Page 110 SA Orthop J 2023;22(2)
CPD QUESTIONNAIRE. MAY 2023 VOL 22 NO 2
Complications of surgically managed pelvic and acetabular fractures (Mbatha ST, Duma MTN, Maqungo S, Marais LC) 1. Which of the following was not a risk factor for
developing complications post pelvic and acetabular fracture fixation?
a. Sustaining a combined pelvic and acetabular fracture A b. A pelvic fracture with an associated sacral fracture B c. A partial articular acetabular fracture C
d. Kocher-Langenbeck approach D
e. Intraoperative blood transfusion E
2. Which injury was more commonly associated with a pelvic and/or acetabular fracture?
a. Traumatic brain injury A
b. Lung contusion B
c. Long bone fracture C
d. AAST grade 3 kidney injury D
e. Bladder contusion E
3. What was the most commonly encountered complication?
a. Early fracture-related infection A
b. Heterotopic ossification B
c. Avascular necrosis C
d. Increased need for postoperative blood transfusion D
e. Metalware failure E
Analysis of orthopaedic injuries in CT pan scans of polytrauma patients at a quaternary academic hospital (Laney W, Naicker D, Milner B, Omar S)
4. What was the most common mechanism of injury in this study?
a. Gunshot wounds A
b. Fall from height B
c. Stab wounds C
d. Road traffic accidents D
e. Assault E
5. What was the most common combination of injury found?
a. Rib fracture and traumatic brain injury A b. Chest injury and pelvic/sacral fracture B
c. Tibia fracture and pelvic fracture C
d. Splenic rupture and femur fracture D
e. Traumatic brain injury and C-spine fracture E 6. Road traffic accidents were significantly associated
with which fractures?
a. C-spine fractures A
b. Metacarpal fractures B
c. Tibial/fibular fractures C
d. Pelvic fractures D
e. Humerus fractures E
The Bridging Infix: a modified, minimally invasive
subcutaneous anterior pelvic fixation technique (Strydom S, Snyckers CH)
7. Which of the following is not an indication for using the Bridging Infix?
a. Patients admitted to intensive care unit (ICU) A
b. Obese patients B
c. Elderly patients with a pelvic fragility fracture C d. Patients with purely ligamentous injuries resulting in pubic
symphysis diastasis D
e. To enhance anterior pelvic ring stability after adequate
posterior fixation was done E
8. Which of the following statements regarding the surgical approach for the Bridging Infix is true?
a. A lateral window is made from the ASIS, extending 4 cm
proximally along the crest A
b. A middle window is made 2 cm inferior to the pubic symphysis B c. Subcutaneous tunnels are made staying deep and parallel to
the inguinal ligament C
d. The subcutaneous tunnel should directly link the two lateral windows, remaining inferior to the umbilicus D e. Dissection in the middle window should be through the rectus
abdominis fascia to allow exposure of the pubic symphysis E 9. Which statement regarding the Bridging Infix construct is
false?
a. Two 4 mm plate-rods and a 6 mm straight rod is used A b. Once the plate-rod has been fixed to the crest, absolutely
no further bending of the construct is allowed B c. The tip of the rod is guided from the lateral to the middle
window with a Kocher forceps C
d. One method to reduce the fracture is by using the distraction or compression instruments before securing the second
rod-rod connector D
e. Posterior injuries must be reduced and stabilised before
anterior fixation is done E
10. Which statement is true?
a. The wounds must be irrigated with povidone (iodine) solution
prior to closure A
b. All patients must remain non-weight-bearing for a period of
six weeks B
c. Physiotherapy (in-bed mobilisation) can be started the same
day as the surgery C
d. A drain is routinely placed in the middle window D e. After fixation, patients must limit hip abduction for six weeks E
Orthopaedic surgical antibiotic prophylaxis administration compliance with prescribing guidelines in a private hospital in the North West province, South Africa (Jordaan M,
Du Plessis J, Rakumakoe D, Mostert L)
11.Surgical antibiotic prophylaxis (SAP) redosing occurred in:
a. All prolonged procedures A
b. One of the three prolonged procedures B
c. Two of the seven prolonged procedures C
d. None of the prolonged procedures D
e. None of the above statements are correct E
ORTHOPAEDIC JOURNAL
S O U T H A F R I C A N
CONTENTS
TH
ESOUTH
AFRI CAN O R T H O PAED I C
A SSOCIATIO
N
ENOXAPARIN SODIUM
VTE, venous thromboembolism
References: 1. Sandoz SA (Pty) Ltd. NOXFIBRA (Solution for injection). Professional information, V1.1 (20/01/2021), approved 25 February 2020. 2. South African Health Products Regulatory Authority. Biosimilar medicines quality, non-clinical and clinical requirements. August 2014. 3. González JM, Monreal M, Almagia IA, Garín JL, et al. Bioequivalence of a biosimilar enoxaparin sodium to Clexane® after single 100 mg subcutaneous dose: results of a randomized, double-blind, crossover study in healthy volunteers. Drug Des Devel Ther. 2018;12:575-582. doi:10.2147/DDDT.S162817. 4. Sandoz SA (Pty) Ltd. Data on file. Pricing data. November 2022. 5. Sandoz SA (Pty) Ltd. Data on file. Global Noxfibra® syringe sales. November 2022. 6. Sandoz SA (Pty) Ltd. Data on file. South African Noxfibra® syringe sales. November 2022. 7. Sandoz SA (Pty) Ltd. Data on file. Updated PSUR reports. November 2022. 8. Sanofi-Aventis South Africa (Pty) Ltd. CLEXANE® (Injection). Professional information, approved 26 October 2012. 9. Our history. Sandoz. Accessed November 8, 2022. https://www.sandoz.com/about-sandoz/our-history.
