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/10.1590/1806-9282.61.01.0041. 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
)