Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

5. OITE > Sports Medicine 2015 > Flashcards

Sports Medicine 2015 Flashcards

1
Q
  1. A professional basketball player underwent anterior cruciate ligament reconstruction and is going through an uneventful postsurgical rehabilitation. He would like to know how his return to play will be evaluated. The ideal method with which to determine the timing of his return should involve which factors?
  2. Time since his reconstruction
  3. Consultation with the team owner
  4. The surgeon’s rehabilitation protocol
  5. Discussion with the team’s athletic trainer and physical therapist
  6. Stipulations in the player’s contract regarding the percentage of games played
A
  1. Discussion with the team’s athletic trainer and physical therapist

RECOMMENDED READINGS

Shrier I, Safai P, Charland L. Return to play following injury: whose decision should it be? Br J Sports Med. 2014 Mar;48(5):394-401. doi: 10.1136/bjsports-2013-092492. Epub 2013 Sep 5. PubMed PMID: 24009011.

Clover J, Wall J. Return-to-play criteria following sports injury. Clin Sports Med. 2010 Jan;29(1):169-75, table of contents. doi: 10.1016/j.csm.2009.09.008. PubMed PMID: 19945592.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
  1. Figures 23a through 23c are the clinical photographs of a 52-year-old tennis player who has lateral shoulder pain with activity and difficulty with his serve. Examination reveals pain resolution during a scapular assistance test. What is the most appropriate initial treatment of this patient’s condition?
  2. Scapulothoracic fusion
  3. Transfer of the levator scapulae and rhomboid muscles
  4. Exploration of the spinal accessory nerve
  5. Decompression of the long thoracic nerve
  6. Pectoralis stretching and strengthening of rhomboids, serratus, and trapezius
A
  1. Pectoralis stretching and strengthening of rhomboids, serratus, and trapezius

RECOMMENDED READINGS

Meininger AK, Figuerres BF, Goldberg BA. Scapular winging: an update. J Am Acad Orthop Surg. 2011 Aug;19(8):453-62. Review. PubMed PMID: 21807913.

Kibler WB, Sciascia A, Wilkes T. Scapular dyskinesis and its relation to shoulder injury. J Am Acad Orthop Surg. 2012 Jun;20(6):364-72. doi: 10.5435/JAAOS-20-06-364. Review. PubMed PMID: 22661566.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
  1. Figures 42a and 42b are the MR images of an 18-year-old collegiate football player who landed awkwardly after jumping to defend a pass. He reported a buckling sensation in his left knee and required assistance off the field. Knee examination reveals an increase in translation during a Lachman test but a feeling of an end point. He has mild varus laxity without a palpable lateral collateral ligament (LCL). What is the most appropriate treatment option?
  2. LCL repair
  3. LCL repair with augmentation
  4. Anterior cruciate ligament (ACL) reconstruction with an Achilles allograft
  5. ACL reconstruction and posterolateral corner reconstruction
  6. Rehabilitation and bracing to continue play with surgical treatment after the season
A
  1. ACL reconstruction and posterolateral corner reconstruction

RECOMMENDED READINGS

Ranawat A, Baker CL 3rd, Henry S, Harner CD. Posterolateral corner injury of the knee: evaluation and management. J Am Acad Orthop Surg. 2008 Sep;16(9):506-18. Review. PubMed PMID: 18768708.

Engelman GH, Carry PM, Hitt KG, Polousky JD, Vidal AF. Comparison of allograft versus autograft anterior cruciate ligament reconstruction graft survival in an active adolescent cohort. Am J Sports Med. 2014 Oct;42(10):2311-8. doi: 10.1177/0363546514541935. Epub 2014 Jul 31. PubMed PMID: 25081312.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q
  1. Figures 51a through 51e are the radiographs, MR image, and CT scans of a 25-year-old man who has had right shoulder instability for 6 years. He had an initial episode while playing basketball and a second episode a few years later (also while playing basketball). Both injuries were anterior glenohumeral dislocations that necessitated reduction. Currently he feels instability with simple maneuvers and overhead activities. Examination reveals apprehension with abduction and external rotation and relief with posterior-directed force on the proximal humerus in this position. A strengthening program has not provided adequate stability. What is the best treatment option?
  2. Shoulder arthroscopy with rotator cuff repair
  3. Shoulder arthroscopy with superior labral repair
  4. Shoulder arthroscopy with anterior labral repair and capsulorrhaphy
  5. Shoulder stabilization procedure to address glenoid bone loss
  6. Continued physical therapy and a shoulder stabilization exercise program
A
  1. Shoulder stabilization procedure to address glenoid bone loss

