A 36-year-old man was injured in a motorcycle collision and sustained the injury shown in the figure below . He has a blood pressure (BP) of 70/40 mm Hg, pulse of 148 beats per minute (bpm), and Glasgow Coma Scale score of 6 (scores lower than 8 indicate severe brain injury), and there is negligible urine output. His airway is secure and intravenous (IV) access is obtained. Two liters of warm crystalloid solution are given; repeated vital signs reveal the same BP and a pulse of 142 bpm. What is the best next step?
( @OrthoTalK )

6% (10) Administer IV fluids and then reassess vital signs before making further decisions
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8% (13) Pelvic binder and IV fluids
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10% (15) Pelvic binder and immediate transfusion
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73% (108) Pelvic binder, IV fluids, type and cross-match, and then transfuse
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👮????? ????????
👥 146 - gross votes

 The figures below show the MRI scans of a 56-year-old woman with progressively worsening low back and bilateral lower extremity pain. Based on these images, what muscle or muscle group would be expected to be weak on physical examination?
( @OrthoTalK )

10% (12) Quadriceps
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10% (12) Hamstrings
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4% (5) Hip adductors
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64% (73) Extensor hallucis longus
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9% (11) Gastrocnemius
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👮????? ????????
👥 113 - gross votes

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अधिक आर्थोपेडिक परीक्षण और उनके जवाब के लिए... सम्मिलित हों ( @OrthoTalK )

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 The figure below is the MRI scan of a 52-year-old active man who fell from a ladder 6 weeks ago and sustained an isolated glenohumeral dislocation that was reduced in the emergency department. He wore his sling for about 2 weeks and arrived at your clinic today after referral by his primary care doctor. Examination reveals sensation intact throughout his hand, forearm, and shoulder girdle. Belly press examination findings are normal, but painful. He has tenderness to palpation on the anterior shoulder and a painful speed test. Rotator cuff repair associated with tenotomy of the indicated structure will result in what condition when compared to tenodesis of the same structure? ( @OrthoTalK )

60% (27) Decreased strength in forward elevation
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20% (9) Increased external rotation
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11% (5) Cosmetic deformity
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8% (4) Earlier fatigability with pronation
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👮????? ????????
👥 45 - gross votes

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JBJS May 2017

Your country ? ?
( @OrthoTalK )

▪️ 3% Ethiopia


▫️ 1% Nepal


▪️ 0% Spain


▫️ 27% Iraq
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▪️ 15% India
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▫️ 5% Egypt
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▪️ 6% Indonesia
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▫️ 4% Iran
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▪️ 7% Brazil
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▫️ 4% Yemen
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▪️ 4% Syria
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▫️ 3% Sudan


▪️ 2% Pakistan


▫️ 1% Venezuela


▪️ 0% Malaysia


▫️ 2% Peru


▪️ 0% Argentina


▫️ 1% Turkey


▪️ 0% Somalia


▫️ 2% Nigeria


▪️ 1% Kenya


▫️ 1% Jordan

👮Sᴀʟᴀᴍ Aʙᴀʏᴀᴛᴄʜɪ

 Figures below are the 6-week postsurgical anteroposterior hip radiograph and current radiograph of a 54-year-old avid hiker who returns for routine follow-up 3 years after an uncomplicated uncemented modular metal-on-metal hip replacement. He reports mild activity-related aching diffusely around the right hip region, but does not feel restricted with his activities. Examination reveals no local tenderness, a well-healed incision, and mild discomfort at the extremes of rotation. An erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are obtained, showing 9 mm/h (reference range, 0-20 mm/h) and 2.0 mg/L (reference range, 0.08-3.1 mg/L), respectively. What is the etiology of the radiographic finding?
( @OrthoTalK )

▪️ 63% (55) Osteolysis secondary to metal particle wear (an adverse reaction to metal debris)
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▫️ 19% (17) Osteolysis secondary to loosening of the femoral implant
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▪️ 8% (7) Metastatic lesion to the proximal femur
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▫️ 8% (7) Deep periprosthetic joint infection
?
👮????? ????????
👥 86 - gross votes

May 2017

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