Q

The failure rate of meniscal tear repairs done during ACL reconstruction are the same for ‘all-inside’ and ‘inside-out’

A

False

10% inside-out, 16% all inside

JAAOS Jan 2019

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10
Q

Most common location of bone bruising in ACL injuries is lateral tibial plateau and medial femoral condyle

A

False

Lateral tibia + Lateral femur

JAAOS Jan 2019

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11
Q

OATS is superior to microfracture for acute chondral injuries treated during ACL reconstruction with an average size of 2.6cm2

A

True

JAAOS Jan 2019

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12
Q

The rate of adjacent level disease (symptomatic radiculopathy) after ACDF is unacceptably high and arthroplasty (disc replacement) should be preferred

A

False

2.9% per year

JAAOS Jan 2019

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13
Q

90% of cervical radicular symptoms are progressive and worsen with majority requiring surgery

A

False

Benign course, 29% require surgery

JAAOS Jan 2019

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14
Q

Cervical myelopathy is progressive and does not respond to non-surgical treatment

A

True

JAAOS Jan 2019

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15
Q

Cervical disc arthroplasty should be limited to 3 levels

A

True

JAAOS Jan 2019

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16
Q

Cervical arthroplasty is contraindicated with kyphotic deformity, previous surgery or facet joint arthropathy

A

True

JAAOS Jan 2019

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17
Q

Cervical arthroplasty is proven to have a notable improvement is saggital plane motion compared to ACDF

A

False

No difference in motion in any plane

JAAOS Jan 2019

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18
Q

Disc pressure is the same in adjacent levels with ACDF and Cervical arthroplasty

A

False

Lower pressure in disc replacement (in cadavers)

JAAOS Jan 2019

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19
Q

Breaking through the subchondral bone is essential for bony integration of Cervical arthroplasty and is a requirement of implantation

A

False

Risk of subsidance, avoid breakthrough

JAAOS Jan 2019

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20
Q

Long term studies are available and show a lower secondary procedure rate for arthroplasty compared to ACDF for adjacent segment disease

A

True

But interpret with caution due to different implant designs

JAAOS Jan 2019

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21
Q

Incidence of HO is variable with Cervical arthroplasty (7-70%) and has not been shown to be clinically significant

A

True

JAAOS Jan 2019

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22
Q

The smooth surfaces of the SI joint make it susceptible to ligamentous strains

A

False

Articular surface is rough

JAAOS Jan 2019

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23
Q

Ventral branches of L4-S3 supply the SI joint

A

False

Dorsal branches of L4-S3 and Anterior branches of L2-S2

JAAOS Jan 2019

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24
Q

Inflammatory arthropathy affects SIJ neural structures more due to the incompetent capsular envelope

A

True

Poor / incomplete capsule allows inflammatory mediators to “leak” out to neural structures

JAAOS Jan 2019

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25
Q

There is 5-10deg movement in saggital and axial planes only of the SIJ

A

False

Saggital (1-4mm) and translation (0.5-2mm)

JAAOS Jan 2019

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26
Q

Only the anterior 1/3 of the SIJ between sacrum and ilium is a true synovial joint and the rest is just ligamentous structures

A

True

JAAOS Jan 2019

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27
Q

Scoliosis, previous spinal fusions and LLD are the main secondary contributors of SIJ pain

A

True

JAAOS Jan 2019

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28
Q

Ank spond is the only inflammatory arthropathy to affect the SIJ

A

False

Reiter’s, Rheumatoid, Psoriatic

JAAOS Jan 2019

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29
Q

Most common symptom of SI joint pathology is buttock pain

A

True

94% have buttock pain, 72% have back pain

JAAOS Jan 2019

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30
Q

Fortin finger test is SIJ pain reproduced during PR examination

A

False

There is no such test. Why are you even doing a PR?

No reference needed.

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31
Q

Physical exam can reliably elicit SIJ pathology especially rising from a chair

A

False

Dreyfuss et al tested 12 exam findings, none were reliable. Pain on rising from a chair is most highly correlated with SIJ pathology.

JAAOS Jan 2019

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32
Q

Multiple national joint registries show a lower revision with cemented vs cementless in the >75yr age group

A

True

JAAOS Feb 2019

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33
Q

Collars in cemented stems have been proven to improve proximal loading of the cement mantle and prevents stress shielding

A

False

JAAOS Feb 2019

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34
Q

2mm of cemented stem subsidence, typically seen at the shoulder of the prosthesis is normal in the first 12 months

A

True

JAAOS Feb 2019

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35
Q

Lat dorsi originates from the iliac crest, thoracolumbar fascia, and inferior thoracic and lumbar spinous processes and inserts on the medial lip of the intertubercular groove

A

True

JAAOS Feb 2019

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36
Q

Lat dorsi nerve supply is from the dorsal scapular nerve (C5-7)

A

False

Thoracodorsal via C5,6,7

JAAOS Feb 2019

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37
Q

Lat dorsi acts to adduct, extend and externally rotate the shoulder

A

False

Add, Ext and ER

JAAOS Feb 2019

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38
Q

Most common Lat dorsi injury is muscle belly strain, seen in pitchers/ crossfit and rock climbing

A

True

JAAOS Feb 2019

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39
Q

All Lat dorsi injuries (except humeral insertion rupture) can be managed conservatively

A

True

JAAOS Feb 2019

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40
Q

Radial nerve passess anterior to lat dorsi tendon at an average of 2cm from its insertion

A

True

JAAOS Feb 2019

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41
Q

In hip ostoelysis, Particles <7um (micrometers or microns) can be eaten by macrophages

A

True

JAAOS Mar 2019

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42
Q

In hip osteolysis, The time from 3rd body wear to visible bone loss on Xray is quite fast 1-2 years

A

False

Usually doesn’t start until 1 year and no bone loss until 5+ years

JAAOS Mar 2019

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43
Q

THR Constrained liners are indicated with abductor dysfunction

A

True

JAAOS Mar 2019

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44
Q

In hip osteolysis, the primary reason for a head and liner exchange is to address the wear generator

A

True

JAAOS Mar 2019

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45
Q

In THR wear, most common complication of a head/liner exchange is not recognising implant loosening

A

False

Hip dislocation is most common

JAAOS Mar 2019

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46
Q

PFJ OA is a contraindication for UKR due to risk of early revision due to disease progression

A

False

No difference in function or revision with PFJ OA

JAAOS Mar 2019

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47
Q

Valgus stress views at 20 deg flexion showing >5mm width and correctible alignment are good predictors of lateral compartment OA in the decision making of UKR

A

False

No correlation with Outerbridge grading of lateral joint cartilage

JAAOS Mar 2019

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48
Q

Most common reason for revision for UKR is aseptic loosening regardless of cemented or uncemented

A

True

JAAOS Mar 2019

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49
Q

Revision rate for cemented and uncemented UKRs are equivalent

A

True

95% cemented and 97% uncemented survivorship at 10 years.