RECOMMENDED READINGS

Burkhart SS, De Beer JF. Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: significance of the inverted-pear glenoid and the humeral engaging Hill- Sachs lesion. Arthroscopy. 2000 Oct;16(7):677-94. PubMed PMID: 11027751.

Itoi E, Lee SB, Berglund LJ, Berge LL, An KN. The effect of a glenoid defect on anteroinferior stability of the shoulder after Bankart repair: a cadaveric study. J Bone Joint Surg Am. 2000 Jan;82(1):35-46. PubMed PMID: 10653082.

Burkhart SS, De Beer JF, Barth JR, Cresswell T, Roberts C, Richards DP. Results of modified Latarjet reconstruction in patients with anteroinferior instability and significant bone loss. Arthroscopy. 2007 Oct;23(10):1033-41. Erratum in: Arthroscopy. 2007 Dec;23(12):A16. Criswell, Tim [corrected to Cresswell, Tim]. PubMed PMID: 17916467.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
  1. A 19-year-old recreational runner sustains an inversion injury to her right ankle during a cross country run and is unable to bear weight. Emergency department radiographs show no fracture. A splint is placed, she is told to not place weight, and she is sent to you for follow-up 4 days later. Examination reveals swelling and ecchymosis of her lateral ankle, tenderness over the lateral ankle ligaments, and positive talar drawer and tilt test findings. What is the best next step?
  2. Lateral ligament repair
  3. MR imaging
  4. Functional rehabilitation
  5. Casting for 6 weeks followed by rehabilitation
  6. Immobilization for 7 to 10 days followed by rehabilitation
A
  1. Immobilization for 7 to 10 days followed by rehabilitation

RECOMMENDED READINGS

Petersen W, Rembitzki IV, Koppenburg AG, Ellermann A, Liebau C, Brüggemann GP, Best R. Treatment of acute ankle ligament injuries: a systematic review. Arch Orthop Trauma Surg. 2013 Aug;133(8):1129- 41. doi: 10.1007/s00402-013-1742-5. Epub 2013 May 28. Review. PubMed PMID: 23712708.

Kaminski TW, Hertel J, Amendola N, Docherty CL, Dolan MG, Hopkins JT, Nussbaum E, Poppy W, Richie D; National Athletic Trainers’ Association. National Athletic Trainers’ Association position statement: conservative management and prevention of ankle sprains in athletes. J Athl Train. 2013 Jul- Aug;48(4):528-45. doi: 10.4085/1062-6050-48.4.02. Review. PubMed PMID: 23855363.

Pihlajamдki H, Hietaniemi K, Paavola M, Visuri T, Mattila VM. Surgical versus functional treatment for acute ruptures of the lateral ligament complex of the ankle in young men: a randomized controlled trial. J Bone Joint Surg Am. 2010 Oct 20;92(14):2367-74. doi: 10.2106/JBJS.I.01176. Epub 2010 Sep 10. PubMed PMID: 20833874.

