Protected: BAHT Level II Fractures Re-Sit Exam

State 4 of the bony articulations of the scaphoid (2 marks)

Describe the actions of the volar interossei (2 marks)

Describe 2 exercises that would strengthen the volar interossei (4 marks)

Case 1. Question 1

A 24 year old man presents 3 days after a fall onto his left non-dominant hand with the following fracture:

Describe the pathology you see on the X-ray  (2 marks)

Case Study 1. Question 2

A 24 year old man presents at 3 days after a fall on his outstretched left non-dominant hand.

State the most common option for management for this fracture described in the previous question   (1 mark)

(X-rays repeated below) 

Case Study 1. Question 3.

Describe 2 differences between primary and secondary bone healing  (2 marks) 

Case Study 1. Question 4

Discuss the impact that primary and secondary healing may have on clinical reasoning for therapy management of fractures (4 marks)

Case Study 1. Question 5

Discuss the common complications following scaphoid fractures (3 marks)

Case study 1. Question 6

A 24 year old man falls on his outstretched left non-dominant hand. He has undergone open reduction internal fixation (ORIF) for the fracture seen in the previous X-rays. He has been in a POP for 4 weeks. 

Describe in detail, with justification for your reasoning, how would you manage this patient with this now stable fracture post ORIF in the first therapy session at 4 weeks post op.          (6 marks)

Case Study 2. Question 1

A 35 year old man presents with the following fracture after hitting a lift door in anger. 

Describe the pathology that you see in the X-rays (2 marks) 

Case Study 2. question 2

A 35 year old man presents with the following fracture after hitting a lift door in anger. 

List the options for operative and non-operative management for this fracture

(2 marks)

Case Study 2. Question 3

Describe how you would assess for a potential angulation of a metacarpal fracture. (2 marks)

Case 2. Question 4

A 35 year old man presents with the following fracture after hitting a lift door in anger. 

Following a decision for non-operative management, PRIORITISE how would you manage this patient in the FIRST therapy session and justify your reasoning for the following modality:

    The splint and wearing regime you would choose. Justify your choice     

   (6 marks)

Case 2. Question 5

A 35 year old man presents with the following fracture after hitting a lift door in anger. 

Following a decision for non-operative management, PRIORITISE how would you manage this patient in the FIRST therapy session and justify your reasoning for the following modality:

    THREE exercises you would choose for THIS man and THIS stage . Justify your choices        (6 marks)     

Case Study 3. Question 1

A 56 year old woman presents with a stiff wrist following a distal radius fracture. This was managed with a volar plate and screw 8 weeks ago. (see X-rays below)

She is slow to regain supination. She reports weakness in grips and difficulties with heavy lifting

Choose TWO treatment modalities you would prioritise for THIS patient with STIFFNESS IN SUPINATION at this 8 week stage. Justify your choices.

(4 marks)

Case Study 3. Question 2

A 56 year old woman presents with a stiff wrist following a distal radius fracture. This was managed with a volar plate and screw 8 weeks ago. 

She is slow to regain supination. She reports weakness in grips and difficulties with heavy lifting

Choose TWO treatment modalities you would prioritise for THIS patient to INCREASE STRENGTH and FUNCTION at this 8 week stage. Justify your choices.

(4 marks)