JAAOS Mar 2019

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50
Q

IV drug user is the second most common risk factor for Necrotizing Fasciitis

A

True

43% IVDU, but Diabetes is 71%

JAAOS Mar 2019

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51
Q

Clostridium monomicrobial Necrotizing Fasciitis accouns for the highest mortality and limb amputation

A

True

Higher than monomicrobial Strep A

JAAOS Mar 2019

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52
Q

In Necrotizing Fasciitis, Exotoxins caused by the strep A prevent the spread of the infection and keep it localised

A

False

Causes a highly invasive infection

JAAOS Mar 2019

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53
Q

Bullae/ ecchymosis is a hard sign and are almost always present in Necrotizing Fasciitis

A

False

Present 44% of the time

JAAOS Mar 2019

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54
Q

Gas tracking along fascial planes is a soft sign of Necrotizing Fasciitis due to multiple differential causes

A

False

This is a hard sign. Few other things can cause it (post-op ob, or gas injection)

JAAOS Mar 2019

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55
Q

CRP 150 and WCC >25 are indications for immediate surgical debridement in cases of Necrotizing Fasciitis

A

True

JAAOS Mar 2019

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56
Q

Mortality from Necrotizing Fasciitis is high ~ 60%

A

False

33% (still high)

JAAOS Mar 2019

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57
Q

The apical ectodermal ridge, the zone of polarisation and Wnt signalling pathway are key for limb development between 4th and 7th week of life

A

True

JAAOS Mar 2019

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58
Q

There is a specific gene which is responsible for tibial deficiency

A

False

JAAOS Mar 2019

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59
Q

Associations in Tibial Deficiency are DDH, vertebral malformations, imperforate anus and hypospadias

A

True

JAAOS Mar 2019

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60
Q

Visceral organ ultrasound is not required in cases of tibial deficiency

A

False

JAAOS Mar 2019

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61
Q

Treatment fundamentally revolves around a stable plantigrade foot/ankle

A

True

JAAOS Mar 2019

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62
Q

Tibial deficiency is typically associated with equinovalgus foot

A

False

EquinoVarus (swings to empty area where tibia is supposed to be)

JAAOS Mar 2019

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63
Q

Fibula centralisation (brown procedure) is robust with good results

A

False

Most end up needing amputation

JAAOS Mar 2019

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64
Q

Children with unreconstructable Tibial Deficiency with functioning knee should get a Symes amputation and those without should get a Through Knee amputation

A

True

JAAOS Mar 2019

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65
Q

50% of patients over the age of 66 have degenerative rotator cuff tears

A

True

JAAOS Mar 2019

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66
Q

Supraspinatus has the largest footprint of the rotator cuff tendons on the GT

A

False

Supra 12.6mm, Infra 32.7mm

JAAOS Mar 2019

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67
Q

Vascular supply to the rotator cuff has little involvement in the development of degenerative Rotator Cuff tears

A

False

Directly related to poor vascularity, tendinopathy and tear

JAAOS Mar 2019

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68
Q

The risk of partial rotator cuff tears progressing is approximately 10% over 2 years and 30% for 5 years

A

True

JAAOS Mar 2019

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69
Q

The incidence of scapular notching in shoulder replacement is wide and clinical implications are unknown

A

True

4%-96% incidence, no clinically proven complications

JAAOS Mar 2019

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70
Q

Clinical outcome scores are equivalent between shoulder replacement with notching or without notching

A

False

Lower Constant scores in the notching group

JAAOS Mar 2019

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71
Q

Ways to avoid scapular notching in shoulder replacement is a smaller glenosphere and decreased offset

A

False

Increase Glenosphere and Offset to reduce risk

JAAOS Mar 2019

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72
Q

Implant removal and reconstruction (Post traumatic THA) are usually planned to be performed in a single procedure

A

True

Except for cases of infection. No literature to support 1 or 2 stage.

JAAOS April 2019

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73
Q

In THA after previous ORIF, existing implants are left in situ until the hip is dislocated

A

True

To avoid fracture during hip dislocation

JAAOS April 2019

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74
Q

Patients over 60 having hip arthroplasty due to post traumatic arthritis have lower revision rates for aseptic loosening than patients with primary OA

A

False

Higher risks of infection, dislocation, loosening, sciatic nerve damage and heterotopic ossification

JAAOS April 2019

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75
Q

Patients who underwent salvage total hip arthroplasty for prior intertrochanteric fractures reported a mean surgical duration of 4 hours and estimated blood loss of 1,125 mL

A

True

JAAOS April 2019

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76
Q

Alzheimer Disease is a progressive, incurable neurologic illness

A

True

Loss of neuronal synapses. 3 to 12 year survival after diagnosis.

JAAOS April 2019

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77
Q

Global memory decline is typically the first sign of Alzheimer Disease

A

True

Dx criteria:

  1. Loss of cognitive function
  2. Progressive deterioration
  3. Duration >6 months
  4. Absence of another cause of dementia

JAAOS April 2019

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78
Q

Patients with Alzheimer Disease treated with surgical fixation for stable femoral neck fractures are less prone than the general geriatric population to loss of reduction and fixation failure than healthy elderly individuals

A

False

JAAOS April 2019

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79
Q

Ankle fractures in Alzheimer Disease treated with hind foot fusion nailing has better outcome than ORIF

A

True

Lower complications and shorter hospital stay

JAAOS April 2019

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80
Q

The incidence of Fat Embolism Syndrome in paediatrics is less than in adults

A

True

JAAOS April 2019

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81
Q

Patients with Duchenne Muscular Dystrophy have lower risk of developing Fat Embolism Syndrome than average population

A

False

Higher risk

JAAOS April 2019

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82
Q

Petechial rash of Fat Embolism Syndrome can appear on the back of a supine patient

A

False

Never on the back (at least in supine patient). Fat droplets float up to non-dependant areas.