Lamb SE, Marsh JL, Hutton JL, Nakash R, Cooke MW; Collaborative Ankle Support Trial (CAST Group). Mechanical supports for acute, severe ankle sprain: a pragmatic, multicentre, randomised controlled trial. Lancet. 2009 Feb 14;373(9663):575-81. doi: 10.1016/S0140-6736(09)60206-3. PubMed PMID: 19217992.

van Dijk CN, Lim LS, Bossuyt PM, Marti RK. Physical examination is sufficient for the diagnosis of sprained ankles. J Bone Joint Surg Br. 1996 Nov;78(6):958-62. PubMed PMID: 8951015.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
  1. A 17-year-old football player is hit during the course of play. He lies down on the field as the training staff enters the field to assist. By the time they arrive to the player, he is sitting up. He quickly stands and is walked to the sideline. The player experiences initial confusion when questioned on the sideline, but this quickly passes. He has no memory loss; is alert and oriented to person, place, and time; and has a mild headache. He wants to return to the game and the coach asks if he can play. What is the best next step?
  2. No return to play this game
  3. Immediate return to the game
  4. Obtain an immediate head CT scan
  5. Return to the game only if the team’s needs necessitate it
  6. Return to the game when his headache symptoms resolve
A
  1. No return to play this game

RECOMMENDED READINGS

McCrory P, Meeuwisse WH, Aubry M, Cantu B, Dvorák J, Echemendia RJ, Engebretsen L, Johnston K, Kutcher JS, Raftery M, Sills A, Benson BW, Davis GA, Ellenbogen RG, Guskiewicz K, Herring SA, Iverson GL, Jordan BD, Kissick J, McCrea M, McIntosh AS, Maddocks D, Makdissi M, Purcell L, Putukian M, Schneider K, Tator CH, Turner M. Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012. Br J Sports Med. 2013 Apr;47(5):250-8. doi: 10.1136/bjsports-2013-092313. PubMed PMID: 23479479.

Putukian M. The acute symptoms of sport-related concussion: diagnosis and on-field management. Clin Sports Med. 2011 Jan;30(1):49-61, viii. doi: 10.1016/j.csm.2010.09.005. Review. PubMed PMID: 21074081.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q
  1. A 26-year-old professional football player is experiencing sharp stabbing pain that radiates from his neck to his left thumb. The pain began acutely after a tackle. An MR image of the cervical spine reveals a lateral disk herniation with foraminal encroachment but no abutment of the cervical cord or central stenosis. Which treatment most likely will allow an expedient return to play?
  2. Cervical foraminotomy
  3. Cervical disk replacement
  4. Oral methylprednisolone
  5. Chiropractic manipulation
  6. Anterior cervical decompression and fusion
A
  1. Oral methylprednisolone

RECOMMENDED READINGS

Meredith DS, Jones KJ, Barnes R, Rodeo SA, Cammisa FP, Warren RF. Operative and nonoperative treatment of cervical disc herniation in National Football League athletes. Am J Sports Med. 2013 Sep;41(9):2054-8. doi: 10.1177/0363546513493247. Epub 2013 Jun 20. PubMed PMID: 23788681.

Wong JJ, Côté P, Quesnele JJ, Stern PJ, Mior SA. The course and prognostic factors of symptomatic cervical disc herniation with radiculopathy: a systematic review of the literature. Spine J. 2014 Aug 1;14(8):1781-9. doi: 10.1016/j.spinee.2014.02.032. Epub 2014 Mar 12. PubMed PMID: 24614255.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q
  1. At the request of his parents, a 12-year-old Little League player is being evaluated for shoulder and elbow pain in his pitching arm. He plays baseball through the spring, summer, and fall. When he is not playing for multiple teams, he works with a pitching coach, throwing 3 to 4 days a week. He throws fastballs, a change-up, and recently began throwing a curveball. With regard to his shoulder and elbow pain, what is the most appropriate advice?
  2. Throwing the curveball causes his pain, so be sure to inform his pitching coach.
  3. Not pitch for at least 4 months out of the year.
  4. Increase the time he spends with his pitching coach.
  5. Begin a weight-lifting program for his shoulder and elbow.
  6. Ulnar collateral ligament (UCL) reconstruction to address his elbow mechanics.
A
  1. Not pitch for at least 4 months out of the year.

RECOMMENDED READINGS

Olsen SJ 2nd, Fleisig GS, Dun S, Loftice J, Andrews JR. Risk factors for shoulder and elbow injuries in adolescent baseball pitchers. Am J Sports Med. 2006 Jun;34(6):905-12. Epub 2006 Feb 1. PubMed PMID: 16452269.

