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B

ernardo

WM

et

al

.

4

R

ev

A

ssoc

M

ed

B

ras

2015; 61(1):3-4

F

elipe

-S

ilva

A

U

pdate

on

femoral

neck

fracture

in

children

:

treatment

and

complications

ACCREDITATION

Update on femoral neck fracture in children: treatment and

complications

B

ernardo

WM, A

kkari

M, S

antili

C, A

kel

E, A

ngelim

R

http://dx.doi.org/10.1590/1806-9282.61.01.004

1. Most relevant risk factors for the development of

avascular necrosis after femoral neck fractures do

NOT include:

a.

Type of fracture.

b.

Occurrence of deviation.

c.

Gender and race.

d.

Quality of reduction.

2. Surgical or conservative treatment?

a.

Closed reduction is recommended.

b.

Fracture surgical fixation is recommended.

c.

Immobilization is sufficient.

d.

Reduction, immobilization and late surgery.

3. What kind of reduction (open or closed) is most

appropriate in this type of fracture?

a.

Closed treatment is the rule.

b.

Always closed reduction.

c.

Always open reduction.

d.

Anatomical reduction (closed or open).

4. Does early hip decompression reduce the risk of

avascular necrosis (AVN)?

a.

Decompression of the early hematoma reduces the

risk of AVN.

b.

This does not interfere with the rate of AVN.

c.

Decompression must be delayed to avoid infection.

d.

It depends on the success of the closed reduction.

5. What is the maximum time between the accident

and early therapeutic approach to minimize the

most common complications?

a.

The first 12 hours.

b.

The first 24 hours.

c.

The first 48 hours.

d.

The first 72 hours.

A

nswers

to

clinical

scenario

:

degenerative

spondylolisthesis

:

surgical

treatment

[P

ublished

in

2014; 60(6)]

1. Is the use of bone substitutes such as BMP (bone

morphogenetic protein) safe and effective in lum-

bosacral arthrodesis?

Complications include osteolysis and heterotopic os-

sification. (Alternative

B

)

2. Bone substitutes are equal or superior to auto-

grafts in this situation?

The association of local bone graft (from the poste-

rior vertebral elements) and beta-tricalcium phospha-

te is a therapeutic option. (Alternative

C

)

3. What is the most appropriate diagnostic study in

this clinical context?

The most appropriate diagnostic test in this situa-

tion is plain radiography. (Alternative

D

)

4. Is it necessary to refer the patient to arthrodesis

with use of rigid pedicle screws (non-dynamic)?

Instrumented fusion produces less progression and

improved walking ability. (Alternative

B

)

5. For how long should non-surgical treatment be

conducted?

After 12 weeks of failure in conservative treatment.

(Alternative

C

)