JAAOS April 2019

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83
Q

Patients with long bone fracture who get late stabilization are in an increased risk of Fat Embolism Syndrome in comparison to patients who
get early stabilization

A

True

JAAOS April 2019

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84
Q

There is a Six times greater incidence of acute lung injury with intramedullary femoral nailing compared to Ex Fix

A

True

However, no difference in ARDS or Mortality

JAAOS April 2019

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85
Q

Good evidence to suggest that unreamed nailing is better in multitrauma setting with regard to Fat Embolism Syndrome

A

False

No evidence

JAAOS April 2019

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86
Q

Reamer irrigator aspirator (RIA) has less embolic load than normal reamer.

A

True

JAAOS April 2019

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87
Q

The use of an intramedullary bone vacuum during cementation in arthroplasty was shown to significantly decrease embolization of marrow contents

A

True

JAAOS April 2019

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88
Q

Routine prophylaxis with steroids is recommended to reduce Fat Embolism Syndrome

A

False

JAAOS April 2019

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89
Q

Fat Embolism Syndrome is characterized by pulmonary distress, neurological symptoms and petechial rash

A

True

JAAOS April 2019

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90
Q

Prolonged NSAID use has a negative effect on bone healing

A

True

Except in Paediatric population

JAAOS April 2019

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91
Q

The first case of DVT after elective shoulder arthroscopy was reported by Burkhart in 1990

A

True

JAAOS April 2019

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92
Q

DVT in upper extremity is higher after shoulder arthroscopy than arthroplasty

A

False

Up to 2.6% in Arthroplasty, Up to 0.38% in Arthroscopy

JAAOS April 2019

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93
Q

rTSR is found to have higher VTE risk than anatomical TSR or hemiarthroplsty

A

False

No definitive link between types of arthroplasty, only surgical time, etc.

JAAOS April 2019

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94
Q

No definitive correlation can be drawn between positioning of shoulder arthroscopy (beach chair or lateral decubitus) and VTE risk

A

True

JAAOS April 2019

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95
Q

Recurrence after Upper Extremity DVT is lower than that after Lower Extremity DVT.

A

True

JAAOS April 2019

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96
Q

Post-thrombotic syndrome of a limb is characterized by hypopigmentation, atrophy and pain

A

False

HypERpigmentation, Edema, Pruritis, Paresthesias, Pain and ulceration.

JAAOS April 2019

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97
Q

Excessive anterior tightening in shoulder stabilization can result in increased posterior subluxation of the humeral head, shearing forces on the posterior glenoid, and eventual arthrosis.

A

True

JAAOS April 2019

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98
Q

Shoulder instability is common, with an incidence of 5% in the general population

A

False

1.7% incidence

JAAOS April 2019

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99
Q

More than 50% of patient with shoulder dislocation will develop arthritis in 25 years

A

True

JAAOS April 2019

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100
Q

Suboptimal (lateral) positioning of the coracoid transfer and/or prominent screws used in the Bristow-Latarjet procedure is thought cause impingement against the humeral head during abduction and external rotation

A

True

JAAOS April 2019

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101
Q

The number of anchors used in Bankart repair is not a risk factor of radiographic arthritic changes

A

False

More anchors, number of dislocations, young age at primary dislocation, anterior tightening procedures all associated with more arthritis

JAAOS April 2019

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102
Q

Eden-Hybinette operation -is an augmentation of the anterior glenoid rim with an iliac crest bone graft – is associated with extremely high shoulder arthrosis rate

A

True

JAAOS April 2019

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103
Q

In post-dislocation arthropathy, tightening of the anterior capsule can result in posterior displacement of the head, resulting in severe B2 and B3 deformities

A

True

JAAOS April 2019

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104
Q

Radiographs of post-dislocation arthropathy typically demonstrate joint space narrowing, osteophyte an cyst formation, subchondral sclerosis, and posterior glenoid wear

A

True

JAAOS April 2019

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105
Q

The aim of ream & run technique is to create a cancellous bed for the humeral head to minimize the risk of glenoid erosion

A

False

The aim is to re-center the glenoid without resurfacing, to help prevent glenoid component failure in young patients

JAAOS April 2019

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106
Q

Matsen highlighted the increased failure risk of total shoulder arthroplasty in patients with the “arthritic triad” of posterior humeral head displacement, glenoid biconcavity, and retroversion

A

True

JAAOS April 2019

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107
Q

Reverse total shoulder arthroplasty should be considered over anatomic in older patients with post-dislocation arthropathy with an intact rotator cuff and sufficient bone stock to support the glenoid component

A

False

Consider anatomic, not reverse (weird question though)

JAAOS April 2019

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108
Q

Shoulder arthroplasty outcome is similar for patients with prior instability to results in patients with primary osteoarthritis.

A

False

Better outcomes in primary OA

JAAOS April 2019

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109
Q

Outcome of reverse TSA in patients with prior anterior instability are similar to outcome in patients with cuff
arthropathy

A

True

JAAOS April 2019

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110
Q

The B2 glenoid has been associated with poor outcomes after anatomic shoulder arthroplasty

A

True

JAAOS April 2019

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111
Q

Velocity of the bullet is a more important determinant of Kinetic Energy than bullet mass, and a higher velocity bullet will lead to a much higher degree of soft-tissue and bony injury

A

T

KE = 1/2 m v2

JAAOS April 2019

112
Q

Lower density tissues, such as lung tissue, fat, and muscle, will generally absorb more energy from the bullet than bones

A

False

Absorb less

JAAOS April 2019

113
Q

Handguns generally cause minimal soft-tissue injury, whereas shotguns can cause extensive soft-tissue injury, especially when fired at close range.

A

True

JAAOS April 2019

114
Q

The rate of fractures associated with GSWs to the extremities was 22%.

