Page 52 SA Orthop J 2023;22(1)

CPD QUESTIONNAIRE. MARCH 2023 VOL 22 NO 1
Low dislocation rate one year after total hip arthroplasty at 
a tertiary hospital in South Africa (Fourie PJ, Erasmus RD, 
Botha T, Jacobs HW)
1. Most dislocations after total hip arthroplasty (THA) occur:
a. Intraoperatively A
b. While the surgical wound is still healing B
c. During the first year C
d. After five years D
e. After ten years E
2. The most common complication after THA surgery is:
a. Periprosthetic fracture A
b. Infection B
c. Dislocation C
d. Aseptic loosening D
e. Metallosis and immune responses E
3. The following factor potentially decreases the risk for post-

THA dislocation:
a. Increasing cup anteversion above 30° A
b. Increasing cup abduction above 60° B
c. Using a femur head size ≥ 32 mm C
d. Alternating surgical approaches to remain rehearsed in all of 

them D

e. Using single mobility implants E
Functional outcome of free fibula grafting in benign  
non-reconstructable bone tumours involving the hand  
(Shah MR, Shah MM, Shah IM)
4. What are the advantages of use of the free fibula graft in 

treatment of benign non-reconstructable bone tumours 
involving the hand?

a. Provides strut support A
b. Relatively easy to procure B
c. Medullary canal helps in fixation C
d. Shape matches with small hand bones D
e. All of the above E
5. Criteria for non-reconstructable hand tumours in the  

article means?
a. Non-contained lesions A
b. Lytic expansile lesions with more than 70% bone destruction B
c. Pathological fractures C
d. Conventional bone grafting is not possible D
e. All of the above E
6. At final biopsy, tumours in the study were 

histopathologically of the following varieties except?
a. Aneurysmal bone cyst A
b. Enchondroma B
c. Benign histiocytic lesion C
d. Chondrosarcoma D
e. Giant cell tumour E

A survey on the educational value of an mHealth referral 
app for orthopaedics in South Africa (Kauta NJ, Owolabi EO, 
Salence B, Swanepoel S, Roche S, Chu KM)
7. One of the key messages from the results of this study is:
a. More than 60% of users felt that orthopaedic referral group 

(ORG) was a good platform to keep up to date with current 
principles of fracture management and for on-the-job 
continuous medical education

A

b. While the platform helps expedite the management of trauma 
cases in community health centres (CHCs), thanks to the 
advice from the specialist team, there is no educational value 
to it

B

c. The platform is not a sustainable mHealth strategy for tele-
mentoring due to a large volume of cases being discussed 
from different CHCs

C

d. Fifty per cent of users felt overburdened with the frequency of 
clinical queries and responses posted on ORG D

e. Most users were dissatisfied with ORG because of massive 
delays in getting responses from the specialist team E

8. ORG users were able to improve their conservative 
management skills for the following injuries:

a. Femur fracture, tibia fracture, hip dislocation A
b. Ankle fractures, distal radius fractures, shoulder dislocations B
c. Ankle fractures, tibia fractures, clavicle fractures C
d. Shoulder dislocation, clavicle fractures, distal radius fractures D
e. Hip dislocation, shoulder dislocation, knee dislocation E
9. When contemplating sharing patients’ information for 

clinical discussion with peers or mentors on social 
platforms, which one of the following ethical statements  
is correct?

a. Patient consent is not needed if the information shared 
informs the patient management plan A

b. Patient consent should be obtained before information is 
shared B

c. The provider has the right to share any patient information C
d. Patient consent is not needed if an encrypted platform is used D
e. Patient consent is not needed if the information shared is de-

identified E

Enhancing healthcare services in an orthopaedic 
department utilising a system dynamics and participatory 
action research perspective to optimise patient flow 
(Ansermeah MMF, Proches CG, Snyders R)

10. In the participatory action research process, which of the 
following is correct:

a. The primary researcher is not considered to be an active 
agent of transformation A

b. The researcher is relegated to being a mere passive observer B
c. This methodological process involves cyclical processes of 

reflection, action and observation C

d. The researcher is not considered to be part of the affected 
community D

e. Participants who are directly affected by the challenges being 
studied are excluded E

ORTHOPAEDIC
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Page 54 SA Orthop J 2023;22(1)

11. Answer true or false: ‘Systems-as-cause’ thinking promotes 
the idea that we have to play an active role in taking 
responsibility for our own actions instead of seeking  
to allocate blame to other sources.

a. True A
b. False B
Factors associated with dissemination and complications  
of acute bone and joint infections in children (Mdingi VS, 
Maré PH, Marais LC)

12. What was the overall rate of chronic osteomyelitis in the 
study?

a. 11% A
b. 31% B
c. 45% C
d. 20% D
e. 5% E

13. Which of the following statements is true?
a. Sixty-five per cent of the children included were female A
b. The median time between onset of symptoms and 

presentation at our institution was two days B

c. Locally advanced disease was defined as adjacent acute 
haematogenous osteomyelitis and septic arthritis C

d. The median age at presentation at our institution was 4 years D
e. Four patients met the Pediatric Sepsis Consensus Conference 

(PSCC) criteria for septic shock E

14. What was the culture-negative rate in our study?
a. 30% A
b. 4% B
c. 50% C
d. 15% D
e. 25% E
Intertrochanteric femur fractures: a current concepts review 
(Sukati FM, Viljoen J, Alexander A)

15. When assessing the reduction quality for intertrochanteric 
femur fractures, which of the following is the best 
reduction?

a. Central axial alignment and a native neck shaft angle A
b. Central axial alignment with smooth anterior cortex contact B
c. A neutral medial cortical apposition and a native neck shaft 

angle C

d. Slight valgus neck shaft angle and positive medial cortical 
apposition D

e. Slight anterior neck on lateral view and a neutral medial 
cortical apposition E

16. Which of the following is not true with regard to the bony 
arcade in the intertrochanteric region?

a. The vertical column originates in the lower lateral femoral 
neck A

b. The vertical column conveys compression forces B
c. The horizontal column originates in the femoral shaft C
d. The horizontal column conveys tension forces D
e. The calcar is situated posterior to the neutral axis of the 

femoral neck E

17. Cephalomedullary nails (CMNs) are commonly used to 
fix intertrochanteric fractures. Which of the following 
statements is true when comparing CMN treatment options?

a. Fractures fixed with long nails show greater torsional stiffness 
than with short nails A

b. Distal locked short CMNs have a higher mean failure to load 
in torsion than unlocked short CMNs B

c. Thigh pain is less common in patients with distally locked than 
unlocked CMNs C

d. Biaxial CMN has lower cut-out rates compared to monoaxial 
CMN D

e. Patients treated with CMN have better mobility at four months 
than those treated with dynamic hip screw (DHS) E

18. Arthroplasty has some benefits over internal fixation, except: 
a. Early postoperative weight bearing A
b. Shorter hospital stay B
c. Lower implant-related complications C
d. Lower re-operation rate D
e. Lower blood loss E
A subungual glomus tumour of the finger with five 
reappearances: a rare case report (Nkosi CS, Sefeane TI)

19. Which of the following does not fit into the classic triad of 
glomus tumour symptoms?

a. Paroxysmal pain A
b. Cold intolerance B
c. Exquisite tenderness to touch C
d. Infection D
e. All of the above E

20. A 65-year-old female presents with 6 months of worsening 
pain in her middle finger. She had previous surgical excisions 
with positive histology results for glomus tumours from the 
same finger. What is the most likely diagnosis?

a. Infection A
b. Recurrent glomus tumour B
c. Fracture C
d. Malinger D
e. Osteoarthritis E

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