Remediation:
A. Open reduction and internal fixation with a plate and screws is the most appropriate treatment choice. This will allow for early motion and provide the best chance of obtaining an anatomic reduction.
B. Although this is a treatment option, this option will not allow early knee motion and provides limited stability to the fracture
C. Knee braces or splints can be used for the initial stabilization of a distal femoral fracture but is not a definitive treatment choice.
D. Total knee arthroplasty is not indicated for a young patient with a distal femoral fracture.

Remediation:
A. Flatfoot reconstruction surgery aims to correct the deformity associated with posterior tibial tendon dysfunction (PTTD)
B. This is for more advanced dysfunction.
C. He has failed nonoperative management. Surgery should be considered.
D. This would not address the hindfoot valgus/flatfoot.

Remediation:
A. Risk factors of proximal junctional kyphosis development include increased age, fusion to the sacrum, combined anterior spinal fusion/posterior spinal fusion (ASF/PSF), and nonanatomic restoration of thoracic kyphosis or lumbar lordosis.
B. Same as A
C. Long-segment fusion is typically defined as 5 or more levels of fusion. Long-segment fusion is a prerequisite for adult spinal deformity surgery and, as such, it is not an independent risk factor for PJK.
D. Correction of the SVA to sagittally balance the spine is a goal of adult deformity surgery; however, the magnitude of correction is related to the risk of PJK. When the SVA is corrected more than 5 cm, the incidence of PJK increases.

Remediation:
A. Multidirectional instability is usually atraumatic and best treated initially with physical therapy.
B. Due to the high risk of recurrent instability in this patient, early surgery is effective in reducing recurrent dislocation rates.
C. Seizures should be under control before considering surgery. If they are not under control, the seizure can lead to recurrent dislocations.
D. Patients who are <20 years old have a substantial risk of recurrent instability. Early surgery is effective in reducing the risk of recurrent dislocations.

Remediation:
A. The case describes a displaced patellar sleeve avulsion fracture. Open reduction and internal fixation is recommended. Nonoperative management is likely to result in substantial extensor lag.
B. Same as A
C. Same as A
D. Same as A

Remediation:
A. This is the definition of sensitivity.
B. A test with high specificity is used to rule out a disease.
C. Highly specific tests may have a large number of true-negative results.
D. A test with high sensitivity is used to confirm a disease.

Remediation:
A. With Bouvier's maneuver, MCP extension is blocked and IP joint extension is evaluated. If IP joint extension is preserved, then only a static transfer is required.
B. The Elson test is used to examine central slip competency in extensor tendon lacerations about zone 3.
C. The Boyes test is used to examine central slip competency in extensor tendon lacerations about zone 3.
D. This is not a described test. The Wartenberg sign is 5th finger digital abduction that is seen in ulnar nerve dysfunction.

Remediation:
A. An isolated soleus contracture is not demonstrated with this examination. Additionally, this type of contracture is difficult to demonstrate.
B. Knee flexion relaxes the gastrocnemius. This degree of increased motion with the knee flexed suggests the presence of an isolated gastrocnemius contracture.
C. Given the increased dorsiflexion on Silfverskiöld testing, anterior block to motion is unlikely.
D. A combined contracture is unlikely given the discrepancy between dorsiflexion with the knee flexed and extended.

Remediation:
A. The tibia is a type-2B defect because it involves both sides of the plateau.
B. Same as A
C. The AORI classification is broken up into 3 types for both the tibia and the femur separately. Type 1 has an intact metaphseal bone stock. Type 2 defects involve the metaphyseal bone and are further divided into A (one condyle/side of the plateau is involved) and B (both condyles/sides of the plateau are involved).  Type-3 defects have major metaphyseal bone involvement and have compromise to the collateral ligaments.
D. The tibia is a type-2B defect because it involves both sides of the plateau. The collateral ligaments are intact.
E. The femur is a type-1 defect because there is no metaphyseal involvement.

Remediation:
A. Charcot arthropathy is a joint pathology associated with a neurological condition such as syringomyelia, neurosyphilis, or diabetic neuropathy. It is most commonly seen in the foot or the ankle in a patient with diabetic arthropathy but may present in the hip. Radiographic findings include femoral head resorption as well as bony debris in the acetabulum. It is important to rule out infectious etiology in these patients.
B. This patient presents with Charcot arthropathy of the hips. Charcot arthropathy is a joint pathology associated with a neurological condition such as syringomyelia, neurosyphilis, or diabetic neuropathy. It is most commonly seen in the foot or the ankle in a patient with diabetic arthropathy but may rarely present in the hip. Radiographic findings include femoral head resorption as well as bony debris in the acetabulum. In this patient with normal serum inflammatory markers and a negative joint aspiration, septic arthritis is unlikely.
C. While severe hip dysplasia can present with femoral head resorption on imaging, there is typically a long-standing history of deformity and it is not usually associated with any neurological deficits. In addition, the bony debris and hypertrophy seen on these images are more commonly associated with Charcot arthropathy.
D. Osteoarthritis of the hip does not usually present with femoral head resorption, bony debris, and limb shortening as with this patient. In addition, this patient's history of syphilis and neurological deficits suggest a diagnosis of Charcot arthropathy.