Fracture management (closed, open and pathological)

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QUESTION 1 OF 2

49.A 70-year-old lady presents with an acute worsening of right thigh pain, which started 6 weeks ago. She has been taking Alendronic acid for the last 12 years since sustaining a wrist fracture. She is also taking Ramipril for hypertension and otherwise in good health. There is no clear history of injury or fall leading to the presentation. X-ray of right femur shows a transverse fracture of proximal femur.
Which of the following statements is true regarding this fracture?

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QUESTION ID: 2262

1. Assessment of Calcium and vitamin D levels is not necessary for management
2. Discontinuing bisphosphonates does not reduce the risk of contralateral femur fracture
3. High turnover of the bone is the cause of atypical fracture of femur
4. Plate fixation is preferred in comparison to intramedullary nail for fracture stabilisation
5. Teriparatide (recombinant PTH), is useful in medical management of atypical femoral fractures
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QUESTION 2 OF 2

59.A 60-year-old lady with a known diagnosis of metastatic breast cancer presents with a lesion in the subtrochanteric region of the proximal femur. She has pain on weight bearing. On plain radiographs, the lesion has a mixed lytic and blastic appearance and takes up more than a third of the width of the bone.
Which of the following statements is true?

QUESTION ID: 2269

1. According to the Mirel scoring system, expected duration of survival is important for fracture risk
2. According to the Mirel scoring system, the risk of fracture is low for this patient
3. Endoprosthetic replacement has no role in the treatment of a femoral metastasis.
4. Load sharing devices are ideal for the fixation of pathological fractures
5. Mechanical pain on weight bearing is an important predictor of the risk of fracture
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