Page 236 SA Orthop J 2022;21(4)

CPD QUESTIONNAIRE. NOVEMBER 2022 VOL 21 NO 4
Access gate-related lower limb fractures in children and 
adolescents: a review of injury patterns and evaluation of 
associated injuries (Phala MP, Rachuene PA, Socutshana B, 
Bila KS)
1. Which of the following statements is correct relative to 

access gate-related injuries in South Africa?
a. Motorised gates account for the majority of the injuries A
b. Injuries are equally observed in both motorised and manually 

operated gates B

c. Gate falling onto the child is the most common mechanism of 
injury C

d. A and C are correct D
e. All of the above statements are correct E
2. Which of the following statements correctly describes 

fracture distribution in victims of access gate injuries?
a. Femur fractures are commoner than the other lower limb 

fractures A

b. Tibia fractures are commoner than the other lower limb 
fractures B

c. Both the femur and the tibia are equally affected C
d. The majority of the cases will present with multiple fractures D
e. Physeal injuries were observed to be occurring around the 

knee joint in this cohort E

3. Which of the following statements correctly describes injury 
patterns in victims of access gate injuries?

a. Compound fractures were the most commonly found fracture 
patterns in these patients A

b. The majority of the patients have associated head injury B
c. Head injuries were commonly seen in patients with open tibia 

fractures C

d. Head injuries were commonly seen in patients with femur 
fractures D

e. Open fractures more commonly involved the ankle joint E
An audit on the accuracy of freehand acetabular cup 
positioning in total hip arthroplasty with the direct lateral 
approach at a tertiary institution over seven years  
(Erasmus RD, Fourie PJ, Janse van Rensburg C,  
Jacobs HW)
4. What was the initial safe zone described by Lewinnek for 

acetabular cup placement?
a. 20° ± 10° anteversion and 40° ± 10° inclination A
b. 15° ± 10° anteversion and 30° ± 10° inclination B
c. 15° ± 5° anteversion and 40° ± 10° inclination C
d. 15° ± 10° anteversion and 40° ± 10° inclination D
e. 20° ± 10° anteversion and 30° ± 10° inclination E
5. What was our freehand cup placement accuracy?
a. 37% A
b. 47% B
c. 57% C
d. 67% D
e. 77% E
6. What was our dislocation rate?
a. 5% A
b. 4% B

c. 3% C
d. 2% D
e. 1% E
A retrospective comparative study of complications 
after total knee replacement in rheumatoid arthritis and 
osteoarthritis patients (Nansook A, Ryan P)
7. What is the overall complication rate in this article?
a. 15% A
b. 7% B
c. 3% C
d. 40% D
e. 26% E
8. Which of the following statements is true?
a. The study showed a higher complication rate in the 

rheumatoid arthritis subgroup A

b. There was a statistical significance in complication rates 
between the groups B

c. HIV did not increase the overall risk of complications C
d. Most patients were male (87%) D
e. No complications occurred in the osteoarthritis subgroup E
9. A local study by Hodkinson et al. showed that:
a. Despite appropriate treatment, a large proportion of RA 

patients still develop significant functional impairment A

b. HIV is the leading cause of postoperative complications B
c. RA patients have low functional impairment C
d. Only a small portion of patients develop complications post 

TKA D

e. DVT is the most common complication E
Retrospective audit of serum vitamin D levels in patients 
who underwent Latarjet procedure for anterior shoulder 
instability (Rachuene AP, Dey R, De Villiers S, Berry K, 
Mulder M, Du Plessis J-P, Roche S)

10. With reference to vitamin D deficiency in young patients, 
which of the following statements is correct?

a. Vitamin D deficiency in the young South African population is 
reported to be uncommon in the literature A

b. Vitamin D deficiency only affects elderly patients and children 
with rickets B

c. Vitamin D deficiency is reported to affect over 15% of South 
African children C

d. People with dark skin pigment have increased vitamin D 
synthesis, and hypovitaminosis D is uncommon in this 
population group

D

e. All of the above statements are correct E
11. Which of the following statements is correct regarding 

Latarjet procedure?
a. Latarjet procedure is a successful procedure with minimal to no 

risk of complications A

b. Coracoid bone block has blood supply from the conjoint tendon, 
therefore non-union and resorption are not a concern B

c. CT scan-based studies report over 90% bone block resorption 
rate following this procedure, with minimal clinical impact C

d. CT scan-based studies report under 10% bone block 
resorption rate following this procedure, with great clinical 
impact

D

e. Bone block will invariably cause recurrent instability E

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Page 238 SA Orthop J 2022;21(4)

