¿Puedes responder correctamente a esta pregunta diaria de nuestro Free QBank? …

by | 21 de Oct, 2022 | 10 comments

Can you answer this daily question from our Free QBank correctly?

A 32-year-old female is transported to your institution’s emergency department after being involved in a motor vehicle collision. You are consulted after initial imaging shows the injury in Figures A and B. After your examination you conclude this to be an isolated injury and there is no neuromuscular compromise of the limb. Further imaging of the injury is shown in Figures C and D. What is the most appropriate management of this injury?

1. Arm sling for 1-2 weeks followed by graduated advancement of range of motion

2. Figure-of-Eight sling for 1-2 weeks followed by graduated advancement of range of motion

3. Open reduction internal fixation of only the scapula utilizing deltopectoral approach

4. Open reduction internal fixation of only the scapula only utilizing the extensile Judet approach

5. Open reduction internal fixation of the scapula and clavicle

QID: 214001
**The answer will be posted in 24 hours.
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¿Puedes responder correctamente a esta pregunta diaria de nuestro Free QBank? Una mujer de 32 años es transportada al departamento de emergencias de su institución después de estar involucrada en una colisión de vehículos motorizados. Se le consulta después de que las imágenes iniciales muestran la lesión en las Figuras A y B. Después de su examen, concluye que se trata de una lesión aislada y que no hay compromiso neuromuscular de la extremidad. En las Figuras C y D se muestran imágenes adicionales de la lesión. ¿Cuál es el tratamiento más apropiado para esta lesión? 1. Cabestrillo para el brazo durante 1 a 2 semanas seguido de un avance gradual del rango de movimiento 2. Cabestrillo en forma de ocho durante 1 a 2 semanas seguido de un avance gradual del rango de movimiento 3. Fijación interna de reducción abierta de solo la escápula utilizando deltopectoral abordaje 4. Fijación interna de reducción abierta de solo la escápula utilizando únicamente el abordaje extensible de Judet 5. Fijación interna de reducción abierta de la escápula y la clavícula QID: 214001 **La respuesta se publicará en 24 horas. #orto #cirugíaortopédica #ortopedia #cirujanoortopédico #ortopedia #ortopedia #ortopedia #ortholife #orthobullets #orthresidents #orthresident #orthresidency #medicalschool #medicalstudent #medstudent #doctor #medical

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10 Comments

  1. Tri.

    5

    Reply
  2. Orthobullets

    The preferred response is:

    5. Open reduction internal fixation of the scapula and clavicle

    The imaging shows a displaced extra-articular scapula fracture and comminuted clavicle fracture, creating an unstable shoulder girdle which requires fixation of both fractures.

    Scapula fractures have traditionally been treated with benign neglect given the shoulder’s great capacity for compensatory motion despite malunion. Not until recently have surgeons quantified the amount of disability displaced scapula fractures can cause and begun surgically treating these. Despite this, few high-level studies exist that delineate criteria for surgical stabilization. The few consensus indications that exist for extra-articular fractures include medial displacement over 2cm, flexion-extension angulation over 45 degrees, and glenopolar angle less than 22 degrees. Additionally, double disruptions in the superior shoulder suspensory complex (as in this case) create an unstable shoulder girdle and warrant fixation.

    Click the linkin,bio for a full question explanation, supporting articles, and free premium videos related to this question.

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