A

True

JAAOS April 2019

115
Q

Lead levels greater than 18 μg/dL-1 in adults and 5 μg/dL-1 in children are associated with neurotoxicity

A

True

Can also develop lead arthropathy or tenosynovitis if fragments are not removed from around wrist and hand

116
Q

No increased nonunion rate in patients with gunshot-associated fractures compared to those with closed fractures

A

True

JAAOS April 2019

117
Q

In GSW associated fracture there is a slight increase in non union (without statistical significance) with patients treated non surgically compared with surgically treated patients

A

True

Satisfactory healing rates if treated non-op

JAAOS April 2019

118
Q

Elbow arthroplasty in non reconstructable elbow fractures associated with GSW is associated with poor results

A

True

JAAOS April 2019

119
Q

The spontaneous recovery rate is < 40 % in nerve palsies associated with low-velocity GSWs to the upper extremity

A

False

69% spontaneous recovery rate within 4-8 months. 27% nerve laceration rate with palsy

JAAOS April 2019

120
Q

The shoulder accounts for approximately 15% of primary sarcomas and is the third most common site, behind hip, pelvis and the knee

A

True

JAAOS April 2019

121
Q

Malignant tumors are more commonly symptomatic with severe pain

A

True

Benign tumors usually less symptomatic

JAAOS April 2019

122
Q

Osteochondromas are the most common primary benign lesion of the shoulder

A

True

JAAOS April 2019

123
Q

Enchondromas are the second most common benign tumor

A

True

JAAOS April 2019

124
Q

The risk of malignant transformation is low for solitary enchondromas; however, the risk is 25% for Ollier disease (multiple enchondromatosis) and even higher in Maffucci syndrome (multiple enchondromas and soft-tissue hemangiomas)

A

True

JAAOS April 2019

125
Q

Osteoblastoma are lesions > 2 cm and the pain is typically relieved with NSAID

A

False

Not relieved with NSAIDs and usually requires surgery for pain relief

JAAOS April 2019

126
Q

Multiple myeloma is the most common primary malignancy of bone, with an incidence approximately double that of osteosarcoma.

A

True

JAAOS April 2019

127
Q

The features of soft-tissue sarcomas over benign lesions are 1. Non-tender, 2. Firm consistency, 3. Subfascial location, 4. Size larger than 5 cm

A

True

JAAOS April 2019

128
Q

A broad zone of transition can be seen in aggressive lesions, infection and eosiophilic granuloma

A

True

JAAOS April 2019

129
Q

There is a 1.5% rate of C5 palsy after single or multi-level ACDF

A

False

5.1% rate of palsy

JAAOS April 2019

130
Q

Parallel oriented cannulated screws for subcapital NOF # are associated with poor outcomes in up to 46% of the clinical cases

A

True

JAAOS June 2019

131
Q

Kibler assessment of scapular dyskinesia: Type I dyskinesis has a prominent inferior medial scapular border

A

True

1 = Inferior medial border prominence
2 = Entire medial border prominence
3 = Superior medial border prominence (migration)
4 = Normal symmetric posterior tilting, ER and upward rotation

JAAOS June 2019

132
Q

Tests of scapular dyskinesia have low sensitivity & specificity

A

True

JAAOS June 2019

133
Q

The Neer sign is the only test to reliably predict subacromial bursitis alone or partial thickness rotator cuff tears

A

True

JAAOS June 2019

134
Q

Many of the physical examination tests with a high sensitivity and low LR- (negative likelihood) are excellent screening tests.

A

True

JAAOS June 2019

135
Q

A diagnosis of RCTA (rotator cuff tear arthropathy) encompasses patients with three defining characteristics: rotator cuff insufficiency, glenohumeral arthritis, and superior migration of the humeral head

A

True

JAAOS June 2019

136
Q

The best screening test for ruling out AC joint pathology if negative is the tenderness to palpation at the AC joint

A

True

Sensitivity 96%, NLR 0.4

JAAOS June 2019

137
Q

The O’Brien test is a good tool to diagnose SLAP lesion

A

False

O’Brien is not a reliable screening or confirmatory test

JAAOS June 2019

138
Q

Combining the anterior slide and crank tests improved the ability to rule in a SLAP tear

A

True

JAAOS June 2019

139
Q

MRA has been shown to have a specificity of 91% to 98% in diagnosing labroligamentous lesions compared with arthroscopy

A

True

Arthroscopy is the gold standard, so 100% sensitive

JAAOS June 2019

140
Q

The anterior apprehension, Jobe relocation, surprise, and anterior load and shift tests are all excellent screening and confirmatory tests for diagnosing anterior shoulder instability, given their high sensitivity and specificity

A

True

Crucial to use “apprehension” as the positive rather than “pain”, as this significantly improves post-test probability

JAAOS June 2019

141
Q

The Jerk and Kim tests are both excellent screening and confirmatory tests for diagnosing posterior shoulder instability, given their high sensitivity and specificity.

A

True

JAAOS June 2019

142
Q

Adhesive Capsulitis primarily involves contracture of the joint capsule and the rotator interval, which is composed of the superior glenohumeral ligament and the coracohumeral ligament (CHL).

A

True

JAAOS June 2019

143
Q

The degree of stiffness of the capsule in Adhesive Capsulitis directly correlates to patient pain

A

False

Degree of stiffness correlated with ROM (well, duh)

JAAOS June 2019

144
Q

The incidence of Adhesive Capsulitis in the diabetes group was associated with how long they had been diabetic and had poor blood glucose control

A

True

Diabetics are 5x more likely to develop Adhesive Capsulitis

JAAOS June 2019

145
Q

30% of patients with Adhesive Capsulitis have diabetes, while 13% of the diabetic patients have AC.

A

True

JAAOS June 2019

146
Q

5-11% of the patients who had previous shoulder surgery develop Adhesive Capsulitis at 6 months

A

True

JAAOS June 2019

147
Q

Intra-articular injection of steroids in the early stages of Adhesive Capsulitis has both improved outcome on the short & long term

A

True

Aim for early injection after 1 month of physio

JAAOS June 2019

148
Q

Hydrodistention combined with joint manipulation under an interscalene block provided better long term results when compared with single intra articular corticosteroid injection in patients with AC

A

False

Better short term, but same long term

JAAOS June 2019

149
Q

Patients with Adhesive Capsulitys on a background of type 1 diabetes mellitus were at a 38% increased risk of requiring a repeat MUA, compared to 18% risk in all comers

A

True

JAAOS June 2019

150
Q

Blind MUA in Adhesive Capsulitis has more complications than arthroscopy with MUA.

