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Question #4
Plating vs Nailing for Shaft of Humerus fractures?
Which humerus fractures would you nail and which would you plate?
The Bone Stories asked 11 hours ago24 views · 1 comments · active 9 hours ago
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Question #20
Acute Achilles rupture: are you still routinely operating on young active patients?
With modern functional rehabilitation protocols showing good outcomes, what patients with acute Achilles rupture are you still recommending surgery for? Does tendon gap on ultrasound in plantar flexion influence your decision?
The Bone Stories asked 9 hours ago3 views · 0 comments · active 9 hours ago
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Question #19
Displaced 5th metatarsal base avulsion fracture — when do you fix it?
For a Zone 1 avulsion fracture with a small but clearly displaced or rotated fragment, what makes you choose fixation rather than functional treatment? Do displacement measurements alone influence you, or are joint involvement and symptoms more important?
The Bone Stories asked 9 hours ago3 views · 0 comments · active 9 hours ago
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Question #18
New radial nerve palsy after reducing a humeral shaft fracture — explore or observe?
The patient had normal radial nerve function initially but develops a complete radial nerve palsy after manipulation/reduction of a closed humeral shaft fracture. Would you observe with serial examinations/EMG or proceed to early exploration? Does the fracture pattern alter your decision?
The Bone Stories asked 9 hours ago5 views · 0 comments · active 9 hours ago
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Question #17
Have your indications for operating on proximal humerus fractures become narrower?
For displaced 2-part and 3-part proximal humerus fractures in patients above 60, what patterns are you still fixing? With the outcomes of conservative management and concerns regarding fixation failure, has your threshold for surgery changed over the last few years?
The Bone Stories asked 9 hours ago3 views · 0 comments · active 9 hours ago
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Question #16
Full-thickness supraspinatus tear in a 65-year-old: when do you operate?
MRI shows a full-thickness supraspinatus tear with mild retraction in an otherwise active 65-year-old. Pain is significant but strength is reasonably preserved. How long would you trial physiotherapy/injection before offering repair, and which MRI features make you operate earlier?
The Bone Stories asked 9 hours ago3 views · 0 comments · active 9 hours ago
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Question #15
How far do you push the indication for meniscal repair?
For a longitudinal meniscal tear extending partly into the white-white zone in a young adult, do you still attempt repair if the tissue quality is good? What factors make you decide that a tear is simply not worth repairing?
The Bone Stories asked 9 hours ago3 views · 0 comments · active 9 hours ago
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Question #14
Complete ACL tear but no instability in daily life — would you operate?
A recreationally active adult has MRI-confirmed complete ACL tear but minimal symptoms during daily activities and no recurrent giving-way episodes. Would you initially rehabilitate or recommend reconstruction based on activity goals? What makes you change from conservative treatment to surgery?
The Bone Stories asked 9 hours ago5 views · 0 comments · active 9 hours ago
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Question #13
What is your real-world threshold for operating on a patella fracture?
Textbooks give displacement and articular step-off cutoffs, but how strictly do you use them? If the extensor mechanism is intact but there is a 3–4 mm gap or articular incongruity, would you operate? Does fracture pattern matter more to you than the measured gap?
The Bone Stories asked 9 hours ago3 views · 0 comments · active 9 hours ago
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Question #12
Stable isolated lateral malleolus fracture — immediate weight bearing?
For an isolated Weber B fracture with a congruent mortise and no medial clear-space widening, are you allowing immediate weight bearing in a boot? Do you routinely obtain stress or weight-bearing radiographs before deciding that it is stable?
The Bone Stories asked 9 hours ago5 views · 0 comments · active 9 hours ago
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Question #11
Femoral neck fracture at 55–65 years: fixation or replacement?
This age group often creates a difficult decision. For a physiologically young, active patient with a displaced intracapsular neck of femur fracture, what factors push you towards fixation versus THA? Is chronological age still a useful cutoff in your practice?
The Bone Stories asked 9 hours ago4 views · 0 comments · active 9 hours ago
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Question #10
Good TAD (Tip Apex Distance) but slightly anterior blade position — would you accept it? Details:
Suppose the helical blade is central on AP but slightly anterior on lateral, with good reduction and a TAD below 25 mm. Would you accept the construct or revise the blade position? How much importance do you give to Cleveland zone versus TAD/calTAD?
The Bone Stories asked 9 hours ago3 views · 0 comments · active 9 hours ago
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Question #9
Are we operating on too many midshaft clavicle fractures?
For an adult with a displaced midshaft clavicle fracture with >2 cm shortening but no skin threat or neurovascular issue, are you routinely offering fixation? In your experience, which patients genuinely benefit enough from surgery to justify the implant-related complications?
The Bone Stories asked 9 hours ago4 views · 0 comments · active 9 hours ago
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Question #8
Would you re-reduce a Colles fracture if you achieve neutral tilt but good length?
After closed reduction of an extra-articular Colles fracture, radial height and inclination are acceptable but the lateral X-ray shows neutral tilt rather than volar tilt. In a middle-aged patient, would you accept this or attempt another reduction? At what point does repeated manipulation cause more harm than benefit?
The Bone Stories asked 9 hours ago4 views · 0 comments · active 9 hours ago
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Question #7
When do you actually use a long nail for an intertrochanteric fracture?
For routine unstable intertrochanteric fractures without subtrochanteric extension, do you generally prefer a short or long cephalomedullary nail? What specific fracture or patient factors make you choose a long nail?
The Bone Stories asked 9 hours ago3 views · 0 comments · active 9 hours ago
