Remediation:
A. De Giacomo et al. found that malalignment and malunion were both low (2% and 3%, respectively) when distal third of the tibia fractures were fixed without associated fibular fixation.
B-D. Same as A

Remediation:
A. Radiographs reveal an anterior tibial transverse stress fracture with the “dreaded black line” and anterior bowing centered proximal to the fracture. The initial treatment in this patient should consist of limited weightbearing to the involved extremity and close follow-up.
B. Segmental osteotomies may be an appropriate treatment should the patient have refractory pain and radiographic findings. With a diagnosis of tibial pseudarthrosis in a patient with osteogenesis imperfecta, operative planning should incorporate deformity correction, a load-sharing implant, and consideration of biologic supplementation in the form of autograft cancellous bone or osteoinductive commercial grafts.
C. With anterior bowing, insertion of a rigid tibial rod may result in breaching of the anterior diaphyseal cortex. Additionally, there is marked cortical thickening and a relatively narrow intramedullary canal (7 mm at the isthmus) that may make reaming with a flexible device technically difficult.
D. Comprehensive orthopaedic care for adults with skeletal dysplasias remains a challenge. The patient's care should be reviewed by the multidisciplinary team, and a treatment plan should be agreed upon. Referral to a pediatric orthopaedist is not necessary.

Remediation:
A. This patient sustained a gunshot wound to the spine, resulting in a complete spinal cord injury. Penetrating trauma to the flank and the abdomen is associated with concomitant injury to the abdominal viscera, with rates as high as 90%.
B. Same as A
C. Same as A
D. This patient sustained a gunshot wound to the spine, resulting in a complete spinal cord injury. Penetrating trauma to the flank and the abdomen is associated with concomitant injury to the abdominal viscera, with rates as high as 90%. During the advanced trauma life support (ATLS) survey, the provider must be vigilant for an acute surgical abdomen, which is characterized by abdominal guarding and rebound tenderness.

Remediation:
A. Diabetes mellitus has not been shown to be a risk factor for the development of a nerve-related complication after elbow arthroscopy. It is a risk factor for infection after elbow arthroscopy.
B. Rheumatoid arthritis and contracture are the two most common risk factors for a nerve-related complication after elbow arthroscopy.
C. Posttraumatic arthritis of the elbow is not a major risk factor for development of a nerve-related complication after elbow arthroscopy. The main risk factors are rheumatoid arthritis and elbow contracture.
D. Same as C

Remediation:
A. The clinical scenario describes a patient with short trunk dwarfism and a waddling gait, with lumbar lordosis related to hip flexion contractures. Spine radiographs demonstrate platyspondyly. The pelvic radiograph demonstrates bilateral coxa vara with delayed epiphyseal ossification and a concern for hip dislocation. The clinical picture suggests spondyloepiphyseal dysplasia congenita, and the genetic defect involves the COL2A1 gene on chromosome 12.
B. The clinical scenario describes a patient with short trunk dwarfism and a waddling gait, with lumbar lordosis related to hip flexion contractures. Spine radiographs demonstrate platyspondyly. The pelvic radiograph demonstrates bilateral coxa vara with delayed epiphyseal ossification and a concern for hip dislocation. The clinical picture suggests spondyloepiphyseal dysplasia congenita, and the genetic defect involves the COL2A1 gene on chromosome 12. The FGFR-3 gene is associated with achondroplasia, a disproportionate dwarfism with relatively normal trunk height.
C. The clinical scenario describes a patient with short trunk dwarfism and a waddling gait, with lumbar lordosis related to hip flexion contractures. Spine radiographs demonstrate platyspondyly. The pelvic radiograph demonstrates bilateral coxa vara with delayed epiphyseal ossification and a concern for hip dislocation. The clinical picture suggests spondyloepiphyseal dysplasia congenita, and the genetic defect involves the COL2A1 gene on chromosome 12. The COL1A1 gene is associated with osteogenesis imperfecta, a brittle-bone skeletal dysplasia characterized by multiple fractures and long bone deformities.
D. The clinical scenario describes a patient with short trunk dwarfism and a waddling gait, with lumbar lordosis related to hip flexion contractures. Spine radiographs demonstrate platyspondyly. The pelvic radiograph demonstrates bilateral coxa vara with delayed epiphyseal ossification and a concern for hip dislocation. The clinical picture suggests spondyloepiphyseal dysplasia congenita, and the genetic defect involves the COL2A1 gene on chromosome 12. The PMP-22 gene is associated with Charcot-Marie-Tooth disease, a common hereditary peripheral neuropathy that does not result in short stature.

Remediation:
A. Sedentary mice with Kif3a mutations show normal bone mineral density.
B. Same as A
C. Kif3a knockout studies impede cilia formation in osteocytes and result in bone having a reduced anabolic response to mechanical loading.
D. Mice with conditional bone-specific Kif3a mutations are viable.

Remediation:
A. There is a significant humpback deformity seen on the sagittal cut of the computed tomography scan. The humpback deformity is more readily corrected via a volar approach.
B. Compression screw fixation has been shown to have superior union rates, time to union, and return to activity compared with K-wire fixation in the treatment of scaphoid nonunions.
C. Reported union rates for vascularized bone grafts for scaphoid nonunion range from 27% to 100%, but comparative studies are lacking.
D. There is controversy over use of vascularized versus nonvascularized bone grafts for the treatment of scaphoid nonunions. No clear difference has been shown, but there have not been Level I comparative studies.

Remediation:
A. As Astion and colleagues noted in their frequently cited biomechanical investigation, the talonavicular joint is the "key" to the triple joint complex of the hindfoot. The talonavicular joint has the greatest range of motion, and simulated arthrodesis essentially eliminated motion of the other hindfoot joints.
B. As Astion and colleagues noted in their frequently cited biomechanical investigation, the talonavicular joint is the "key" to the triple joint complex of the hindfoot. The talonavicular joint has the greatest range of motion, and simulated arthrodesis essentially eliminated motion of the other hindfoot joints.
C. The subtalar joint has the second-most amount of motion of the hindfoot joints.
D. The 1st tarsometatarsal joint is not addressed in a triple arthrodesis.

Remediation:
A. There is no difference in failure rate for cemented versus press-fit stems in patients with a BMI >35 kg/m²
B. There is no difference in failure rate for cemented versus press-fit stems in patients with tibial bone deficits.
C. Patients younger than the age of 65 years have higher mechanical failure rates with either cemented or press-fit stems when compared to those older who are older than 65 years.
D. There is no difference in failure rate for cemented versus press-fit stems in patients with increased level of constraint.

Remediation:
A. This patient likely has pain related to eccentric polyethylene wear and osteolysis in the setting of well-fixed and well-positioned components. Head-liner exchange is the best option to address the cause of her symptoms while minimizing potential morbidity from the procedure.
B. This patient is unlikely to have an infection given her normal inflammatory markers; therefore aspiration is not indicated.
C. This patient is unlikely to have metallosis and an associated pseuodotumor given her low serum metal ions and lack of metal-on-metal bearing surface.
D. The acetabular component looks to be in an adequate good position and is well-fixed. If the hip is stable intraoperatively, then it does not need to be revised. A constrained liner should be reserved for abductor deficiency.
E. In the absence of infection, loosening, or implant malposition, there is no reason to revise all of the components.