12. Regarding hypovitaminosis D in patients undergoing 
Latarjet procedure for anterior shoulder instability, which of 
the following statements is correct?

a. In the study, hypovitaminosis D was directly correlated to poor 
bone block union rate A

b. Hypovitaminosis D is common in young patients undergoing 
Latarjet procedure and supplementation should be considered 
in these patients

B

c. Hypovitaminosis D was shown to be associated with 
increased risk of bone block fracture C

d. Vitamin D has no impact on bone healing; therefore, it should 
not be considered in patients undergoing Latarjet procedure D

e. The study found hypovitaminosis D to affect only female 
patients E

The burden of road traffic accident-related trauma to 
orthopaedic healthcare and resource utilisation at a  
South African tertiary hospital: a cost analysis study 
(Thikhathali ND, Ngcelwane MV)

13. Which statement is true with regard to road traffic accidents 
(RTAs) in South Africa?

a. The most common cause of trauma in South Africa is road 
traffic accident followed by interpersonal violence A

b. RTAs cause less trauma in South Africa than interpersonal 
violence B

c. The majority of RTA trauma patients have polytrauma C
d. B and C only D
e. A, B and C E

14. Regarding the burden of trauma for our institution:
a. The management of trauma patients does not influence the 

management of the non-trauma elective patients A

b. The biggest cost driver in this study was hospital stay B
c. Management of acute fractures with external fixators does not 

have a significant impact on the overall costs of implants C

d. External fixators were the most utilised implants accounting 
for 40% of the implants utilised in this study D

e. The average number of days spent in hospital for these 
patients was 18 days per patient admitted E

15. Choose the correct statement from the options below:
a. The causes of RTA-related injuries are preventable, as putting 

preventative measures in place as well as applying punitive 
measures for the offenders will help minimise the RTAs

A

b. The number of mortalities from RTAs is only reflected by the 
number of in-hospital mortalities B

c. In comparison to previous studies done in Africa, the 
commonest mode of RTA-related injuries for this study was 
pedestrian-vehicle accident

C

d. A and C only D
e. A, B and C E
The mechanical testing of a novel interlocking forearm nail 
(Pretorius HS, Burger MC, Ferreira N)

16. The nail produced in the article is made from titanium 
because of its low modulus of elasticity close to that of the 
radius. What is the modulus of elasticity
of the radius?

a. 90–100 GPa A
b. 67–87 GPa B
c. 10–17 GPa C
d. 10–28 GPa D
e. 34–53 GPa E

17. Which standardised tests are performed on the radius to 
evaluate the nail for strength and durability?

a. Four-point torsion test, static rotational test and bending test A
b. Four-point rotational test, static rotational test and bending 

test B

c. Four-point bending test, static rotational test and rotational 
fatigue test C

d. Four-point bending test, static rotational test and four-point 
fatigue test D

e. Four-point rotational test, static rotational test and bending 
fatigue test E

18. The use of a semi-logarithmic graph is used in testing for 
what reason?

a. It is the only way to predict outcome in testing with these 
variables A

b. It is the best way to represent graphs with vastly different X 
and Y values B

c. It is the best way to represent X and Y values with equivalent 
values C

d. It is the only way to represent X and Y values with equivalent 
values D

e. It is the best way to represent X and Y values with extremely 
large values E

Truth or DAIR? A review of debridement, antibiotics and 
implant retention (Blair NR, Van der Merwe JF, Matshidza S)

19. A 72-year-old female underwent left total knee arthroplasty 
(TKA) 9 months ago. She now has new onset pain, with 
decreased range of motion. PJI is suspected. Based on the 
on the Musculoskeletal Infection Society (MSIS), which of 
the following, if present, can be used in isolation for the 
diagnosis of an infected TKA? 

a. Elevated synovial WBC count and PMNs A
b. CRP of 55 mg/l B
c. Sinus tract communicating with the prosthesis C
d. Purulence in the knee joint D
e. ESR of 60 mm/h E

20. In reference to debridement, antibiotics and implant retention 
(DAIR), which of the following statements is incorrect?

a. Irrigation with normal saline with or without the addition of an 
antiseptic solution is strongly recommended A

b. DAIR can be performed in patients with a previous mega-
prosthesis B

c. The causative organism does not play a role in DAIR success 
rates C

d. DAIR performed for PJI after fracture arthroplasty shows an 
increased risk for failure compared to PJI after primary joint 
arthroplasty

D

e. Exchange of mobile components is an independent factor 
related to DAIR success E

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