Question - The radiograph of the proximal femur showing a lytic lesion. Which of these do you think might assist in the treatment?
a. MESS score
b. Ganga score
c. WOMAC score
d. Mirel's criteria
Answer - D, Mirel's criteria. These criteria help in decision of 'prophylactic fixation' of impending fractures due to pathological lesions. It has 4 variables- Site, Size , Lesion and pain. Score 7 or less observed or irradiated and score 8 or more require prophylactic fixation.
Question - Is fixation without presence of fracture necessary in our case?
Answer - the location of pertrochanteric area has higher stresses and higher chances of pathological fracture makes it necessary for early fixation to prevent it.
Question - What kind of fixation would you prefer?
Answer - In this case, a cephalo-medullary implant like proximal femoral nail is a good option.
Q- what about other options?
A- MESS score is used for limb salvage in cases of severely damaged limb(mangled limb) - stands for Mangled Extremity Severity Score.
Gangs hospital open injury score (GHOIS) is a classification for open fractures. Advocated by Gangs hospital ,Coimbatore, India.
WOMAC score is for osteoarthritis, Western Ontario McMaster university .
a. MESS score
b. Ganga score
c. WOMAC score
d. Mirel's criteria
Answer - D, Mirel's criteria. These criteria help in decision of 'prophylactic fixation' of impending fractures due to pathological lesions. It has 4 variables- Site, Size , Lesion and pain. Score 7 or less observed or irradiated and score 8 or more require prophylactic fixation.
Question - Is fixation without presence of fracture necessary in our case?
Answer - the location of pertrochanteric area has higher stresses and higher chances of pathological fracture makes it necessary for early fixation to prevent it.
Question - What kind of fixation would you prefer?
Answer - In this case, a cephalo-medullary implant like proximal femoral nail is a good option.
Q- what about other options?
A- MESS score is used for limb salvage in cases of severely damaged limb(mangled limb) - stands for Mangled Extremity Severity Score.
Gangs hospital open injury score (GHOIS) is a classification for open fractures. Advocated by Gangs hospital ,Coimbatore, India.
WOMAC score is for osteoarthritis, Western Ontario McMaster university .
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