Orthopedic Treatment Methods Quiz

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Questions and Answers

What is a basic science concept supporting the use of electrical stimulation?

  • Generates electronegative potentials for bone formation (correct)
  • Reduces TGF-β and BMP's
  • Promotes angulation
  • Inhibits osteoinduction

Which of the following is a contraindication for Electrical Stimulation?

  • Stimulates neovascularization
  • Corrects angulation and deformity
  • Faster healing in fresh fractures
  • Synovial pseudoarthrosis (correct)

What is the purpose of Extracorporeal Shock Wave Therapy (ESWT)?

  • Stimulates neovascularization and cell differentiation (correct)
  • Promotes angulation
  • Induces bone resorption
  • Accelerates bone healing

Which treatment option is considered the 'gold standard' for promoting vascular ingrowth and healing?

<p>Autologous Bone Graft (D)</p> Signup and view all the answers

What is an essential consideration when defining the operative strategy for nonunion treatment?

<p>Location in the diaphysis or metaphysis (C)</p> Signup and view all the answers

Which treatment option involves a piezoelectric transducer generating an acoustic pressure wave?

<p>Extracorporeal Shock Wave Therapy (ESWT) (D)</p> Signup and view all the answers

What is the key factor in the 'Diamond Concept' of bone healing?

<p>Mechanical stability (C)</p> Signup and view all the answers

Which type of bone healing involves 'Relative Stability' of bony surfaces?

<p>Secondary/Callus healing (C)</p> Signup and view all the answers

What is a common non-operative treatment option for bone healing that uses biophysical principles?

<p>Electrical Stimulation (A)</p> Signup and view all the answers

Which bone graft type is often used with Electrical Stimulation as a treatment for bone healing?

<p>Autograft (B)</p> Signup and view all the answers

What is a commonly used operative treatment option for nonunion of bone?

<p>Compression lag screw fixation (A)</p> Signup and view all the answers

In the context of bone healing, which treatment modality involves the application of pressure to achieve stability?

<p>Compression plating (A)</p> Signup and view all the answers

Which type of nonunion involves a reduction in blood flow from organisms consuming the nutrition to healthy bone?

<p>Septic Nonunion (B)</p> Signup and view all the answers

What type of nonunion combines atrophic and hypertrophic characteristics, leading to incomplete callus formation?

<p>Oligotrophic Nonunion (A)</p> Signup and view all the answers

In nonunion, which type is characterized by excessive motion and instability, leading to the formation of a false joint over a significant time period?

<p>Pseudoarthrosis (C)</p> Signup and view all the answers

What plays a crucial role in encouraging osteoblasts for ossification to occur during nonunion treatment?

<p>Compression and distraction (B)</p> Signup and view all the answers

Which nonoperative treatment option involves the use of electrochemical signals to impact cellular development?

<p>Electrical Stimulation (C)</p> Signup and view all the answers

Which operative treatment option creates a mechanical and physiological environment that significantly influences subsequent lineage differentiation of stem cells?

<p>Ilizarov frame application (B)</p> Signup and view all the answers

What should be considered regarding nonunion until proven otherwise?

<p>Infection should be ruled out (D)</p> Signup and view all the answers

Which factor should be evaluated to optimize the factors contributing to bone nonunion?

<p>Renal sufficiency (C)</p> Signup and view all the answers

What is a potential sign of infection that should be evaluated during the physical exam for nonunion?

<p>Presence of sinus tracts (A)</p> Signup and view all the answers

Which lab workup aspect should be considered important in evaluating patients with nonunion?

<p>Renal function tests (D)</p> Signup and view all the answers

What approach is recommended for the treatment of nonunion due to the emphasis on debridement?

<p>Surgical debridement (A)</p> Signup and view all the answers

Which factor should be assessed during the patient work-up to identify potential risk factors for nonunion?

<p>Smoking history (A)</p> Signup and view all the answers

What is the main concern with using electrical stimulation in nonunion treatment?

<p>Synovial pseudoarthrosis (C)</p> Signup and view all the answers

Which treatment option for bone nonunion involves applying mechanical stress to generate electrical potentials?

<p>Electrical stimulation (A)</p> Signup and view all the answers

What is the primary function of extracorporeal shock wave therapy (ESWT) in bone nonunion treatment?

<p>Microtrauma induced vascularization (D)</p> Signup and view all the answers

In the context of bone healing, what does autologous bone graft provide that makes it the 'gold standard'?

<p>Viable osteoblasts and progenitor cells (C)</p> Signup and view all the answers

Which factor is crucial when defining the operative strategy for nonunion treatment?

<p>Infections at the fracture site (B)</p> Signup and view all the answers

What characteristic is associated with hypertrophic nonunion?

<p>'Relative Stability' of bony surfaces (B)</p> Signup and view all the answers

What is a key determinant of the treatment of nonunion of bone?

<p>Diamond Concept (B)</p> Signup and view all the answers

Which factor plays a crucial role in encouraging osteoblasts for ossification to occur during nonunion treatment?

<p>Cellular proliferation and differentiation (B)</p> Signup and view all the answers

What is a major characteristic of nonunion that involves excessive motion and instability?

<p>Malunion (C)</p> Signup and view all the answers

Which type of bone healing involves 'Relative Stability' of bony surfaces?

<p>Secondary/Callus healing (D)</p> Signup and view all the answers

In the context of bone healing, which factor is essential for osseous healing according to the Diamond Concept?

<p>Mechanical stability (C)</p> Signup and view all the answers

Which type of bone healing involves 'Absolute Stability' of bony surfaces?