Bruce JR, Andrews JR. Ulnar collateral ligament injuries in the throwing athlete. J Am Acad Orthop Surg. 2014 May;22(5):315-25. doi: 10.5435/JAAOS-22-05-315. Review. PubMed PMID: 24788447.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q
  1. A 43-year-old marathon runner has pain deep in her buttocks. She has pain with running and difficulty sitting on hard surfaces because of her pain at the ischium. She slipped on ice almost 1 year ago and believes this was when her pain started. An MR image of the hip reveals a partial avulsion of the proximal hamstring origin. She has been doing appropriate physical therapy since her injury occurred but has not experienced symptom relief. What is the most appropriate treatment option?
  2. Percutaneous tenotomy
  3. Cessation of distance running
  4. Use of a foam roller in therapy
  5. Open debridement and repair
  6. Administration of an oral corticosteroid
A
  1. Open debridement and repair

RECOMMENDED READINGS

Bowman KF Jr, Cohen SB, Bradley JP. Operative management of partial-thickness tears of the proximal hamstring muscles in athletes. Am J Sports Med. 2013 Jun;41(6):1363-71. doi: 10.1177/0363546513482717. Epub 2013 Apr 10. PubMed PMID: 23576684.

Hofmann KJ, Paggi A, Connors D, Miller SL. Complete Avulsion of the Proximal Hamstring Insertion: Functional Outcomes After Nonsurgical Treatment. J Bone Joint Surg Am. 2014 Jun 18;96(12):1022-1025. [Epub ahead of print] PubMed PMID: 24951738.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q
  1. A 20-year-old collegiate football player is seen after season completion with midfoot pain and bone scan findings consistent with a navicular stress fracture. What is the most effective treatment option?
  2. Rest from running, but no immobilization
  3. Placement in a cast with no weight bearing for 2 weeks
  4. Placement in a cast with no weight bearing for 6 weeks
  5. Placement in a fracture boot with weight bearing as tolerated
  6. Open debridement of the fracture site with internal fixation
A
  1. Placement in a cast with no weight bearing for 6 weeks

RECOMMENDED READINGS

Torg JS, Moyer J, Gaughan JP, Boden BP. Management of tarsal navicular stress fractures: conservative versus surgical treatment: a meta-analysis. Am J Sports Med. 2010 May; 38(5):1048-53. doi: 10.1177/0363546509355408. Epub 2010 Mar 2. PubMed PMID: 20197494.

Burne SG, Mahoney CM, Forster BB, Koehle MS, Taunton JE, Khan KM. Tarsal navicular stress injury: long-term outcome and clinicoradiological correlation using both computed tomography and magnetic resonance imaging. Am J Sports Med. 2005 Dec;33(12):1875-81. Epub 2005 Sep 12. PubMed PMID: 16157855.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q
  1. An 18-year-old freshman is seen for her preparticipation lacrosse physical. She reports a history of asthma but says that the albuterol inhaler that she was prescribed does not effectively clear her symptoms. She has difficulty with breathing only during conditioning workouts, practices, and games. What is the most appropriate recommendation for this athlete?
  2. Refer her for confirmation of her asthma diagnosis
  3. Initiate a course of oral steroids
  4. Add a steroid inhaler
  5. Add nebulizer treatments
  6. Disqualify her from participation
A
  1. Refer her for confirmation of her asthma diagnosis

RECOMMENDED READINGS

Nielsen EW, Hull JH, Backer V. High prevalence of exercise-induced laryngeal obstruction in athletes. Med Sci Sports Exerc. 2013 Nov;45(11):2030-5. doi: 10.1249/MSS.0b013e318298b19a. PubMed PMID: 23657163.

