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    Fracture Fixation Principles

    SCREW

    ‣
    What is a screw? What are the types?
    ‣
    What are the components of a screw?
    ‣
    What is the relationship between pitch and lead?
    ‣
    Difference between cortical and cancellous screws?
    ‣
    What is the usual failure mechanism between cortical and cancellous screws?
    ‣
    Why does fatigue failure occur at the neck-shaft junction?
    ‣
    What is the difference between self-tapping and self-drilling screws?
    ‣
    Should self-drilling screws be used unicortically or bicortically?
    ‣
    What are the different uses of screws?
    ‣
    What is countersinking?
    ‣
    How to increase pull-out strength of screws?
    ‣
    What are the lag screw principles?
    ‣
    What size drills for lag screws?
    ‣
    Why do you use a washer? How do you use it?
    ‣
    What are reverse cutting screws?
    ‣
    What is the working length of the screw?
    ‣
    How do interference screws work?
    ‣
    What are bioabsorbable screws? Pros and cons?

    PLATES

    ‣
    Types of Plate configuration?
    ‣
    How to improve fixation in osteoporosis? How does it change?
    ‣
    How does compression plating work?
    ‣
    How much compression is achieved when you use the compression plate?
    ‣
    How do you sequentially compress the plate?
    ‣
    How do you put on a compression plate? [Draw]
    ‣
    How do locking plates differ from compression plates?
    ‣
    Why do you need to prebend the plate?
    ‣
    What is the working length of plates?
    ‣
    Ideal plate density?
    ‣
    Why is ideal plate span width 2-3 x the length for a comminuted fracture?
    ‣
    What kind of plate should you use for humeral shaft, and why?
    ‣
    How does a tension band construct work?

    image
    ‣
    Problems with a short working length in bridge plating?
    ‣
    Can you describe the near-near-far-far principle?

    Dynamic Hip Screw

    ‣
    Explain screw cut out in DHS?

    RIGIDITY

    ‣
    Relative Young's Modulus of materials and tissues vs bone?
    ‣
    What are the types of deforming forces?
    ‣
    In an IM nail, what determines the rigidity?
    ‣
    What determines the bending rigidity?
    ‣
    What determines the torsional rigidity?

    NAILS

    ‣
    What is the working length of a nail?
    ‣
    What does it mean that the nail is load sharing or load bearing?
    ‣
    What is the effect of reaming and blood supply? How long does it take to revascularize?
    ‣
    What are the benefits of reaming?
    ‣
    What are the concerns with reaming and how do you address them?
    ‣
    Why hollow vs Solid rods?
    ‣
    Why hollow vs Solid rods? [Simple Answer]
    ‣
    Why hollow vs Solid rods assuming same amount of material (Wang Ming)
    ‣
    Why closed section nails vs open section (i.e., Slotted) nails?
    ‣
    Circular vs cloverleaf shaped nail (Kuntscher nail)?
    ‣
    How can you describe nails?
    ‣
    How do you reduce hoop stresses when inserting the IM nail? [Why are nails curved?]

    LOCKING BOLTS

    ‣
    How are locking bolts different from other screws?
    ‣
    What are the advantages of locking bolts?
    ‣
    What are potential disadvantages of locking bolts and their holes?
    ‣
    What happens if you place too many bolts in multiple planes?
    ‣
    How can you reduce the risk of locking screw fatigue?
    ‣
    Why shouldn't we simply use the largest possible locking screw?
    ‣
    What forces act on the locking bolt?
    ‣
    Why does the locking bolt need a large core diameter compared to the nail?

    K-WIRES

    ‣
    What are the various designs of K-wire tips?
    ‣
    How to reduce temperature and heat necrosis?
    ‣
    What is the olive tip used for?

    EXTERNAL FIXATION

    ‣
    What kind of Ex fix do you make?
    ‣
    What increases stability of the Ex fix?
    ‣
    Principles of circular frame? What is an ideal "ring block"
    ‣
    Wire principles for circular frame?
    ‣
    How to increase stability for circular ex fix?
    📖

    My son, keep your father's commandment, and forsake not your mother's teaching. Proverbs 6:20

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