<p>Direct/Primary healing (C)</p> Signup and view all the answers

What are the most important mediators having a direct effect on progenitor cells for osteoblastic differentiation?

<p>Platelet-derived growth factor (PDGF) (D)</p> Signup and view all the answers

Which proteins are included in the transforming growth factor beta (TGFβ) family that have a significant role in osteoblastic differentiation?

<p>BMP-2, BMP-4, BMP-6 (A)</p> Signup and view all the answers

Which cells are critical in guiding the proliferation and differentiation process of mesenchymal stem cells (MSCs) for callus formation?

<p>Bone morphogenetic proteins (BMPs) (B)</p> Signup and view all the answers

What encourages preferential MSC differentiation into osteoblasts during bone healing?

<p>High oxygen tension at periosteal surfaces (A)</p> Signup and view all the answers

Which type of cells are activated based on the local fracture environment in the haematoma?

<p>Endothelial progenitor cells (A)</p> Signup and view all the answers

What initiates periosteal osteoblasts to produce type 1 collagen leading to intramembranous ossification during bone healing?

<p>Osteocalcin (D)</p> Signup and view all the answers

What type of collagen is initially laid down by chondrocytes in the central zones during endochondral ossification?

<p>Type 2 collagen (A)</p> Signup and view all the answers

What serves the purpose of a 'natural' scaffold when there is good apposition of bone at the fracture site?

<p>Necrotic bone (B)</p> Signup and view all the answers

What is defined as a fracture that is a minimum of 9 months post occurrence, has not healed, and has not shown radiographic progression for 3 months?

<p>Nonunion (C)</p> Signup and view all the answers

In the context of bone healing, what type of bone matrix is mentioned as a treatment option when there is insufficient 'natural' scaffold?

<p>Allograft bone matrix (D)</p> Signup and view all the answers

What is considered multifactorial and requires clinicians to consider multiple therapeutic interventions?

<p>Nonunion (C)</p> Signup and view all the answers

What must be evaluated to determine fracture healing, as demonstrated by cortical bridging of the fracture lines?

<p>Radiographs (B)</p> Signup and view all the answers

Which type of bone healing involves 'Absolute Stability' of bony surfaces and minimal interfragmentary strains of less than 2%?

<p>Primary bone healing (A)</p> Signup and view all the answers

What is the major determinant of treatment in nonunion of bones according to the text?

<p>Diamond Concept (A)</p> Signup and view all the answers

Which concept in bone healing emphasizes the importance of understanding the cause of nonunion to provide proper treatment?

<p>Diamond Concept (B)</p> Signup and view all the answers

Which principle focuses on the differentiation and remodeling aspects in bone healing?

<p>Remodeling principle (A)</p> Signup and view all the answers

What is the primary feature of 'Relative Stability' as related to secondary bone healing?

<p>Cellular proliferation (A)</p> Signup and view all the answers

Which factor is NOT mentioned as a key element for osseous healing in the text?

<p>Inflammation (B)</p> Signup and view all the answers

In nonunion, which type is characterized by incomplete callus formation due to a combination of atrophic and hypertrophic characteristics?

<p>Oligotrophic nonunion (D)</p> Signup and view all the answers

Which type of nonunion involves a false joint forming over time due to excessive motion and instability?

<p>Hypertrophic nonunion (A)</p> Signup and view all the answers

What type of nonunion typically has adequate vascularity but so much mechanical instability that the body forms a false joint over time?

<p>Atrophic nonunion (B)</p> Signup and view all the answers

In which type of nonunion does a reduction in blood flow from organisms consuming nutrition lead to decreased new bone formation?

<p>Oligotrophic nonunion (D)</p> Signup and view all the answers

Which type of nonunion forms a false joint over time due to sufficient biology but significant mechanical instability?

<p>Pseudoarthrosis nonunion (B)</p> Signup and view all the answers

What type of nonunion involves excessive motion and instability, leading the body to be tricked into thinking there should be a joint present?

<p>Septic pseudoarthrosis (C)</p> Signup and view all the answers

What type of nonunion is characterized by a reduction in blood supply to the fracture site, leading to bone resorption and thinning of the cortex?

<p>Atrophic (C)</p> Signup and view all the answers

Which term refers to a type of pseudoarthrosis where there is excessive motion and instability at the fracture site, leading to the formation of a false joint over time?

<p>Pseudoarthrosis (B)</p> Signup and view all the answers

In which type of nonunion does the fracture site fail to develop a vascular network and is often associated with a lack of callus formation?

<p>Oligotrophic (C)</p> Signup and view all the answers

What type of pseudoarthrosis is characterized by the presence of infection at the fracture site?

<p>Septic (B)</p> Signup and view all the answers

Which term describes a nonunion where there is an excessive formation of callus at the fracture site, resulting in a robust but structurally unsound repair?

<p>Hypertrophic (B)</p> Signup and view all the answers

In what type of nonunion is there minimal biological activity at the fracture site, resulting in a lack of callus formation and delayed healing?

<p>Atrophic (D)</p> Signup and view all the answers

What is a characteristic of hypertrophic nonunion?

<p>Decreased vascularity (C)</p> Signup and view all the answers

Which factor distinguishes atrophic nonunion?

<p>Excessive callus formation (D)</p> Signup and view all the answers

What is a common feature of oligotrophic nonunion?

<p>False joint formation (A)</p> Signup and view all the answers

Which term best describes septic nonunion?

<p>Excessive callus formation (D)</p> Signup and view all the answers

What is a key feature of pseudoarthrosis?

<p>Inadequate bone healing (B)</p> Signup and view all the answers

Which type of nonunion presents with incomplete callus formation?

<p>Atrophic (D)</p> Signup and view all the answers

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