Trauma

Question 0

Main blood supply to femoral and humeral heads

Answer 0

Femoral - medial femoral circumflex via lateral epiphyseal artery

Humeral -
Anterior HCA branches to arcuate coursing bicipital groove and major supply to head and GT

PCHA - GT and posterior head

Vascular supply for humeral head optimised with 8mm or more of intact medial calcar

Question 1

Most common tendon interposed in Galleazzi fracture

Answer 1

ECU

Question 2

Principles of Flexible elastic intramedullary nails

Answer 2

Use 2 for diametrically opposed curves - insert at same time or will displace
Diameter 2/5 medullary canal
Precontour nails
Reduce before fixing
Metaphyseal entry point
3 point fixation (trifocal buttressing)
Stability with elasticity
Relative axial/bending/rotational stability
Secondary fracture healing - micro motion and callus

Question 3

What are surgical indications for scapula fractures

Answer 3

Lateral border offset 20mm
Glenopolar angle 20•
Angulation on transscapular view >45•
Double disruptions of SSSC - displaced

Non-op - weekly radiographs for 2-3 weeks to check not progressive

Question 4

Indications for urgent SCH # fixation

Answer 4

Open
White pulse less
Skin puckering
Floating elbow
Nerve injury
Compartment syndrome
Unable to assess NV status of young kid