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

� � � � � � 
 � � 
 
 
 	 � �

 T
H
E
 
S
O

U
T

H
 
A

F
R
IC

A

N
 O

R T H O PA

E
D
IC

 
A

S
S
O

C
IA

T
IO

N

E N OX A P A R I N  S O D I U M

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.

SCRIPT BY NAME, EXPECT THE SAME1-3

Bioequivalence, approved indications and dosing that match the reference medication1,3,5-8

Brought to you by Sandoz, a global leader in high-quality generics and biosimilars9

An affordable option with a proven real-world track record1,4-7

Noxfibra®, the 1st enoxaparin sodium biosimilar to market, is indicated for the prevention and 
treatment of VTE1,4

9713 Sandoz Noxfibra Refresh KV.indd   19713 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

Subscribers and other recipients of SAOJ visit our new CPD portal at  
www.mpconsulting.co.za
• Register with your email address as username and MP number with seven 

digits as your password and then click on the icon “Journal CPD”. 
• Scroll down until you get the correct journal. On the right hand side is an  

option “ACCESS”. This will allow you to answer the questions. If you still can 
not access please send your Name and MP number to cpd@medpharm.
co.za in order to gain access to the questions.

• Once you click on this icon, there is an option below the title of the journal: 
Click to read this issue online.

• Complete the questionnaire and click on submit.
• Your points are automatically submitted to the relevant authority.
• Please call MPC Helpdesk if you have any questions: 0861 111 335.  

Medical Practice Consulting: 
Client Support Center:  

+27121117001 
Office – Switchboard:  

+27121117000
MDB015/069/01/2023