A

True

JAAOS June 2019

151
Q

Over half of all postoperative infections after shoulder arthroplasty are due to Propionibacterium acnes

A

T

Even “aseptic” revisions often end up culturing P. acnes.

JAAOS June 2019

152
Q

Current standard antibiotic prophylaxis and skin preparation methods in Shoulder Arthroplasty are effective against P. acnes

A

False

Skin preparation should add benzoyl peroxide

JAAOS June 2019

153
Q

The main sources of instability in the setting of Reverse TSA are inadequate soft tissue tensioning and component malpositioning leading to impingement

A

True

Bilateral full-length humeral x-rays could be useful in revision cases to judge deltoid tensioning.

JAAOS June 2019

154
Q

Humeral loosening is generally rare in shoulder arthroplasty

A

True

JAAOS June 2019

155
Q

Glenoid component loosening is common in Reverse TSA

A

False

It is “common” in Anatomic TSA, but “uncommon” in Reverse TSA

JAAOS June 2019

156
Q

The vertical humeral osteotomy for stem removal in Shoulder Arthroplasty is generally performed just medial to the pectoralis insertion

A

False

Just lateral to pec insertion. An osteotomy 4cm less than the length of the stem is usually enough for removal of the stem and then re-implantation of a normal sized (similar) stem, without risk of fracture propagation

JAAOS June 2019

157
Q

Techniques to address osseous deficiencies in Revision Shoulder Arthroplasty include eccentric reaming, augmented glenoid components, and bone grafting techniques

A

True

Revision TSA = global bone loss
Primary OA = posterior wear
Cuff Arthropathy = superior wear

JAAOS June 2019

158
Q

Klippel-Feil Syndrome, down syndrome and Achondroplasia can lead to cervical spine deformity

A

True

JAAOS June 2019

159
Q

In Seronegative spondyloarthropathies, psoriatic arthritis is the most common of the seronegative disorders to affect the Cervical Spine

A

False

Ankylosing Spondylitis is most common

JAAOS June 2019

160
Q

Rheumatoid arthritis (RA) is the most common inflammatory disorder that can affect the Cervical Spine

A

True

JAAOS June 2019

161
Q

During surgical exposure of the lateral masses, facet capsule violation can lead to accelerated spondylosis, axial neck pain, and loss of lordosis

A

True

JAAOS June 2019

162
Q

Postoperative functional outcome scores are markedly lower in patients with C2-C7 SVA –sagital vertical axis- of >50mm

A

True

SVA is normally 16.8 +/- 11.2mm

JAAOS June 2019

163
Q

The incidence of cervical kyphosis is likely to be twice as high if a patient has a higher T1 slope

A

True

JAAOS June 2019

164
Q

The chin brow vertebral axis (CBVA) is used to assess horizontal gaze and is defined by the angle subtended between a line drawn from the patient’s chin to brow and a vertical line

A

True

JAAOS June 2019

165
Q

Normal cervical lordosis is between 10⁰ and 20⁰ with an average of 14.4⁰ (as measured by C2-C7 angle).

A

True

JAAOS June 2019

166
Q

C8 or T1 nerve root palsy with profound intrinsic hand weakness can occur after C7 or T1 pedicle substraction osteotomy

A

True

PSO’s should be done at T2 or below

JAAOS June 2019

167
Q

Obesity affects about 2/3 of the general population

A

False

1/3rd of the population

JAAOS June 2019

168
Q

There is no relationship between obesity and back pain

A

False

Linear relationship between BMI and degenerative disease of the spine

JAAOS June 2019

169
Q

Obesity has been linked to arthritis in non–weight-bearing joints such as the hand

A

True

JAAOS June 2019

170
Q

Nonsurgical & surgical (bariatric surgery) weight loss may improve the back pain and the neurological symptoms with association of increase disk height

A

True

JAAOS June 2019

171
Q

Obesity is an important risk factor for failure of nonsurgical care in severely obese patients

A

True

JAAOS June 2019

172
Q

Obese patients scheduled to undergo bariatric surgery demonstrated substantial deficiencies in vitamin D and iron

A

True

JAAOS June 2019

173
Q

Intraoperative frozen section is accurate in 95.3% of bone biopsy cases

A

False

Accurate in 54.2% of cases
Helpful in 75.4% of cases
Open biopsy (not the FrozSect part) has a diagnostic accuracy of 95.3%

JAAOS June 2019

174
Q

Extended culture (14 days) improves the culture yield by 30% in hip and knee prosthetic joint infection

A

False

No change to culture yield. Grew a few more cases of P.acnes (so might be useful in shoulders)

JAAOS June 2019

175
Q

Periprosthetic intraoperative THA and TKA fractures are associated with a 2x increase in mortality among patients with primary osteoarthritis

A

False

No excess mortality with intraop or post-op periprosthetic fractures (except in comorbid patients)

JAAOS May 2019

176
Q

Narcotic medications have adverse effects of habituation, nausea and constipation

A

True

JAAOS May 2019

177
Q

Nerve ablations can be associated with burning discomfort, lack of efficacy, recurrent symptoms, and infection

A

True

JAAOS May 2019

178
Q

High-frequency stimulation, burst stimulation, tonic stimulation with broader paddles, and new stimulation targets such as the dorsal root ganglion hold promise for improved pain management via neuromodulation

A

True

JAAOS May 2019

179
Q

Electrical stimulation of Aβ fibers in the dorsal column, could alter painful signals in the small Aδ and C fibers

A

True

JAAOS May 2019

180
Q

For ischaemic limbs, limb salvage rate is significantly higher with the use of Spinal Cord Stimulation

A

True

JAAOS May 2019

181
Q

Burst spinal cord stimulation can deal with the physiological tolerance which arise from tonic constant stimulus.

A

True

JAAOS May 2019

182
Q

Psychiatric illness is correlated with better outcomes after Spinal Cord Stimulation

A

False

Worse outcomes

JAAOS May 2019

183
Q

Spinal Cord Stimulation is more expensive and less effective than revision surgery in selected failed back surgery syndrome patients

A

False

More effective and less expensive.

JAAOS May 2019

184
Q

The ultrasonography beam creates a two dimensional image of sound waves emitted from the footprint of the probe.