NOXFIBRA 20 (Solution for injection). Reg. No.: 52/8.2/0495. Composition: Noxfibra 20 pre-filled syringe contains enoxaparin sodium 20 mg/0,2 mℓ (equivalent to 2 000 IU Anti Factor Xa). NOXFIBRA 40 (Solution for injection). Reg. No.:
52/8.2/0496. Composition: Noxfibra 40 pre-filled syringe contains enoxaparin sodium 40 mg/0,4 mℓ (equivalent to 4 000 IU Anti Factor Xa). NOXFIBRA 60 (Solution for injection). Reg. No.: 52/8.2/0497. Composition: Noxfibra 60 pre-filled syringe contains enoxaparin sodium 60 mg/0,6 mℓ (equivalent to 6 000 IU Anti Factor Xa). NOXFIBRA 80 (Solution for injection). Reg. No.: 52/8.2/0498. Noxfibra 80 pre-filled syringe contains enoxaparin sodium 80 mg/0,8 mℓ (equivalent to 8 000 IU Anti Factor Xa). Pharmacological Classification: A8.2 Anticoagulants. For full prescribing information refer to the Sandoz Professional Information approved by the South African Health Products Regulatory Authority (SAHPRA).
Sandoz SA (Pty) Ltd, Reg. No. 1990/001979/07, Magwa Crescent West, Waterfall City, Jukskei View, Midrand, 2090. Tel: +27 (11) 347 6600. SANCAL Customer Call Centre: 0861 726 225. Reporting of AEs: https://www.report.novartis.com SAN.NOXF.2022.11.95
Visit your online Sandoz Portal:
https://my-sandoz.com/za-en/en Connecting. Educating. Enabling.
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9713 Sandoz Noxfibra Refresh KV.indd 1 2022/12/12 10:192022/12/12 10:19
Page 112 SA Orthop J 2023;22(2) 12.The study identified orthopaedic SAP practice burdens in
the following areas:
a. Route of administration, choice of SAP and incorrect dosing A b. SAP overuse, prolonged duration of use and surgical site
infections (SSIs) B
c. SSIs, administration time and incorrect dosing C d. Prolonged duration of use, overuse and incorrect dosing D e. Overuse, unattended dose adjustments and route of
administration E
13. Orthopaedic SAP choice was deemed correct if the following were prescribed:
a. Cefazolin, ceftriaxone or cefuroxime A
b. Vancomycin, clindamycin or teicoplanin B c. Amoxicillin-clavulanic acid or moxifloxacin C
d. Options A and B D
e. Options B and C E
14. SAP guidelines require the following replacement to be used in the presence of penicillin allergy:
a. Cefazolin A
b. Clindamycin B
c. Moxifloxacin C
d. Teicoplanin D
e. None of the above E
Acute haematogenous osteomyelitis in the paediatric population: a current concepts review (Thiart M, Nansook A) 15.Kingella kingae accounts for the majority of acute
haematogenous osteomyelitis (AHOM) cases in which age group?
a. Neonates A
b. Babies under 6 months B
c. Children between 6 months and 5 years C
d. Adolescents D
e. Children between 5 and 10 years of age E 16. Negative cultures are seen in up to 50% of cases in AHOM.
What factors contribute to this?
a. Moderate bacterial load A
b. A Gram-negative organism B
c. Using blood culture bottles C
d. Older children D
e. Difficult surgical approach E
17. The most common clinical feature seen in children with AHOM is?
a. Localised signs/symptoms A
b. Fever B
c. Decreased range of motion C
d. Pain D
e. Inability to bear weight E
18. The empiric antibiotic of choice in infants from birth to under 3 months with a community-acquired infection is:
a. Cloxacillin and first-generation cephalosporin A
b. Vancomycin and linezolid B
c. Linezolid and rifampicin C
d. Co-amoxiclav and rifampicin D
e. Cloxacillin and third-generation cephalosporin E Cutaneous adenoid cystic carcinoma: clinical conundrum of a lower limb mass (Philip S, Kgagudi MP)
19. Adenoid cystic carcinoma (ACC) accounts for what percentage of all salivary gland tumours?
a. 50% A
b. 22% B
c. 10% C
d. 0.7% D
e. 33% E
20.What is the suggested management of primary ACC?
a. Intralesional curettage and cryoablation A
b. Chemotherapy B
c. Neoadjuvant therapy and excision C
d. Wide local excision and radiotherapy D
e. Immunotherapy E
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