Eichenberger PA, Diener SN, Kofmehl R, Spengler CM. Effects of exercise training on airway hyperreactivity in asthma: a systematic review and meta-analysis. Sports Med. 2013 Nov;43(11):1157-70. doi: 10.1007/s40279-013-0077-2. Review. PubMed PMID: 23846823.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q
  1. What is the best reason to use an autograft (rather than an allograft) for anterior cruciate ligament (ACL) reconstruction in a young athlete?
  2. Lower infection risk
  3. Lower graft rupture rate
  4. Lower long-term risk for arthritis
  5. Lack of donor-site morbidity
  6. Better incorporation of the graft material
A
  1. Lower graft rupture rate

RECOMMENDED READINGS

Kaeding CC, Aros B, Pedroza A, Pifel E, Amendola A, Andrish JT, Dunn WR, Marx RG, McCarty EC, Parker RD, Wright RW, Spindler KP. Allograft Versus Autograft Anterior Cruciate Ligament Reconstruction: Predictors of Failure From a MOON Prospective Longitudinal Cohort. Sports Health. 2011 Jan;3(1):73-81. PubMed PMID: 23015994; PubMed Central PMCID: PMC3445196.

Krych AJ, Jackson JD, Hoskin TL, Dahm DL. A meta-analysis of patellar tendon autograft versus patellar tendon allograft in anterior cruciate ligament reconstruction. Arthroscopy. 2008 Mar;24(3):292-8. doi: 10.1016/j.arthro.2007.08.029. Epub 2007 Nov 5. Review. PubMed PMID: 18308180.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q
  1. Figures 181a and 181b are the arthroscopic views of an 18-year-old collegiate basketball player who has recurrent effusions 9 months after his fourth patella dislocation. He has had bracing and physical therapy since the previous dislocation. Radiographs reveal lateral congruence. MR imaging shows articular cartilage loss in the inferolateral patella. Lateral tibial tubercle offset relative to the trochlea groove is 19 mm. Diagnostic arthroscopy figures show the patella before and after debridement. An articular cartilage biopsy is obtained. Reimplantation of articular cartilage should be undertaken in conjunction with which other procedure(s)?
  2. Galeazzi realignment
  3. Anteromedial tibial tubercle transfer
  4. Vastus medialis oblique (VMO) advancement
  5. VMO advancement and lateral release
  6. Medial tibial tubercle transfer and lateral release
A
  1. Anteromedial tibial tubercle transfer

RECOMMENDED READINGS

Beck PR, Thomas AL, Farr J, Lewis PB, Cole BJ. Trochlear contact pressures after anteromedialization of the tibial tubercle. Am J Sports Med. 2005 Nov;33(11):1710-5. Epub 2005 Aug 10. PubMed PMID: 16093531.

Strauss EJ, Galos DK. The evaluation and management of cartilage lesions affecting the patellofemoral joint. Curr Rev Musculoskelet Med. 2013 Jun;6(2):141-9. doi: 10.1007/s12178-013-9157-z. PubMed PMID: 23392780; PubMed Central PMCID: PMC3702778.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q
  1. Which effect does initiation of early eccentric strengthening at 3 weeks from surgery have in rehabilitation of anterior cruciate ligament (ACL) reconstruction compared to traditional initiation at 3 months?
  2. Improved control of postsurgical effusion
  3. Increased pain in the surgical extremity
  4. Increased muscle mass of the quadriceps and hamstrings
  5. Increased risk for graft loosening because the tunnels have not healed
  6. Decreased risk for rupture of the contralateral ACL
A
  1. Increased muscle mass of the quadriceps and hamstrings

RECOMMENDED READINGS

Kruse LM, Gray B, Wright RW. Rehabilitation after anterior cruciate ligament reconstruction: a systematic review. J Bone Joint Surg Am. 2012 Oct 3;94(19):1737-48. doi: 10.2106/JBJS.K.01246. Review. PubMed PMID: 23032584; PubMed Central PMCID: PMC3448301.

van Grinsven S, van Cingel RE, Holla CJ, van Loon CJ. Evidence-based rehabilitation following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2010 Aug;18(8):1128-44. doi: 10.1007/s00167-009-1027-2. Epub 2010 Jan 13. Review. PubMed PMID: 20069277.