A

True

The waves from the transducer generate an image by returning echoes from the structures encountered, which are identified by their different echogenicity

JAAOS May 2019

185
Q

Local anaesthesia chondrotoxicity is dose and time dependent

A

True

JAAOS May 2019

186
Q

Corticosteroid injection can increase a patient’s risk of periprosthetic infection if given within 90 days of surgery

A

True

JAAOS May 2019

187
Q

Corticosteroid injection (CSI) may accelerate the rate of loss of total cartilage volume without reducing the overall pain levels with repeated injections over a 2-year period

A

True

JAAOS May 2019

188
Q

Hyaluronic acid injections into the hip joint are are not recommended due to a high incidence of serious adverse side effects

A

False

No significant adverse effects except for local reactions of pain and transient synovitis

JAAOS May 2019

189
Q

Leukocyte-poor Protein Rich Plasma is preferred for Intraarticular (IA) injections, and leukocyte-rich PRP is better for tendon and muscle injections

A

True

JAAOS May 2019

190
Q

Platelet Rich Plasma should not be injected into the tendon to prevent injury

A

False

PRP should be injected directly into the areas of injury within the tendon to stimulate healing while corticosteroids should not be injected directly into the tendon to avoid iatrogenic rupture

JAAOS May 2019

191
Q

Positive response to local intraarticular injection will predict a positive outcome with arthroscopic FAI surgery

A

False

A positive response doesn’t predict success, but
A negative response does predict surgical failure

JAAOS May 2019

192
Q

Corticosteroid, PRP & Hyaluronic acid injections are shown to improve pain & function in mild hip OA on the short term

A

True

JAAOS May 2019

193
Q

Piriformis syndrome has both somatic and neuropathic components.

A

True

somatic component is caused by a myofascial pain syndrome of the muscle itself, and the neuropathic component is caused by irritation of the sciatic nerve while it traverses near or through the piriformis

JAAOS May 2019

194
Q

Compartment syndrome in a child is generally done via the “3 A’s”, which are anxiety, agitation, and an increasing analgesia requirement

A

True

JAAOS May 2019

195
Q

Pediatric distal humerus injuries rarely require physical therapy postoperatively

A

True

JAAOS May 2019

196
Q

Similar to adults, paediatric remodeling is extremely limited in the distal humerus

A

True

Occurs mainly in the saggital plane

JAAOS May 2019

197
Q

Biomechanically, the crossed pin configuration confers the same stability as divergent lateral pin configuration in paediatric elbow fractures

A

False

Superior stability with crossed pins

JAAOS May 2019

198
Q

Patients with an average limb-length discrepancy of 1.6 +/- 2.3 cm have no demonstrable difference in gait mechanics between the short and long side

A

True

patients adopted toe-walking as a compensatory mechanism when the limb discrepancy reached 6.5 +/- 2.8 cm, or a difference >5.5% between the short and long leg

JAAOS May 2019

199
Q

Sustained pelvic obliquity –due to LLD- throughout gait can potentially result in dynamic uncovering of the femoral head with point-loading causing increased weight bearing on the articular cartilage of the hip

A

T

this is a mechanism through which hip arthrosis of the longer limb can develop

JAAOS May 2019

200
Q

Peak height velocity (PHV) and the Risser sign has specifically been used to assist with skeletal maturity assessment in the setting of limb length inequality

A

False

JAAOS May 2019

201
Q

Before onset of the adolescent growth spurt, chronologic age is superior to skeletal age for predicting ultimate limb length

A

True

However, skeletal age is superior for predicting limb length once the child enters his or her adolescent growth spurt

JAAOS May 2019

202
Q

Computer software systems -such as Bone Xpert- analyze differences in bone age radiographs to determine skeletal age. This method has been shown to be faster and potentially introduces less variability in bone age analysis when compared to Gruelich-Pyle or Tanner-Whitehouse methods

A

T

JAAOS May 2019

203
Q

The transition from stage 2 to stage 3 in Sanders method -of estimation of skeletal age- correlates with 90% final height and the onset of PHV

A

True

JAAOS May 2019

204
Q

The multiplier Method is the least accurate among the other methods to predict LLD

A

True

it has an error of 1.1 +/- 0.9 cm in LLD prediction. The use of skeletal age can improve its accuracy

JAAOS May 2019

205
Q

Scheuermann believed that osteonecrosis of the vertebral ring apophysis resulted in longitudinal growth arrest of the anterior vertebral body, thus causing a wedging of the vertebrae

A

True

JAAOS May 2019

206
Q

In patients with mild Scheuermann’s Kyphosis treated non surgically, the degree of radiographic deformity increased only slightly during long term follow-up

A

True

JAAOS May 2019

207
Q

Initial bracing treatment can achieve an almost 50% reduction in kyphosis in many patients, but some loss of correction occurred after termination of brace treatment

A

True

indications of bracing are: smaller and more flexible curves in immature patients (ie, curves less than 55⁰ to 80⁰, with passive correction of 40% or more

JAAOS May 2019

208
Q

Post-operative Spinal Junctional Kyphosis is defined as a Cobb measurement of greater than 40⁰ between the fused and unfused segments

A

False

Greater that 10 degrees

JAAOS May 2019

209
Q

Proximal junctional kyphosis (PJK) was found to be related to obtaining greater than 80% correction of Scheuermann’s Kyphosis at the time of surgery

A

False

Greater than 50% correction

JAAOS May 2019

210
Q

In Scheuermann’s Kyphosis, the fusion should extend roughly the same extent from the apex proximally and distally, with some consideration for adding one additional proximal fusion level to ensure that the proximal end vertebra is also included in the fusion construct

A

True

JAAOS May 2019

211
Q

Metastatic disease, myeloma, and lymphoma are the most common diagnoses in a patient older than 40 years with a destructive bony lesion

A

True

JAAOS May 2019

212
Q

The use of CT based structural rigidity analysis (CTRA) of metastatic lesions is less accurate than Mirel criteria for predicting fracture risk in femoral metastatic disease

A

False

More accurate

JAAOS May 2019

213
Q

Human monoclonal antibody that binds to RANKL, denosumab, competitively inhibits the osteoclast binding of RANK and RANKL, decreasing bone resorption

A

True

JAAOS May 2019

214
Q

Cementless arthroplasty is preferred more than cemented due to better outcome in the tumour patients

A

False

cemented arthroplasty should be used because of the low likelihood of bony ongrowth and risk of fracture associated with press-fit implants in pathologic and/or irradiated bone

JAAOS May 2019

215
Q

Bone cement implantation syndrome (BCIS) is characterized by hypoxia, hypotension, cardiac arrhythmias, increased pulmonary vascular resistance, and/or cardiac arrest during cementation and/or implantation of the femoral implant.

