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Principles of Fracture Fixation Techniques

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Authors and Affiliations

  1. Training and Education Centre, ICAR- Indian Veterinary Research Institute, Pune, India

    Hari Prasad Aithal

  2. Division of Surgery, ICAR- Indian Veterinary Research Institute, Bareilly, Uttar Pradesh, India

    Amar Pal, Prakash Kinjavdekar & Abhijit M Pawde

Authors
  1. Hari Prasad Aithal
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  2. Amar Pal
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  3. Prakash Kinjavdekar
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  4. Abhijit M Pawde
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Chapter 2: Sample Questions

Chapter 2: Sample Questions

Q. No. 1: Mark the most appropriate answer.

  1. 1.

    Intramedullary pinning is most resistant against

    (a) bending, (b) rotation, (c) tension, (d) torsion

  2. 2.

    Bone plating should be done at the following surface of a long bone.

    (a) compression side (b) tension side (c) lateral side (d) medial side

  3. 3.

    Technique of fracture fixation wherein multiple percutaneous, transcortical pins are passed in the proximal and distal bone segment and are connected to a rigid external frame is known as

    (a) external fixation (b) internal fixation (c) external skeletal fixation (d) none of the above

  4. 4.

    Which of the following is not true with respect to an ESF?

    (a) strength increases as complexity of design increases (b) increasing the number of pins increases fixator strength (c) the larger the pin diameter, the greater is the fixation stability (d) the more the distance from the bone to side bars increases, the more the fixation stiffness

  5. 5.

    Avulsion fracture of the olecranon can be better treated by

    (a) screw fixation (b) IM pinning (c) tension band wiring (d) cross pinning

  6. 6.

    Transfixation pinning and casting are a type of

    (a) external fixation (b) internal fixation (c) external skeletal fixation (d) none of these

  7. 7.

    The technique of choice for the fixation of a supracondylar femoral fracture is

    (a) retrograde technique of single pinning, (b) stack pinning, (c) cross intramedullary pinning, (d) K-nailing

Q. No. 2: State true or false.

  1. 1.

    A plaster cast applied straight can neutralize bending and rotational forces but generally unable to resist compressive, shear, and tensile forces.

  2. 2.

    Creating an opening (window) in the cast will reduce its strength considerably and make the window site prone for breakage.

  3. 3.

    Modified Thomas splint is indicated in proximal femoral and humeral fractures.

  4. 4.

    IM nailing in a long bone fracture is contraindicated if periosteal system is already damaged.

  5. 5.

    In fractures with smaller bone segment, retrograde pinning is preferred due to accurate placement and better purchase of pin.

  6. 6.

    K-nails are not indicated if there are longitudinal cortical cracks in the fractured bone.

  7. 7.

    Plaster cast can be used for effective immobilization of fractures at the distal end of the femur.

  8. 8.

    Close pinning can only be used for recent stable fractures.

  9. 9.

    Internal fixation should be avoided in the presence of infection.

  10. 10.

    Periosteal stripping is preferred during plate fixation.

  11. 11.

    Cross IM pinning using small diameter pins can provide stable fixation of small fracture segments near the joint with minimal damage to the growth plate.

  12. 12.

    Interlocking nail is biomechanically superior to bone plate.

  13. 13.

    Limited contact DCPs with undercut can reduce the contact between the plate and the bone surface and in turn reduce the stress protection and vascular compromise.

  14. 14.

    Fully threaded cortical screw can be used as ‘lag screw’ by over-drilling the far cortex to achieve interfragmentary compression.

  15. 15.

    Positive-profile threaded pins are stronger than negative-profile threaded pins of similar size.

  16. 16.

    During ESF application, pins are introduced using high-speed, low torque power drills to avoid wobbling and reduce thermal necrosis of the bone.

  17. 17.

    A properly tensioned 1.6 mm K-wire provides stiffness equivalent to a 4 mm fixator pin.

Q. No. 3: Fill in the blanks.

  1. 1.

    ________________________ sling is used to hold the shoulder joint in flexion, while ________________________ sling is indicated to hold the hip joint in flexed position.

  2. 2.

    Introduction of the pin for IM pinning through one end of the bone is called as _________________________ technique, and when it is introduced through the fracture site, it is termed as ________________________ technique.

  3. 3.

    The diameter of the intramedullary pin should be about ______________________ of medullary cavity diameter, to achieve adequate stability.

  4. 4.

    Interlocking nailing with fixation of either proximal or distal transfixation bolts is called as _____________________________, whereas fixation of both proximal and distal bolts is termed as ______________________________.

  5. 5.

    ____________________________________ plates with threaded screw holes typically have combi holes to allow placement of either __________________________ or ____________________________ screws.

  6. 6.

    Minimally invasive plate osteosynthesis is _______________ (less/more) traumatic, ___________________ (less/more) biological, and __________ (less/more) rigid than standard plate fixation.

  7. 7.

    An orthopedic wire placed around the circumference of the bone is called as _________________________________, and a wire passed through a hole drilled in the bone to partially encircle the bone is ______________________________.

  8. 8.

    The methods used to reduce thermal necrosis of tissues during ESF application include __________________________, _______________________________, and ____________________________________.

  9. 9.

    Free-form fixation has the advantage of ________________________________________________________, but the disadvantage is _________________________________________.

Q. No. 4: Write short note on the following.

  1. 1.

    Principles of locking compression plate

  2. 2.

    Advantages of interlocking nailing

  3. 3.

    Minimally invasive plate osteosynthesis

  4. 4.

    Principles of external skeletal fixation

  5. 5.

    Plaster cast vs. fiberglass cast

  6. 6.

    Rush pinning vs. cross IM pinning

  7. 7.

    Dynamic self-compression plate vs. locking plate

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Aithal, H.P., Pal, A., Kinjavdekar, P., Pawde, A.M. (2023). Principles of Fracture Fixation Techniques. In: Textbook of Veterinary Orthopaedic Surgery. Springer, Singapore. https://doi.org/10.1007/978-981-99-2575-9_2

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