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Q1: Scaphoid Fracture (3 min)
"How do you manage a suspected scaphoid fracture?"
- Snuffbox tenderness + normal X-ray → immobilise in scaphoid cast, repeat X-ray at 10-14 days OR MRI
- MRI is gold standard for occult fracture
- Waist fracture: 6 weeks in cast
- Proximal pole: 3 months, highest AVN risk (retrograde blood supply)
Q2: Open Fracture Management (3 min)
"How do you manage an open fracture?"
- IV antibiotics within 1 hour (flucloxacillin + gentamicin)
- Tetanus prophylaxis
- Saline dressing + photograph
- Splint
- Debridement within 24 hours (golden period)
- Stabilisation: external fixator or ORIF (grade dependent)
- Gustilo-Anderson classification guides management
Q3: Femoral Neck Fracture (3 min)
"Describe the management of a displaced NOF fracture."
- Garden classification (I-IV)
- Displaced (III-IV): hemiarthroplasty or THR (not internal fixation)
- Undisplaced (I-II): cannulated screws or DHS
- Surgery within 36 hours
- VTE prophylaxis, osteoporosis treatment, orthogeriatric MDT
Q4: Supracondylar Fracture (2 min)
"What are the complications of supracondylar fracture of the humerus?"
- Volkmann's ischaemic contracture (brachial artery injury)
- Median nerve injury
- Cubitus varus (gunstock deformity) — malunion
- Check radial pulse pre- and post-reduction
- Pink, warm hand without pulse → reduce first; white, cold hand → vascular exploration