Hello , I am Fifth Year Medical Student and Yesterday did my ortho examination and i wanna check some T/F because i searched many resources and couldn't get the proper answers :
1. Swelling of the hand's digits is an early sign of hand compartment syndrome.
2. femoral head necrosis could occur from intra-articular injection of steroid.
3. the process of bone re-modelling occurs at the surface of bone trabeculae only
4. malrotation is a common complication of external fixation
5. Fracture Tibia heal in average 7 month.
Thank You
The following would be my answers. I did not "look up" the answers and most of these questions are poorly written and full of caveats. I may be wrong. I encourage anyone else to correct me.
1. False. Swelling of the compartments of the hand would cause hand swelling in the hand. The fingers are not in direct contact with the compartments in the hand. However, the reason for the hand compartment syndrome (trauma, snakebite, etc...) is likely to also result in digital swelling. So maybe...
2. True. It has been reported but is not common. It is hard to definitively prove the injection was the cause of femoral head necrosis. It is possible that the reason the person was getting steroids in their hip joint was early necrosis that did not show up on imaging studies.
3. False. Remember cortical bone remodels too, although at a much slower rate. For cortical bone, there is an adaptation of remodeling involving osteoclastic formation of "cutting cones" and the subsequent development of haversian systems and formation of osteons... booooooooooorrrrrrrrrrring...
4. True. Kinda... Depends on your definition of common and the fracture pattern. Most people would not be likely to treat fractures that are rotationally unstable with an external fixator. Malrotation is also "common" after intramedullary fixation of femoral and tibial fracture. I do not know which statistically has a higer rate.
5. False. 3 months. 6 months is a non-union in a tibia.
