ABOS Part I Comprehensive Review - Batch 37

Question 1

A 78-year-old female with a history of bilateral total hip arthroplasty and osteoporosis presents after a low-energy torsional injury. Initial radiographs, similar to the one shown, reveal a comminuted, spiral fracture of the right femoral shaft exte

Accepted Answer

Vancouver Type B1

Question 2

A 65-year-old male with a history of cemented total hip arthroplasty presents with a periprosthetic femoral fracture. The fracture is located at the distal tip of the stem, similar to the case described. Which of the following biomechanical factors i

Accepted Answer

The viscoelastic properties of the native bone compared to the rigid metallic stem

Question 3

Following initial radiographs for a suspected Vancouver B1 periprosthetic femoral fracture, a CT scan of the right lower extremity with metal artifact reduction sequence (MARS) is obtained, as shown in Figure 2. What is the most critical additional i

Accepted Answer

Definitive evaluation of the cement mantle and subtle stem subsidence

Question 4

During the surgical exposure of a Vancouver B1 periprosthetic femoral fracture, the surgeon performs an extensile direct lateral approach. After incising the fascia lata, the vastus lateralis is identified. To preserve the primary periosteal blood su

Accepted Answer

Elevate the vastus lateralis anteriorly off the lateral intermuscular septum, carefully ligating perforating vessels.

Question 5

During the surgical procedure for the Vancouver B1 periprosthetic femoral fracture, after exposing the fracture site, the surgeon performs a critical intraoperative assessment. What is this assessment, and what is its immediate implication if a posit

Accepted Answer

Manual 'push-pull' test of the prosthesis; if motion is detected, the diagnosis changes to Vancouver B2, requiring stem revision.

Question 6

For the Vancouver B1 periprosthetic femoral fracture, a broad, heavy-duty locking compression plate (LCP) is selected. In the proximal segment, where the intramedullary canal is occupied by the existing stem and cement, which of the following fixatio

Accepted Answer

Cerclage cables or wires passed circumferentially around the bone and plate, or specialized unicortical locking screws.

Question 7

To optimize the fixation construct for the Vancouver B1 periprosthetic femoral fracture, the surgeon must ensure the locking plate extends sufficiently. What is the recommended minimum overlap of the plate with the proximal stem to prevent creating a

Accepted Answer

At least two femoral cortical diameters

Question 8

A 78-year-old female, similar to the patient in the case, undergoes surgical fixation for a Vancouver B1 periprosthetic femoral fracture. Postoperatively, she is allowed touch-down weight bearing. What is the primary rationale for allowing immediate,

Accepted Answer

To aid in proprioception and balance while protecting the hardware.

Question 9

Six months after surgical fixation of a Vancouver B1 periprosthetic femoral fracture, a patient presents with progressive pain and radiographic evidence of hardware failure and lack of callus formation. The stem remains well-fixed. What is the most a

Accepted Answer

Revision ORIF with decortication, autologous bone grafting, and potentially dual-plate constructs.

Question 10

The patient in the vignette has a history of osteoporosis and discontinued alendronate therapy. A critical component of her postoperative protocol, beyond surgical fixation, is the reinstitution of metabolic bone management. Which of the following be

Accepted Answer

Consult an endocrinology or metabolic bone specialist to optimize calcium/Vitamin D and initiate appropriate pharmacological therapy.

Orthopaedic Surgery Board Exam Review: ABOS Part I & AAOS OITE Prep Questions | Part 22210

ABOS Part I Orthopaedic Review: Periprosthetic, Subtrochanteric, Pilon Fractures & Management | Part 22203

Key Takeaway