Gerber JP, Marcus RL, Dibble LE, Greis PE, Burks RT, Lastayo PC. Safety, feasibility, and efficacy of negative work exercise via eccentric muscle activity following anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther. 2007 Jan;37(1):10-8. PubMed PMID: 17286094.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q
  1. A 20-year-old dancer has atraumatic onset of midfoot pain. Radiographic findings are normal. Her body mass index is 18.5, and she has had 5 menstrual cycles during the past year. What is the long-term risk of no treatment?
  2. Secondary infertility
  3. Functional hyperthyroidism
  4. Rebound uterine hypertrophy
  5. Secondary calcium deficiency
  6. Irreversible loss of bone mineral density
A
  1. Irreversible loss of bone mineral density

RECOMMENDED READINGS

Nazem TG, Ackerman KE. The female athlete triad. Sports Health. 2012 Jul;4(4):302-11. PubMed PMID: 23016101; PubMed Central PMCID: PMC3435916.

Nattiv A, Loucks AB, Manore MM, Sanborn CF, Sundgot-Borgen J, Warren MP; American College of Sports Medicine. American College of Sports Medicine position stand. The female athlete triad. Med Sci Sports Exerc. 2007 Oct;39(10):1867-82. PubMed PMID: 17909417.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
  1. Figures 201a through 201f are the radiographs and MR images of a 64-year-old woman who has left shoulder pain. She has had the pain “on and off,” and it mostly bothers her at night. She has been taking anti-inflammatory pain medications and has experienced some relief. Examination reveals mildly diminished range of motion in elevation and external rotation, and she reports moderate pain with forced abduction of the shoulder. Her strength in elevation is 4/5, which is limited by pain, and her external rotation strength is 5/5. She has a negative belly press sign. What is the most appropriate next step?
  2. Injection of platelet-rich plasma to the subacromial space
  3. A 6-week course of physical therapy
  4. Arthroscopic capsular release with manipulation under anesthesia
  5. Arthroscopic subacromial decompression with coracoacromial ligament release
  6. Arthroscopic rotator cuff repair
A
  1. A 6-week course of physical therapy

RECOMMENDED READINGS

Kesikburun S, Tan AK, Yilmaz B, Yaşar E, Yazicioğlu K. Platelet-rich plasma injections in the treatment of chronic rotator cuff tendinopathy: a randomized controlled trial with 1-year follow-up. Am J Sports Med. 2013 Nov;41(11):2609-16. doi: 10.1177/0363546513496542. Epub 2013 Jul 26. PubMed PMID: 23893418.

Hall MP, Band PA, Meislin RJ, Jazrawi LM, Cardone DA. Platelet-rich plasma: current concepts and application in sports medicine. J Am Acad Orthop Surg. 2009 ct;17(10):602-8. Review. Erratum in: J Am Acad Orthop Surg. 2010 Jan;18(1):17A. PubMed PMID: 19794217.

Ketola S, Lehtinen J, Arnala I, Nissinen M, Westenius H, Sintonen H, Aronen P, Konttinen YT, Malmivaara A, Rousi T. Does arthroscopic acromioplasty provide any additional value in the treatment of shoulder impingement syndrome?: a two-year randomised controlled trial. J Bone Joint Surg Br. 2009 Oct;91(10):1326-34. doi: 10.1302/0301-620X.91B10.22094. PubMed PMID: 19794168.

Pedowitz RA, Yamaguchi K, Ahmad CS, Burks RT, Flatow EL, Green A, Iannotti JP, Miller BS, Tashjian RZ, Watters WC 3rd, Weber K, Turkelson CM, Wies JL, Anderson S, St Andre J, Boyer K, Raymond L, Sluka P, McGowan R; American Academy of Orthopaedic Surgeons. Optimizing the management of rotator cuff problems. J Am Acad Orthop Surg. 2011 Jun;19(6):368-79. PubMed PMID: 21628648.