A

True

The risk of BCIS is elevated in patients with pathologic fractures particularly proximal femur fractures, metastatic disease, cardiopulmonary disease, & utilization of long-stem prostheses and cement pressurization

JAAOS May 2019

216
Q

The presence of acral metastatic disease should raise suspicion for a lung or renal primary cancer

A

True

JAAOS May 2019

217
Q

The Epineurium is a barrier to regenerating axon so when it is damaged, fascicular escape can occur and neuroma can be formed

A

False

Perineurium is the barrier.
(in to out = Endo, Peri, Epi. Coul remember Endocolon, Peritoneum, Epithelium are in that order)

JAAOS May 2019

218
Q

Long-duration (10 seconds) bipolar diathermy can have a significant reduction in neuroma formation

A

True

JAAOS May 2019

219
Q

Transposition of the proximal nerve stump after neuroma excision into a muscle with large excursion (abductor pollicis longus) or intrinsic hand muscles has been shown to be more effective than transposition into the pronator quadratus (PQ)

A

False

Less effective. The implanted nerve should be:

  1. Tension free
  2. In an area where it will not regenerate to the skin
  3. In an area with minimal scar formation

JAAOS May 2019

220
Q

Augmentin for 100 days can be an effective treatment of Modic type 1 degenerative disc disease.

A

True (but controversial topic)

100% of Modic type 1 cases grew Cutibacterium acnes.
Patients randomized to Augmentin reported statistically significant improvement in outcome scores.

JAAOS July 2019

221
Q

Cutibacterium acnes is a spore forming organism

A

False

Anaerobic, non-spore-forming, G+ve rod

JAAOS July 2019

222
Q

Cutibacterium acnes is gram positive rod

A

True

Anaerobic, non-spore-forming, G+ve rod

JAAOS July 2019

223
Q

Spondylodiscitis with Cutibacterium acnes usually leads to elevated ESR and CRP

A

False

Normal or mildly elevated ESR and CRP

JAAOS July 2019

224
Q

In spinal Cutibacterium acnes infection, the surgical incision may not show any signs of erythema or breakdown

A

True

Incisions usually heal without any signs of infection. Infection is often not picked up for a year after the surgery.

JAAOS July 2019

225
Q

Outcomes of spinal implant-associated infections secondary to Cutibacterium acnes are generally poor compared with infection secondary to other organisms

A

True

“Generally poor compared with infection secondary to other organisms”

JAAOS July 2019

226
Q

Weight bearing films are gold standard and most reliable for diagnosis of syndesmotic injuries

A

False

Stress or Gravity stress external rotation x-rays are gold standard.

JAAOS July 2019

227
Q

MRI is more reliable than stress test for diagnosis of deltoid ligament injury and determination of surgical Vs non surgical treatment

A

False

Stress x-rays have a better inter and intra observer reliability than MRI, particularly when deciding surgical management.

JAAOS July 2019

228
Q

Normal ankle medial clear space is > 5 mm on mortise view

A

False

Should be less than 4mm or within 1mm of the superior mortise clear space.

JAAOS July 2019

229
Q

A 1-mm lateral deviation of the talus on the tibia results in a 40% reduction in the tibio-talar contact area

A

True

1mm translation = 42% less contact area, which lead to more point loading and wear.

JAAOS July 2019

230
Q

Revision Carpal Tunnel Release provides favourable outcomes in majority of patient with recalcitrant CTS

A

False

40% unfavourable outcomes in Revision cases

JAAOS Aug 2019

231
Q

Open or endoscopic carpal tunnel decompression have similar incidence of incomplete decompression in clinical studies

A

True

JAAOS Aug 2019

232
Q

Patients with a history of cervical spine surgery are likely to have inferior outcomes, and lower satisfaction after peripheral nerve release

A

True

Inferior patient reported outcomes and satisfaction if had cervical surgery.

JAAOS Aug 2019

233
Q

Meta-analysis shows similar rate of iatrogenic nerve injury with open and endoscopic techniques

A

False

Higher rate of nerve injury with endoscopic

JAAOS Aug 2019

234
Q

Nerve conduction may not fully recover after Carpal Tunnel Release and may remain abnormal for at least 24 months postoperatively

A

True

Nerve function may not recover in 25% of patients.

JAAOS Aug 2019

235
Q

Ultrasound is as effective as electrodiagnostic studies in diagnosis of primary Carpal Tunnel Syndrome

A

True

Median nerve cross-sectional area at the site of compression is as reliable as NCS (area >9mm2)

JAAOS Aug 2019

236
Q

Perneus longus becomes tendinous distal to the fibular tip, while brevis becomes tendinous proximal to it

A

False

JAAOS Aug 2019

237
Q

The Superficial Peroneal Retinaculum is the most important factor in preventing the Peroneal tendons to subluxate or dislocate

A

True

JAAOS Aug 2019

238
Q

The peroneal tendons have good vascularity between the tip of fibula and cuboid

A

T

It was commonly believed that they don’t, but studies show that they have adequate vascularity in this area.

JAAOS Aug 2019

239
Q

Peroneus longus is more prone to tears than brevis

A

False

Brevis breaks, Longus slips

JAAOS Aug 2019

240
Q

Peroneus longus more prone to dislocation than brevis

A

True

Brevis breaks, Longus slips. PL far more commonly dislocates. PB sits more anterior and medial in the groove.

JAAOS Aug 2019

241
Q

Treatment of the shoulder with Benzoyl Peroxide pre-operatively does not affect Cutibacterium acnes count on the skin at the time of surgery.

A

False

Treatment with Benzoyl peroxide within 48 hours of surgery reduces C acnes.

JAAOS Aug 2019

242
Q

Addition of MRI to CT significantly increases the detection of clinically important cervical spine injuries over CT alone.

