2. spasm of the artery and

3. compression of the artery relieved by manipulation of the fracture

5. Myositis ossificans or calcific tendinitis

6. Neurovascular injuries (8-21% of cases) — ulnar nerve injuries are most common, followed by brachial artery injuries (5-13%)

7. Osteochondral defects, intra-articular loose bodies, and avascular necrosis of the capitellum

8. Instability

9. Secondary injury

10. Most commonly brachial artery injury, and if left untreated could lead to Volkmann's contracture (permanent flexion contracture of the hand at the wrist, resulting in a claw-like deformity of the hand and fingers).

11. Taken from http://en.wikipedia.org/wiki/Supracondylar_fracture

12. T – among the commonest fractures in children (Apley’s concise 3rd edition page 311)

13. F – can cause compartment syndrome (http://emedicine.medscape.com/article/1269576-treatment)

14. F – Occur as a complication of fracture of the lateral condyle of the humerus, which may lead to tardy ulnar nerve palsy. (http://en.wikipedia.org/wiki/Cubitus_valgus)

15. F – Existence of collateral arteries (Netter 4th edition page 434)

16. T – distal fragment may be displaced and / or tilted either posteriorly / anteriorly / medially / laterally / rotated (Apley’s concise 3rd edition page 311)

18. 1 inch (2.54 cm) proximal to the radio-carpal joint

19. dorsal displacement and angulation

21. Nerve injury (median nerve in carpal tunnel)

22. Malunion

23. Tendon rupture (tear of EPL)

24. Joint stiffness

25. Complex regional pain syndrome

26. Treatment:

27. Undisplaced fracture – splintage

28. Displaced fracture – CMR under anesthesia

29. Comminuted and unstable fracture – external fixation with K wire

30. Taken from Apley’s concise 3rd edition page 325

31. T – so-called ‘dinner for deformity’ (Apley’s concise 3rd edition page 324)

32. F – dorsal displacement of the distal fragment of the radius (Apley’s concise 3rd edition page 324)

33. F – control manual reduction is sufficient if its displaced (Apley’s concise 3rd edition page 324)

34. T – can cause stiffness if it the joint is not being used for movement (Apley’s concise 3rd edition page 324)

35. F – Tear of extensor pollicis longus (EPL) a few weeks after fracture (Apley’s concise 3rd edition page 325)

37. The Shenton line is an imaginary line drawn along the inferior border of the superior pubic ramus(superior border of the obturator foramen) and along the inferomedial border of the neck of femur. This line should be continuous and smooth.

38. Interruption of Shenton's line can indicate (in the correct clinical scenario)

39. developmental dysplasia of the hip (DDH)

40. fractured neck of femur

41. taken from http://radiopaedia.org/articles/shenton-s-line-1

42. Garden classified this fracture into four types:

43. Type 1 is a stable fracture with impaction in valgus.

44. Type 2 is complete but non-displaced.

45. Type 3 is displaced (often rotated and angulated) with varus displacement but still has some contact between the two fragments.

46. Type 4 is completely displaced and there is no contact between the fracture fragments.

47. Taken from http://en.wikipedia.org/wiki/Hip_fracture

48. Nonoperative management is reserved only for those with extremely high surgical risk or demented nonambulators with minimal hip pain

49. Taken from http://www.orthopaedia.com/display/Main/Femoral+neck+fractures

50. Operative treatment is almost mandatory. Displaced fracture will not unite without internal fixation. Impacted fracture can be left to unite, but there is always a risk that they may become displaced, even while lying in bed, so fixation is safer.

51. Complications include AVN, non-union, OA, general (thromboembolism, bed sores)

52. Taken from (Apley’s concise 3rd edition page 363)

53. F – most commonly seen in elderly osteoporotic people (Apley’s concise 3rd edition page 362)

54. T – interruption of the Shenton’s line may indicate # of femoral neck (http://radiopaedia.org/articles/shenton-s-line-1

55. F – Garden stage II shows complete but undisplaced fracture (Apley’s concise 3rd edition page 362)

56. T – operative treatment is almost mandatory (Apley’s concise 3rd edition page 363)

57. T - (Apley’s concise 3rd edition page 362)

59. Edema

60. Inflammation

62. Paresthesia

63. Pallor

64. Paralysis

66. Limb should be nursed flat (elevating the limb causes further decrease in end capillary pressure and aggravates muscle ischemia)

67. Fasciotomy

68. Debridement if there is necrosis

69. T – bleeding, edema, inflammation (Apley’s concise 3rd edition page 294)

70. T – presence of pulse does not exclude the diagnosis (Apley’s concise 3rd edition page 295)

71. T – may be caused by swelling of a limb inside a tight plaster cast (Apley’s concise 3rd edition page 294)

72. F – remove cast, bandages or dressings – and the limb should be nursed flat – fasciotomy (Apley’s concise 3rd edition page 295)

73. ??

