image based Q. 43 - child with bowed legs

Q. Which among the below test would be necessary for further clinical evaluation of the given case?




1. Hip external rotation
2. Knee extension
3. Knee flexion
4. Foot thigh angle

Answer -


Knee flexion would determine whether the bowing (genu varum) is due to femoral or tibial cause. Femur causes usually get corrected on knee flexion, while the tibial causes persist in deformity.

Hip external rotation is important in slipped capital femoral epiphysis cases where external rotation in affected side is more (one of very few conditions as most hip pathologies have restricted motion)

Hip thigh angle is measured to ascertain anteversion deformities of proximal femur in children with in-toeing gait..

image based Q. 42- Implant composition

 Q.  The implant used in given picture is composed of all except ?


1. Nickel
2. Vanadium
3. Titanium
4. Aluminium

Answer - 
Nickel



The picture depicts an intramedullary  nail used in pediatric femur fracture fixation thus appears as TENS. TENS stands for Titanium Elastic Nailing System. The implant is made of titanium  which is commonly composed of Titanium along with Aluminium and Vanadium (Ti-Al-6V).

Stainless steel implants used in orthopaedics are mostly made of steel grade 316L. here L stands for Low carbon. It has many alloys and nickel is one of them


Nickel is common cause behind metal hypersensitivity to metal implants.