A

False

JAAOS Aug 2019

243
Q

Stress radiography and laxity testing reliably diagnoses TKR flexion instability in the clinical setting

A

False

JAAOS Sept 2019

244
Q

Increasing poly thickness in TKR flexion instability can usually leads to good patient outcomes

A

False

JAAOS Sept 2019

245
Q

Revision options for TKR flexion instability such as a larger femoral implant with posterior augments and joint line elevation are not usually required

A

False

JAAOS Sept 2019

246
Q

Patient with TKR flexion instability have poor satisfaction rates after revision surgery compared to other indications for revision

A

True

JAAOS Sept 2019

247
Q

Recurrent hemarthrosis after TKA usually presents within weeks following surgery

A

False

Usually presents 24 months post-op

JAAOS Sept 2019

248
Q

Acute presentation of haemarthrosis following TKA within 6 months is more likely because of iatroenic injury in the form of aneurysm or AV fistula

A

True

JAAOS Sept 2019

249
Q

Patellofemroal maltracking after TKA has been identified as a common cause of impingement leading to recurrent hemarthrosis

A

True

Also, lateral retinacular release predisposes to recurrent haemarthrosis

JAAOS Sept 2019

250
Q

Angiography with/without MRI is gold standard in determination of treatment for Recurrent Haemarthrosis following TKR

A

True

MRI / MRA with metal suppression is the author’s prefered investigation.

JAAOS Sept 2019

251
Q

Arthroscopic synovectomy is as successful as open procedure and is preferable in cases of Recurrent Haemarthrosis following TKR

A

False

Can’t get to the area behind the poly without taking it out.

JAAOS Sept 2019

252
Q

US guidance provides more accuracy with placement of intra-articular knee HCLA compared to tactile, non imaged injections

A

True

JAAOS Sept 2019

253
Q

Acurately placed intra-articular knee HCLA injection leads to better reduction in pain scores in osteoarthritis

A

False

Similar results with extra-articular injection

JAAOS Sept 2019

254
Q

Use of sterile gloves for intra-articular HCLA injection for knee OA leads to decreased infection rates

A

False

Similar rates and sterile gloves are 50x more expensive

JAAOS Sept 2019

255
Q

Repeat HCLA injections for knee OA have similar pain relief and duration of efficacy compared to first injection

A

False

JAAOS Sept 2019

256
Q

Intra-articular placebo injection had statistically significant pain relief compared to oral placebo or NSAIDs for symptomatic knee OA

A

True

JAAOS Sept 2019

257
Q

Corticosteroid injections have a higher risk of causing intra-articular infection compared to hyaluronic acid

A

True

Risk factors for infection: GP administration, BMI > 25, Rheumatoid arthritis, Corticosteroid injection.

JAAOS Sept 2019

258
Q

GP administered knee HCLA injections have higher risk of infetion compared to orthopods

A

True

Risk factors for infection: GP administration, BMI > 25, Rheumatoid arthritis, Corticosteroid injection.

JAAOS Sept 2019

259
Q

No evidence to suggest intra-articular HCLA injection within 3 months prior to TKA leads to increased risk of infection

A

False

Higher risk of infection if injection within 3 months.

JAAOS Sept 2019

260
Q

Anterior reduction and fixation is the most important stabilizing factor in pelvic ring injuries

A

False

Posterior reduction and fixation is most important. Anterior reduction is only supplementary or indirect reduction of the posterior structures.

JAAOS Sept 2019

261
Q

The “Gluteal Pillar” used for iliac crest external fixation of the pelvis begins 6-8 cm posterior to the ASIS and extends for 2-3 cm.

A

False

Gluteal pillar begins 2-3 cm posterior to ASIS and runs for 6-8 cm.

JAAOS Sept 2019

262
Q

The corridor of bone for supraacetabular pin external fixation of pelvic ring injuries runs from the Anterior Inferior Iliac Spine to the Posterior Superior Iliac Spine.

A

True

Joint penetration and sciatic notch contents injury are possible complications.

JAAOS Sept 2019

263
Q

In Vertically Unstable pelvic ring injuries, external fixation is likely to worsen the deformity.

A

True

Dickson and Matta found worsening of flexion and / or internal rotation deformity in 73% of patients with a Tile C injury after external fixator placement

JAAOS Sept 2019

264
Q

Traumatic brachial plexopathy usually involves the lower trunk

A

False

Usually involves the upper trunk

JAAOS Sept 2019

265
Q

In traumatic brachial plexopathy a variable degree of weakness in the muscles may last for up to 6 weeks in more severe cases

A

True

JAAOS Sept 2019

266
Q

Cadaveric studies have found the cross-sectional area of the C4-5 neuroforamina to be markedly smaller than C5-6 and C6-7

A

True

JAAOS Sept 2019

267
Q

Patients with decreased space available for the cord or signs of spinal stenosis on imaging studies are more prone to brachial plexus “stingers”

A

True

JAAOS Sept 2019

268
Q

Athletes post brachial plexus “stingers” should have a normal EMG before being allowed to return to sports

A

False

JAAOS Sept 2019

269
Q

The management of brachial plexus “stingers” is predominantly surgical

A

False

JAAOS Sept 2019

270
Q

Preganglionic brachial plexus injuries don’t heal well with non-operative management and usually require surgical intervention with nerve grafting

A

False

Nerve TRANSFERS, not grafts. And ideally before 4 months.

JAAOS Sept 2019

271
Q

40% of Adult Brachial Plexus injuries are associated with a vascular injury.

A

False

28%

JAAOS Sept 2019

272
Q

Mortality rate for distal femur fractures in the elderly is similar to mortality for proximal femur fractures in the elderly

A

True

JAAOS Oct 2019

273
Q

Distal Femoral Replacement for treatment of distal femur fractures in the elderly has no difference in mortality at 12 months as compared to ORIF

A

True

JAAOS Oct 2019

274
Q

The normal angulation of the radial neck in children is 15 degrees Valgus and 10 degrees Apex Posterior relative to the diaphysis

A

True

JAAOS Oct 2019

275
Q

The overall rate of AVN of paediatric radial head fractures is 10-25%

A

True

25% in those that require open reduction

JAAOS Oct 2019

FRACS True / False Quiz (3 decks)

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