75. Displaced intra-articular fractures

76. Certain types of displaced epiphyseal fractures

77. Major avulsion fractures where there is loss of function of a joint or muscle group

78. Non-unions

80. Multiple fractures to assist in care and general management

81. Unable to maintain a reduction

82. Pathological fractures

83. To assist in nursing care

84. To reduce morbidity due to prolonged immobilisation

86. (http://wiki.answers.com/Q/Indication_for_open_reduction_with_internal_fixation)

87. F open fracture with gross contamination F

88. (http://wiki.answers.com/Q/Indication_for_open_reduction_with_internal_fixation)

89. F polytrauma, when to minimize risk of acute respiratory distress syndrome

90. T pathological fracture, whereby bone disease may prevent healing (http://wiki.answers.com/Q/Indication_for_open_reduction_with_internal_fixation)

91. F shortage hospital bed

92. (http://wiki.answers.com/Q/Indication_for_open_reduction_with_internal_fixation

93. Causes of pathological fracture

94. A pathological fracture is one that occurs in abnormal bone, as a result of a normally insignificant stress.

95. Possible causes include:

97. F repetitive stress (repetitive stress is a cause for stress fracture) (http://medical-dictionary.thefreedictionary.com/pathological+fracture)

98. T osteomyelitis (Chronic infection which is a local benign condition) (http://www.wrongdiagnosis.com/p/pathological_fracture/causes.htm)

99. (http://www.gpnotebook.co.uk/simplepage.cfm?ID=859111436)

100. T bone cyst (a local benign condition) (http://www.gpnotebook.co.uk/simplepage.cfm?ID=859111436)

101. T previous traumatic fracture (pathological fracture is due to pathologic bone-weakening condition) (http://www.wrongdiagnosis.com/p/pathological_fracture/causes.htm)

102. T secondary to bone tumour ( osteosarcoma, osteoblastoma, metastatic tumors) (http://www.wrongdiagnosis.com/p/pathological_fracture/causes.htm) (http://www.gpnotebook.co.uk/simplepage.cfm?ID=859111436)

103. The common sites of fractures in patients with osteoporosis are :

104. Femoral neck (True) (typical fragility occurs in vertebral column, hip, ribs , and wrist) http://en.wikipedia.org/wiki/Osteoporosis

105. http://library.med.utah.edu/WebPath/TUTORIAL/OSTEO/OSTEOPOR.html

106. Distal tibia (False)

107. Sacrum (False)

108. Distal radius (True)

109. Vertebrae (True)

110. Traumatic anterior dislocation of the shoulder :

111. Is caused by forced adduction and internal rotation (False) (by forced abduction and external rotation of the soulder) (APLEY’S CONCISE SYSTEM OF ORTHOPAEDICS AND FRACTURES, THIRD EDITION, page 306)

112. Causes the head of the humerus to end up just below the coracoids process (True) ( X-ray shows head of humerus lying below and medial to the socket) (APLEY’S CONCISE SYSTEM OF ORTHOPAEDICS AND FRACTURES , THIRD EDITION, page 306)

113. Is less common occurred as compare to posterior dislocation (False) (humeral head displacement is usually anterior, less often posterior) (APLEY’S CONCISE SYSTEM OF ORTHOPAEDICS AND FRACTURES , THIRD EDITION, page 306)

114. Would result in axillary nerve injury as a complication (True) (The axillary nerve may be injured) (APLEY’S CONCISE SYSTEM OF ORTHOPAEDICS AND FRACTURES , THIRD EDITION, page 306)

116. Pain in leg (unilateral or bilateral) that starts in the buttocks and travels down the back of the thighs and legs (sciatica)

117. Numbness in the groin or area of contact if sitting on the saddle (perineal or saddle paresthesia)

118. Bowel and bladder disturbances (urinary and fecal retention)

119. Lower extremity muscle weakness and loss of sensations

120. Reduced or absent lower extremity reflexes

121. Impairment of penile erection

124. Pain medication, such as NSAIDs (e.g. ibuprofen) and/or acetaminophen

129. Osteochondritis dissecans T

130. Osteoarthritis T

131. Pigmented villous nodular synovitis T

133. Involvement of multiple joint T

134. Marked synovial thickening T

135. Periarticular osteoporosis T

137. Genetic and hereditary T

138. Frequent cracking the knuckles of finger F

139. DM T

141. Below knee amputation ,weight is taken on the stump F

142. Above knee amputation,weight is taken on the ischial tuberosity T

143. Elderly patient refuse to use above knee prostheses because of the high energy requirement T

145. 27Achilles tendon ruptureACommon in people > 40 years oldTApley’s pg 250BSimmond’s test positiveThttp://web.jbjs.org.uk/cgi/reprint/74-B/2/314.pdfhttp://www.youtube.com/watch?v=AmDi08rlR3IUsed to test for rupture of tendo achillis. Positive when no movement of plantarflexion when the culf is squeeze or pushed while the patient is prone and the foot is hanging by the side of the bed.CResult in difficult to walk tip-toeTPatient unable to tiptoe. (Apley’s pg 250).DCannot be treat non-operativelyFImmobilization by plaster is still needed with or without surgery and is worn for 8 weeks with the foot in equines. Shoe with raised heel worn for a further 6 weeks. (apley’s pg 250).Lockable brace is a more sophisticated alternative. (apley’s pg 250).ETreatment via surgical reconstruction will result in wound dehiscence asThttp://www.emedicinehealth.com/achilles_tendon_rupture/page7_em.htm#Surgeryhttp://emedicine.medscape.com/article/85024-treatment

147. Occur when bleeding or edema increases the pressure in one of the osteofascial compartment beyond systemic blood pressure. F

148. Is characterized by excruciating pain F

149. Is a complication of a tight plaster cast T

150. Is adequately treated by analgesics and elevating the limb. F

152. Complete paralysis and anaesthesia is a consequence of spinal shock. T

153. Bladder training is required T

154. Flexion contracture cannot be avoided. F

155. Bedsore developed after 2 day. F

157. Source – Apley’s Concise System of Orthopaedics & Fractures,

159. Avascular necrosis is late complication F

160. Occur commonly in older men T

161. Occur commonly in osteoporotic T

162. Surgery is not indicated if displaced fracture F

163. Garden type II is complete with minimal displacement. F

166. Initiation of intravenous antibiotics that penetrate bone and joint cavities

167. Referral of the patient to an orthopedist or general surgeon

168. Possible medical infectious disease consultation

169. Select the appropriate antibiotics using direct culture results in samples from the infected site, whenever possible.

170. Empiric therapy is often initiated on the basis of the patient's age and the clinical presentation.

171. Empiric therapy should always include coverage for S aureus and consideration of CA-MRSA.

173. Paralysis of the teres minor muscle and deltoid muscle , resulting in loss of abduction of arm (from 15-90 degrees), weak flexion, extension, and rotation of shoulder. Paralysis of deltoid & teres minor results in Flat shoulder deformity.

175. Age T

176. = following the age, if the onset of the Perthes’ disease under the age of 6, it is favorable prognostic sign where they need no active treatment and have to be put under follow up. While, if the onset >6 years old, it is unfavorable sign (poor prognosis) and they need treatment by containment of the femoral head. (‘containment’= keeping the femoral head well seated within the acetabulum)

177. (ref: Apley’s Concise System of Orthopaedics and Fractures)

178. Sex T

179. = Perthes’ disease affects boys four times more frequently than girls. (M: F=4:1).

180. (ref: Apley’s Concise System of Orthopaedics and Fractures)

181. Degree of the head involvement T

183. (ref: Apley’s Concise System of Orthopaedics and Fractures, http://www.wheelessonline.com/ortho/radiographic_evaluation_of_perthes_disease, http://emedicine.medscape.com/article/410482-overview.)

184. Duration of the hip pain F

185. = Duration of the hip pain did not become one of the prognostic features of Perthes’ disease as usually the children will feel intermittent pain for several weeks to months as they often did not complaint about it. The prognostic features for Perthes disease mostly based on age and x-ray appearance.

186. (ref: Apley’s Concise System of Orthopaedics and Fractures, http://emedicine.medscape.com/article/826935-