Page 57SA Orthop J 2022;21(1)

CPD QUESTIONNAIRE. MARCH 2022 VOL 21 NO 1

Evaluating the design modifications of an intramedullary 
forearm nail system: a cadaver study (Pretorius HS,  
Burger MC, Ferreira N) 
1. Maintaining length in a comminuted forearm fracture with 

an intramedullary nail is problematic with conventional 
nails because:

a. The nails are not of a sufficient diameter A
b. The nails do not have non-driving end locking B
c. The nails have poor modulus of elasticity C
d. The nail’s entry reamer is too large D
e. The nail’s radius of curvature is not equal to the native 

forearm E

2. Iatrogenic radial nerve injuries are common with proximal 
radius locking and have been reported in up to 11% of 
cases. The reason for this is:

a. The proximity of the nerve to the radial neck in the  
pronator muscle A

b. The reports are only for sensory branches of the nerve B
c. The proximity of the nerve to the radial neck in the 

brachialis muscle C

d. The proximity of the nerve to the radial neck in the 
supinator muscle D

e. The proximity of the nerve to the radial neck anteriorly E
3. Radiation exposure for intramedullary locking is always 

a concern for surgeons. The radiation exposure in the 
study is lower than other reported studies and attributed 
to:

a. Poor reporting by other authors A
b. Surgeon experience only B
c. Design modifications only C
d. Surgeon experience and locking hole design D
e. Poor radiographer measurements in studies E
A retrospective file audit of preoperative anaemia in patients 
referred to an anaesthesiology clinic before elective 
orthopaedic surgery (Van Marle A, Acho P-M, Chepape CO, 
Mahlaba RM, Dlamini P, Magugu S, Mahlohla KK, Teis N, 
Kachelhoffer AM, Joubert G, Coetzee MJ)
4. Preoperative anaemia has been associated with:
a. Increased risk of postoperative mortality A
b. Prolonged hospital stay B
c. Admission to critical care units C
d. Increased rate of blood transfusions D
e. All of the above E
5. The recommended cut-off value for preoperative anaemia:
a. Depends on the patient’s age and underlying comorbidities A
b. Is 12 g/dL for women and 13 g/dL for men B
c. Should be adjusted according to the height above sea-level C
d. Is 13 g/dL in both sexes D
e. Is 12 g/dL in both sexes E

Orthopaedic surgical training exposure at a South African 
academic hospital – is the experience diverse and in depth? 
(Dunn C, Held M, Laubscher M, Nortje M, Roche S, Dunn R)
6. With the overwhelming trauma load in South Africa, the 

orthopaedic registrars’ exposure to elective and trauma 
cases was:

a. Very low A
b. Low B
c. Similar C
d. More D
e. Much more E
7. At our training hospital, the number of orthopaedic cases 

performed after hours was around:
a. 10% A
b. 20% B
c. 30% C
d. 40% D
e. 50% E
8. Which sub-discipline contributed the most elective 

cases?
a. Upper limb A
b. Lower limb B
c. Hands C
d. Paediatrics D
e. Spine E
Not strong enough? Movements generated during clinical 
examination of sagittal and rotational laxity in a cadaver 
knee (Le Roux JA, Bezuidenhout CW, Klopper J, Hobbs H,  
Von Bormann R, Held M)
9. The anterolateral structures of the knee were originally 

described by:
a. Freddie Fu A
b. Paul Segond B
c. David Dejour C
d. Robert LaPrade D
e. Mininder Kocher E

10. The most reliable test to clinically assess for an 
anterolateral ligament (ALL) injury is:

a. Anterior drawer test A
b. Posterior drawer test B
c. Pivot-shift manoeuvre C
d. Internal rotation of tibia in relation to the femur D
e. No clinical test has been validated to reliably test for an 

ALL injury E

ORTHOPAEDIC
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Page 58 SA Orthop J 2022;21(1)

11. Clinical factors to consider when deciding to reconstruct 
the ALL ligament are:

a. Age A
b. High grade meniscal tear B
c. Hypermobility C
d. Poor patient compliance D
e. All of the above E
The Fassier technique for correction of proximal femoral 
deformity in children with osteogenesis imperfecta  
(Mwelase SM, Maré PH, Thompson DM, Marais LC)

12. Osteogenesis imperfecta is characterised by abnormal:
a. Type 2 collagen A
b. Type 1 collagen B
c. CFTR protein C
d. Type 4 collagen D
e. Elastin E
13. Finidori described a technique to correct coxa vara using:
a. Intramedullary K-wires A
b. Plates B
c. Cast C
d. Telescopic rods D
e. External fixator E
Patient satisfaction following wide awake local anaesthetic 
no tourniquet hand surgery (De Buys BM, Tsama M,  
Aden AA)

14. WALANT hand surgery as described by Lalonde involved 
the following:

a. Patient is sedated, tourniquet used for haemostasis  
and local anaesthetic given for postoperative pain A

b. Selective nerve block given depending on area of  
surgical field B

c. Radial, ulnar and median nerve block at level of  
mid-forearm C

d. Lignocaine/adrenaline mixture injected in a tumescent 
fashion at surgical site D

e. Lignocaine/adrenaline mixture injected directly into radial 
and ulnar digital nerves of finger to be operated on E

15. Lalonde recommends the following drug to be available to 
reverse adrenaline-induced vasoconstriction:

a. Phenylephrine A
b. Phentolamine B
c. Nitroglycerine C
d. Propofol D
e. Magnesium sulphate E
Transarticular gunshot injuries: a systematic review of  
150 years of management (Ferreira N, Anley C, Joubert E)

16. What is the antibiotic of choice for transarticular gunshot 
injuries according to the included literature?

a. Penicillin A
b. Gentamycin B
c. First-generation cephalosporin C
d. Second-generation cephalosporin D
e. Third-generation cephalosporin E

17. What is the most common long-term complication 
following retained intra-articular bullets and bullet 
fragments?

a. Avascular necrosis A
b. Post-traumatic osteoarthritis B
c. Chronic osteomyelitis C
d. Lead arthropathy D
e. Systemic lead toxicity (plumbism) E

18. The highest infective complications were seen following 
transarticular gunshot injuries to which joint?

a. Elbow A
b. Hip B
c. Knee C
d. Shoulder D
e. Wrist E
A rare occurrence of ganglion cysts on the posterolateral 
aspect of the elbow without neurological manifestations:  
a case series and review of the literature (Meier W, Tsama M, 
Aden AA)

19. All of the following conditions can present with pain on  
the lateral aspect of the elbow with an associated 
paraesthesia except:

a. C6-7 cervical radiculopathy A
b. Shingles B
c. Tennis elbow C
d. Anterolateral elbow ganglion D
e. Lateral antebrachial cutaneous neuropathy E

20. Ganglion cysts occur commonly around the wrist and 
hand. They are rare around the elbow, but when they  
do occur, the most frequent presentation is:

a. Asymptomatic, slowly growing mass on the lateral aspect 
of the elbow A

b. Vague anterolateral elbow pain with numbness/
paraesthesia on the dorso-radial aspect of the hand B

c. Vague anterolateral elbow pain with numbness/
paraesthesia on the dorso-radial aspect of the hand and 
difficulty extending the fingers and thumb, and weak radial 
deviation when asked to extend the wrist

C

d. Vague anterolateral elbow pain with difficulty extending the 
fingers and thumb, and weak radial deviation when asked 
to extend the wrist

D

e. Mass on the medial aspect of the elbow with clawing of the 
little and ring fingers and numbness of the ulnar one and  
a half fingers

E

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