17
Q
  1. (Deleted)

Figure 209 is the clinical photograph of a 39-year-old right-hand-dominant woman who had surgery on her lateral elbow 3 months ago. Despite rehabilitation, she has continued lateral elbow pain, “popping” when she attempts to lift anything heavy, and episodic wound drainage. Examination reveals an incision over her lateral epicondyle that appears to have a recently closed sinus tract. She is tender over the lateral epicondyle, has full elbow range of motion, and guards with any other testing maneuver. The figure reveals the findings upon opening the incision. What are the best next steps?

  1. Irrigation and debridement, wound closure, and an infectious disease consultation
  2. Irrigation and debridement, packing the wound open, and an infectious disease consultation
  3. Repair of the extensor carpi radialis brevis and immobilization for several weeks
  4. Repair of the lateral ulnar collateral ligament and immobilization for several weeks
  5. Reconstruction of the lateral ulnar collateral ligament with autologous palmaris longus tendon
A
  1. Reconstruction of the lateral ulnar collateral ligament with autologous palmaris longus tendon

RECOMMENDED READINGS

Parsons BO, Ramsey ML Elbow instability and reconstruction. In: Flynn JM, ed. Orthopaedic Knowledge Update 10. Rosemont, IL: American Academy of Orthopaedic Surgeons; 2011: 343-350.

Kelly EW, Morrey BF, O’Driscoll SW. Complications of elbow arthroscopy. J Bone Joint Surg Am. 2001 Jan;83-A(1):25-34. PubMed PMID: 11205854.

Calfee RP, Patel A, DaSilva MF, Akelman E. Management of lateral epicondylitis: current concepts. J Am Acad Orthop Surg. 2008 Jan;16(1):19-29. Review. PubMed PMID: 18180389.

18
Q

231.

In midseason, a collegiate football player has fatigue, fevers, and “swollen glands.” Examination reveals an enlarged spleen. Laboratory studies confirm the diagnosis of mononucleosis. When should he be cleared to return to play?

  1. 1 week after starting antibiotic treatment
  2. 2 weeks after symptom onset
  3. 3 weeks after he is asymptomatic
  4. He should not return for the current season
  5. As soon as the fatigue and fevers cease
A
  1. 3 weeks after he is asymptomatic

RECOMMENDED READINGS

Feeley BT, Behera S, Luke AC. Medical issues for the athlete. In: Cannada LK, ed. Orthopaedic Knowledge Update 11. Rosemont, IL: American Academy of Orthopaedic Surgeons; 2014:115-127.

Putukian M, O’Connor FG, Stricker P, McGrew C, Hosey RG, Gordon SM, Kinderknecht J, Kriss V, Landry G. Mononucleosis and athletic participation: an evidence-based subject review. Clin J Sport Med. 2008 Jul;18(4):309-15. doi: 10.1097/JSM.0b013e31817e34f8. Review. PubMed PMID: 18614881.

Jaworski CA, Donohue B, Kluetz J. Infectious disease. Clin Sports Med. 2011 Jul;30(3):575-90. doi: 10.1016/j.csm.2011.03.006. PubMed PMID: 21658549.

19
Q
  1. When evaluating accelerated vs nonaccelerated rehabilitation programs after anterior cruciate ligament reconstruction (ACL), outcomes are
  2. similar with each rehabilitation method.
  3. better with accelerated rehabilitation because of earlier return to activity.
  4. better with nonaccelerated rehabilitation because of increased graft strength.
  5. worse with accelerated rehabilitation because of graft loosening.
  6. worse with nonaccelerated rehabilitation because of higher frequency of knee stiffness.
A
  1. similar with each rehabilitation method.

RECOMMENDED READINGS

Kruse LM, Gray B, Wright RW. Rehabilitation after anterior cruciate ligament reconstruction: a systematic review. J Bone Joint Surg Am. 2012 Oct 3;94(19):1737-48. doi: 10.2106/JBJS.K.01246. Review. PubMed PMID: 23032584; PubMed Central PMCID: PMC3448301.

Beynnon BD, Johnson RJ, Naud S, Fleming BC, Abate JA, Brattbakk B, Nichols CE. Accelerated versus nonaccelerated rehabilitation after anterior cruciate ligament reconstruction: a prospective, randomized, double-blind investigation evaluating knee joint laxity using roentgen stereophotogrammetric analysis. Am J Sports Med. 2011 Dec;39(12):2536-48. doi: 10.1177/0363546511422349. Epub 2011 Sep 27. PubMed PMID: 21952714.

