INI-CET 2021 - Orthopaedics PYQs Practice Questions

Q: Following a femoral shaft fracture, your consultant asks you to provide tibia traction. Which of the following will you request from the nurse? 1. Thomas splint 2. K-wire 3. Steinmann pin 4. Denham's pin 5. Bohler's stirrup 6. Bohler Braun splint

$3,5,6$. ***3,5,6*** - For **tibia traction** in a femoral shaft fracture, you would need a **Steinmann pin** for skeletal traction, a **Bohler's stirrup** to apply the traction force, and a **Bohler-Braun splint** to support the limb. - The **Steinmann pin** is inserted into the proximal tibia, the **Bohler's stirrup** attaches to the pin, and the **Bohler-Braun splint** provides a fixed structure for the traction system. *1,2,3,4,5,6* - This option incorrectly includes items not specifically used for applying **tibia traction** (e.g., K-wire is for internal fixation, Thomas splint is for early femur fracture management but not specifically for tibia traction application). - While some components might be used in general fracture management, not all are directly involved in setting up tibia traction as requested. *3,4,5* - This option correctly includes the **Steinmann pin** and **Bohler's stirrup** but incorrectly replaces the **Bohler-Braun splint** with a **Denham's pin**. - A **Denham's pin** is an alternative to a Steinmann pin for skeletal traction, but a **Bohler-Braun splint** is crucial for supporting the limb in this setup, which is missing here. *1,2,4* - This option includes a **Thomas splint** (used for femur fracture support, not tibia traction application), a **K-wire** (used for internal fixation, not traction), and a **Denham's pin** (an alternative to Steinmann pin, but lacks the necessary support and traction application equipment). - These items are not suitable for setting up comprehensive **tibia traction** for a femoral shaft fracture. [Practice more Orthopaedics PYQs on OnCourse]

Q: Following a road traffic accident, a patient develops type IIIa compound tibial fracture. Arrange the following external fixators in decreasing order of their stability (highest to lowest) 1. Ilizarov fixator 2. Uniplanar with a single rod 3. Uniplanar with double rod 4. Biplanar frame/Ring with a cylindrical rod

1>4>3>2. ***1>4>3>2*** - **Ilizarov fixator** utilizes multiple wires **under tension** and rings, providing the most **biologically stable** and rigid fixation due to its distributed force across the bone. - **Biplanar frames/Rings with a cylindrical rod** offer high stability by providing pin fixation in **two different planes**, significantly resisting bending and torsional forces. - **Uniplanar with double rod** provides better stability than a single rod by increasing the **moment of inertia** and reducing deflection under axial and bending loads. - **Uniplanar with a single rod** is the least stable due to its limited resistance to **torsional** and **bending forces** as pin placement is restricted to a single plane. [Practice more Orthopaedics PYQs on OnCourse]

Q: If the outer sheath and nerve fibres are intact and the inner axon is damaged, it is known as

Axonotmesis. ***Axonotmesis*** - This type of nerve injury involves damage to the **axon** itself, while the connective tissue layers (**endoneurium, perineurium, epineurium**) remain intact. - While the axon is disrupted, the preservation of the nerve's outer sheath allows for potential, albeit slow, **regeneration** of the axon. *Axonapraxia* - This term is not a standard classification of nerve injury. The correct term for a transient block in nerve conduction is **neurapraxia**. *Neurotmesis* - **Neurotmesis** is the most severe type of nerve injury, involving complete severance of the **axon** and all supporting **connective tissue sheaths**. - This type of injury requires **surgical repair** for any chance of functional recovery. *Neurapraxia* - **Neurapraxia** is the mildest form of nerve injury, characterized by a temporary **conduction block** without axonal damage. - Recovery is typically complete within days to weeks, as the **myelin sheath** may be temporarily dysfunctional but the axon remains intact. [Practice more Orthopaedics PYQs on OnCourse]

Question 1

Following a femoral shaft fracture, your consultant asks you to provide tibia traction. Which of the following will you request from the nurse?

1. Thomas splint
2. K-wire
3. Steinmann pin
4. Denham's pin
5. Bohler's stirrup
6. Bohler Braun splint

Accepted Answer

$3,5,6$

Answer

$1,2,3,4,5,6$

Answer

$3,4,5$

Answer

$1,2,4$

Question 2

Following a road traffic accident, a patient develops type IIIa compound tibial fracture. Arrange the following external fixators in decreasing order of their stability (highest to lowest)

1. Ilizarov fixator
2. Uniplanar with a single rod
3. Uniplanar with double rod
4. Biplanar frame/Ring with a cylindrical rod

Accepted Answer

1>4>3>2

Answer

2>4>3>1

Answer

1>2>3>4

Answer

2>3>1>4

Question 3

If the outer sheath and nerve fibres are intact and the inner axon is damaged, it is known as

Accepted Answer

Axonotmesis

Answer

Axonapraxia

Answer

Neurotmesis

Answer

Neurapraxia

INI-CET 2021 — Orthopaedics