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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 10 hours ago24 views · 1 comments · active 9 hours ago
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Question #27
When the postoperative X-ray is “not perfect” but clinically acceptable — would you revise?
We occasionally finish a fixation where reduction or implant position is acceptable but not what we ideally wanted. The construct is stable and revising it would require significant additional surgical trauma. What findings make you reopen and revise immediately, and what imperfections are you willing to accept? Interested in examples from actual practice.
The Bone Stories asked 9 hours ago6 views · 0 comments · active 9 hours ago
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Question #26
MRI looks terrible, patient looks fine — when do you operate on lumbar disc prolapse?
A patient has a large L4–5/L5–S1 disc extrusion on MRI but pain is improving, power is preserved and there are no red flags. How much weight do you give the MRI appearance itself? Apart from neurological deficit, what makes you recommend earlier surgery?
The Bone Stories asked 9 hours ago3 views · 0 comments · active 9 hours ago
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Question #25
Gartland II supracondylar fracture: which ones do you pin?
For a child with a Gartland II supracondylar humerus fracture, what radiographic or clinical findings make you choose CRPP rather than closed reduction and casting? Do you distinguish strongly between IIA and IIB when making the decision?
The Bone Stories asked 9 hours ago4 views · 0 comments · active 9 hours ago
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Question #24
How much angulation do you accept in paediatric both-bone forearm fractures?
We know remodeling depends heavily on age and fracture level, but what limits do you actually use clinically? For an 8–10-year-old with a midshaft radius/ulna fracture, how much residual angulation and rotation would make you re-manipulate?
The Bone Stories asked 9 hours ago4 views · 0 comments · active 9 hours ago
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Question #23
Painful TKA with apparently normal X-rays — what is your workup sequence?
Patient presents months after TKA with persistent pain. Plain radiographs look satisfactory and there is no obvious instability on initial examination. What is your step-by-step investigation sequence before labeling it unexplained pain? When do you obtain CT, aspiration or nuclear imaging?
The Bone Stories asked 9 hours ago3 views · 0 comments · active 9 hours ago
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Question #22
Simultaneous bilateral TKA — who is an ideal candidate?
For patients with severe bilateral knee OA requesting both knees to be replaced together, what are your selection criteria? Which comorbidities or age cutoffs make you strongly prefer staged procedures?
The Bone Stories asked 9 hours ago4 views · 0 comments · active 9 hours ago
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Question #21
Severe knee OA at 50–55 years — how long do you delay TKA?
A 52-year-old has severe tricompartmental OA, significant daily pain and failed conservative treatment. Do you still try to delay TKA primarily because of age, or do symptoms and quality of life outweigh revision risk? What is your counselling in this age group?
The Bone Stories asked 9 hours ago2 views · 0 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