20
Q
  1. Which intra-articular injury is most commonly associated with an anterior cruciate ligament (ACL) tear?
  2. Medial meniscus tear
  3. Lateral meniscus tear
  4. Lateral tibial plateau fracture
  5. Articular cartilage lesion of the lateral femoral condyle
  6. Articular cartilage lesion of the medial femoral condyle
A
  1. Lateral meniscus tear

RECOMMENDED READINGS

Piasecki DP, Spindler KP, Warren TA, Andrish JT, Parker RD. Intraarticular injuries associated with anterior cruciate ligament tear: findings at ligament reconstruction in high school and recreational athletes. An analysis of sex-based differences. Am J Sports Med. 2003 Jul-Aug;31(4):601-5. PubMed PMID: 12860552.

Spindler KP, Schils JP, Bergfeld JA, Andrish JT, Weiker GG, Anderson TE, Piraino DW, Richmond BJ, Medendorp SV. Prospective study of osseous, articular, and meniscal lesions in recent anterior cruciate ligament tears by magnetic resonance imaging and arthroscopy. Am J Sports Med. 1993 Jul- Aug;21(4):551-7. PubMed PMID: 8368416.

21
Q
  1. Figures 252a through 252c are the radiographs of a 27-year-old woman who lacks range of motion of her left elbow. She has always had limited range of motion in this elbow; however, this did not bother her until she gave birth. She cannot feed the child using her left arm secondary to the lack of motion, but she denies pain. Examination reveals her left elbow has full and equivalent flexion and extension with a fixed 20 degrees of pronation. No further pronation or supination is present actively or passively. No pain is elicited during the examination. Her right elbow has full flexion and extension as well as full pronation and supination. What is the underlying cause of her condition?
  2. Posttraumatic event
  3. Formation failure
  4. Segmentation failure
  5. Autosomal recessive trait
  6. Disuse
A
  1. Segmentation failure

RECOMMENDED READINGS

Elliott AM, Kibria L, Reed MH. The developmental spectrum of proximal radioulnar synostosis. Skeletal Radiol. 2010 Jan;39(1):49-54. doi: 10.1007/s00256-009-0762-2. PubMed PMID: 19669136.

Cleary JE, Omer GE Jr. Congenital proximal radio-ulnar synostosis. Natural history and functional assessment. J Bone Joint Surg Am. 1985 Apr;67(4):539-45. PubMed PMID: 3980498.

22
Q
  1. A small fracture of the lateral tibial plateau known as a Segond fracture often is associated with anterior cruciate ligament (ACL) injury and represents an avulsion of the
  2. anterolateral ligament.
  3. tibial ACL attachment.
  4. femoral ACL attachment.
  5. lateral capsule.
  6. lateral collateral ligament (LCL).
A
  1. anterolateral ligament.

RECOMMENDED READINGS

Dodds AL, Halewood C, Gupte CM, Williams A, Amis AA. The anterolateralligament: Anatomy, length changes and association with the Segond fracture. Bone Joint J. 2014 Mar;96-B(3):325-31. doi: 10.1302/0301-620X.96B3.33033. PubMed PMID:24589786.

Claes S, Luyckx T, Vereecke E, Bellemans J. The Segond fracture: a bony injury of the anterolateral ligament of the knee. Arthroscopy. 2014 Nov;30(11):1475-82. doi: 10.1016/j.arthro.2014.05.039. Epub 2014 Aug 8. PubMed PMID: 25124480.

Claes S, Vereecke E, Maes M, Victor J, Verdonk P, Bellemans J. Anatomy of the anterolateral ligament of the knee. J Anat. 2013 Oct;223(4):321-8. doi: 10.1111/joa.12087. Epub 2013 Aug 1. PubMed PMID: 23906341.

23
Q
A

5. OITE (41 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions