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Answers to various questions related to orthopedic surgical procedures, including the use of a troch nail, indications for different types of femur fractures, and the treatment of carpal instability. It also covers topics such as the anatomy of the ulnar collateral ligament (ucl) and its injuries, as well as the principles of fixation for pilon fractures.
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When covering a CMC Suspensionplasty using the FiberLock™ Suspension System, what should you bring for the back table? ------ CORRECT ANSWER---------------DX SwiveLock® SL, 1.3 mm SutureTape DX FiberTak®, sterile Mini TightRope® button The FiberLock™ Suspension System includes which drill bit sizes. (Select all that apply) ------CORRECT ANSWER---------------3.0 and 2. True of False: Removal of the trapezium is not needed before completing the CMC Suspensionplasty Using the FiberLock™ Suspension System. ---- --CORRECT ANSWER---------------False When drilling the radial corner of the 1st metacarpal for the Thumb CMC APL Suspensionplasty with InternalBrace™ Ligament Augmentation, overdrill the guidewire with the gold 3.5 mm cannulated drill coupled with the drill guide. The drill guide has a depth stop at ____: ------CORRECT ANSWER---------------1 cm / 10 mm True or False: The Hand and Wrist InternalBrace™ Ligament Augmentation Repair Convenience Kit includes a 3.0 mm cannulated drill bit for constructs with graft incorporation and a 3.5 mm cannulated drill bit all-suture constructs. ------CORRECT ANSWER---------------False
True or False: Harvesting a graft wider than 2 mm to 2.5 mm is not advised and can compromise proper fixation in the blind ------CORRECT ANSWER- --------------True When harvesting the abductor pollicis longus tendon graft for the Thumb CMC APL Suspensionplasty with InternalBrace™ Ligament Augmentation, an ideal tendon graft that would fit through the eyelet of the 3.5 DX SwiveLock® SL anchor and have proper fixation in the blind tunnel, measures: ------CORRECT ANSWER---------------2 x 4 mm Key benefits of the InternalBrace™ Ligament Augmentation include: ------ CORRECT ANSWER---------------Minimally invasive surgical technique Durable, reliable, and stable fixation Shortened immobilization Improved functional results and return to play activities True or False: The Mini TightRope® system and InternalBrace™ Ligament Augmentation were introduced by Arthrex in 2009, enhancing the surgical options to treat the thumb carpal-metacarpal joint. ------CORRECT ANSWER---------------True Which structure is used as a biological tendon graft in conjunction with the InternalBrace™ Ligament Augmentation for thumb carpal-metacarpal arthritis? ------CORRECT ANSWER---------------Abductor Pollicis Longus (APL) True or False: The thumb carpal-metacarpal has a loose capsule allowing for multiple planes of motion in the thumb including flexion, extension,
What bone articulates with distal radius at radial styloid? ------CORRECT ANSWER---------------Scaphoid The torque limiting handle with the distal radius plates should be used for the distal 2.4mm screws to prevent over torquing or under torquing of these screws. ------CORRECT ANSWER---------------True What suture is on the DX fibertak anchor? ------CORRECT ANSWER-------- -------1.3 mm flat suture What is a way to incorporate biologic feature into Fiberlock? ------ CORRECT ANSWER---------------Harvest FCR tendon What is included in nanoscopic release system? ------CORRECT ANSWER---------------180 mm NanoNeedle Scope, a Centerline™ device, and a dilator/synovial scraper instrument. Advantages of ECTR? ------CORRECT ANSWER---------------Cosmetic scar Less pain and faster return to activities End results = equal Surgeon = higher reimbursement Do not have full visualization with mini open / have to cut through thick connective tissue Shiny tissue = antebrachial fascia = continuous with transverse carpal ligament When doing an ECTR what is the main reason a surgeon should avoid making an incision between the flexor carpi radialis tendon and the
palmaris longus tendon? ------CORRECT ANSWER---------------They run the risk of palmar cutaneous branch of median nerve Which of the following conditions can mimic the symptoms of carpal tunnel syndrome? ------CORRECT ANSWER---------------Cervical radiculopathy Thumb CMC arthritis Median nerve entrapment at the elbow Nonspecific Tenosynovitis Where should you make incision for ECTR? ------CORRECT ANSWER------ ---------Proximal wrist crease
What are the most common size distal diameter? ------CORRECT ANSWER---------------10 and 11 mm How many degrees of lateralization? ------CORRECT ANSWER--------------- 5 degree Surgical Steps for Troch Nail: ------CORRECT ANSWER---------------- Find start point with guide wire or awl
What suture should you use to whipstitch your tendon in a SL recon? ------ CORRECT ANSWER--------------- 2 - 0 fiberloop How many guidewires come in the H&W IB? What size are they? ------ CORRECT ANSWER---------------1.35 x What do you need to bring in addition to IB for an all-dorsal scapholunate? ------CORRECT ANSWER---------------An additional 3.5x8.5 SL What do you need to bring in addition to IB for an interossoeus SL recon? - -----CORRECT ANSWER---------------3x8 teno Lasso 3.5x8.5 dx swivelock What suture comes in hand and wrist IB? ------CORRECT ANSWER--------- ------1.3mm suturetape What is your bailout if the lunate tunnel is too short / small for a 3x8 teno screw? ------CORRECT ANSWER---------------If the length of the tunnel is less than 8 mm, the body from a 3.5 mm DX SwiveLock SL anchor can be used. The tunnel should be overdrilled with the 3.5 mm drill if this fixation method is preferred. What bones should you pin for post op scapholunate repair? ------ CORRECT ANSWER---------------Scaphoid & capitate
what nerve is responsible for sensory information of the tip of the index and long finger of the hand? ------CORRECT ANSWER---------------median what area of the hand does the median nerve give sensory information? ---- --CORRECT ANSWER---------------palmar aspect of the thumb, index, long finger, and radial half of the ring what anatomic structure sets the floor for carpal tunnel? ------CORRECT ANSWER---------------proximal carpal row what is the significance of identifying kaplan's cardinal line when using the nanoscopic centerline for ECTR? ------CORRECT ANSWER--------------- identifies distal margin of transverse carpal ligament when doing ECTR what is the main reason a surgeon should avoid making an incision between the flexor carpi radialis and palmar longus tendon? -----
Steiner Lesion ------CORRECT ANSWER---------------UCL kicked from abductor AP neurosis Acute injury Palpable mass / edema Gamekeeper's thumb ------CORRECT ANSWER---------------Chronic attenuation or overuse of UCL > pain and instability Timeline of UCL with IB versus without? ------CORRECT ANSWER----------- ----Range of motion within 1st week Strengthening by 2 weeks (with IB) versus ROM 3-4 weeks, strengthening at 6 weeks What allows pinch grasp? ------CORRECT ANSWER---------------UCL + collateral ligaments What are the three ranges of motion for CMC? ------CORRECT ANSWER-- -------------adduction-abduction, flexion-extension and axial rotation. The thumb carpal-metacarpal is classified as which type of joint: ------ CORRECT ANSWER---------------Bi-concave convex saddle joint The FiberLock™ Suspension System features which of the following advantages: ------CORRECT ANSWER---------------Knotless fixation Single incision Direct visualization while drilling
What degree of anteversion do long & ES nails have? ------CORRECT ANSWER---------------10 degree anteversion in the troch nail system, the lag screw and AR screw cannot be used together. ------CORRECT ANSWER---------------False The Arthrex ES nail is indicated for subtroch fractures that extend into the diaphysis ------CORRECT ANSWER---------------False The subtroch region is defined by area that is just inferior to the lesser troch extending approximately: ------CORRECT ANSWER---------------5cm T/F: All troch nails have a 5 degree lateral bend to accomodate for troch start point ------CORRECT ANSWER---------------true the femoral calcar region of the femur has the strongest bone in the proximal femur. ------CORRECT ANSWER---------------True which type of femur fx makes up 10-30% of all hip fractures, has bimodal distribution in the 20's and 60's age population, and is often associated with biphosphonate drug treatment? ------CORRECT ANSWER--------------- subtroch Pre-op radiographs oof injured femur may be used to establish ------ CORRECT ANSWER---------------- Proper nail diameter
What is the setting time for Quickset? ------CORRECT ANSWER--------------
What are the contents of our allosync gel, putty, paste ------CORRECT ANSWER---------------Allosync putty, Gel and Paste Demineralized Bone Matrix (36%) +Carrier (64%) what is the shelf life of arthrocell? ------CORRECT ANSWER--------------- 3 years True or False: An anterolateral distal tibia fragment (Chaput) can be stabilized with the Straight Plate from the Distal Tibia Plating System. ------ CORRECT ANSWER---------------True All of the following are plate options found in the Pilon Fracture Distal Tibia Plating System, EXCEPT: ------CORRECT ANSWER---------------All of the following are plate options found in the Pilon Fracture Distal Tibia Plating System, EXCEPT: What ankle injury is summarized by the expression "bimalleolar equivalent fracture"? ------CORRECT ANSWER---------------lateral malleoulus fx, medial mal intact, deltoid rupture Which plate included in the Pilon Fracture Distal Tibia Plating System comes in a straight and anatomic option? ------CORRECT ANSWER--------- ------Posterolateral distal fibula plate Which finding is not commonly seen in low-energy pilon fractures? ------ CORRECT ANSWER---------------severe metaphyseal and articular comminution
When a surgeon is using the Arthrex Small External Fixator for a distal radius fracture what position should he/she place the metacarpal pins? -----
The Arthrex Small External Fixator consists of __mm and __mm threaded pins and __mm carbon fiber bars. ------CORRECT ANSWER--------------- 2.0, 3.0, 5. Restore lateral column length ------CORRECT ANSWER--------------- What are the 3 types of proximal femur fractures? ------CORRECT ANSWER---------------Subtroch, Intertroch, Femoral Neck What is the challenge of intra-articular fractures? ------CORRECT ANSWER---------------Synovial fluid in joint capsule is detrimental to healing What defines the subtroch region? ------CORRECT ANSWER--------------- Extends 5 cm distal to lesser trochanter What is the normal neck shaft angle of proximal femur? ------CORRECT ANSWER---------------130 degrees +/- 7 degrees What is the normal femoral anteversion angle and why does it exist? ------ CORRECT ANSWER---------------10 degrees +/- 7 degrees; femoral head is anterior to shaft What is the femoral calcar? ------CORRECT ANSWER---------------Thick cortex running from lesser troch along neck to femoral head; best bolster region in inferior posterior aspect