Question 21#

The following is true regarding Y to V-plasty reconstruction for scar contractures:

A. Because the tips of the flaps are only undermined a small amount, there is less risk of necrosis of these tips

The flaps can be re-advanced if contracture recurs. The Y to V-plasty technique is a versatile technique. There is no undermining at all of the flap tips which makes the flaps robust - more so than Z-plasty flaps, and they can be re-advanced. Long lengths of contracture can be released.

Question 22#

The following is the best surgical option to restore dorsiflexion in isolated loss of tibialis anterior function with footdrop with normal soft tissues:

A. This is not a treatable condition

Tibialis posterior to tibialis anterior transfer. TP to TA transfer is a useful technique. Splintage is not a surgical technique nor does it restore dorsiflexion. Ankle fusion does not restore dorsiflexion. Free functioning muscle transfer is too complex a procedure in comparison to TPTA transfer, has significant donor morbidity, and will not provide as successful a reconstruction where soft tissues are uninjured.

Question 23#

With regards to forearm fasciotomies, which one is true?

A. A single, straight-line incision all the way along the ulnar and volar aspect of the forearm is a well-recognized approach for the volar fasciotomy

A single, straight-line incision all the way along the ulnar and volar aspect of the forearm is a well-recognised approach for the volar fasciotomy. A single ulnar volar incision is a reasonable choice for volar fasciotomy. The Lazy-S incision is anecdotally more popular nevertheless. Mannitol has shown promise as an adjunct, but has not entered routine practice. Hyperbaric oxygen has shown considerable promise as an adjunct, but is limited in its use by availability, cost and transfer issues. 

References:

1. Broughton G II. Compartment syndrome. In: Essentials of plastic surgery handbook: a UT Southwestern Medical Center handbook. Janis JE. St. Louis, USA: Quality Medical Publishing Inc., 2007: 634.

Question 24#

Which of the following is not a criterion for transfer of a burns patient to a specialist burns centre?

A. 25% total body surface area (TBSA) deep partial thickness burns

20% TBSA superficial only burns. D is not a criterion. Referral should be made of all major partial or full thickness burns in adults (>10%TBSA), any childhood burns of concern, and burns to unique areas (hand, genitalia, face), although these criteria vary slightly by country and jurisdiction. High voltage electrical burns with the potential for major internal burn injuries are also included. Superficial only burns are not included when calculating TBSA.

Question 25#

Which of the following is not a function of skin?

A. Thermoregulatory

Vitamin E synthesis. The skin synthesises Vitamin D, not E. Vitamin E is a component of many moisturisers however.