Quiz Question

In Sisk 2024 et al., which nail design feature may reduce infection risk?

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Correct. Solid IMNs showed two-fold reduced infection rates vs. slotted or cannulated nails in rabbit studies:contentReference[oaicite:1]{index=1}
Incorrect. The correct answer is Solid nail design.
Solid IMNs showed two-fold reduced infection rates vs. slotted or cannulated nails in rabbit studies:contentReference[oaicite:1]{index=1}

🔍 Key Findings Summary

  • IMN provides relative stability, resists bending/torsion due to central axis alignment
  • Larger diameter nails = exponentially greater stiffness (∝ D⁴)
  • Trade-off: Larger interlocking holes weaken fatigue strength of the nail
  • Reaming increases contact/stability but has pros/cons:
    • Improves outcomes in closed fractures
    • May reduce endosteal blood flow in thin-walled bones (e.g., cats)
  • Design advances:
    • Angle-stable IMN reduce rotational slack
    • Expandable nails simplify insertion but may compromise removal or compressive load resistance
    • Precontoured nails match bone curvature but lack consistent clinical superiority
  • Material debates continue (e.g., titanium vs. stainless steel vs. magnesium)

Sisk

Veterinary and Comparative Orthopedics and Traumatology

6

2024

Biomechanical Principles of Intramedullary Nails in Veterinary and Human Medicine

2024-6-VCOT-sisk-2

Article Title: Biomechanical Principles of Intramedullary Nails in Veterinary and Human Medicine

Journal: Veterinary and Comparative Orthopedics and Traumatology

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In Kang 2022 et al., on 3D scaffold reconstruction, which material was combined with polycaprolactone (PCL) to enhance osteoconductivity?

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Correct. β-TCP was used to improve hydrophilicity and bone regeneration potential of PCL.
Incorrect. The correct answer is Beta-tricalcium phosphate.
β-TCP was used to improve hydrophilicity and bone regeneration potential of PCL.

🔍 Key Findings

  • Patient-specific 3D-printed PCL/β-TCP scaffold enabled successful zygomatic arch reconstruction in a dog.
  • Complete surgical resection of a zygomatic parosteal osteosarcoma was achieved, with a 0.3 mm histologically clean margin.
  • Post-op imaging showed progressive tissue ingrowth into the scaffold, with Hounsfield Units increasing from 20.4 to 97.8 over 10 months.
  • No complications (e.g., infection, displacement) or tumor recurrence were noted at 16-month follow-up.
  • Use of a patient-specific osteotomy guide improved anatomical fit and facilitated precise excision and implant placement.
  • Facial symmetry and orbital stability were maintained throughout follow-up.
  • The scaffold remained structurally stable despite limited bone regeneration, suggesting connective tissue filled the defect.
  • Topical mitomycin C was applied intraoperatively for possible anti-neoplastic effect, but efficacy remains unclear.

Kang

Veterinary Surgery

8

2022

Zygomatic arch reconstruction with a patient-specific polycaprolactone beta-tricalcium phosphate scaffold after parosteal osteosarcoma resection in a dog

2022-8-VS-kang-1

Article Title: Zygomatic arch reconstruction with a patient-specific polycaprolactone beta-tricalcium phosphate scaffold after parosteal osteosarcoma resection in a dog

Journal: Veterinary Surgery

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In Perez Neto 2025 et al., on hip resurfacing arthroplasty, implantation of the prosthesis reduced maximum load by approximately what percentage compared to controls?

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Correct. Maximum load was 22% lower in prosthetic femurs versus intact controls.
Incorrect. The correct answer is 22%.
Maximum load was 22% lower in prosthetic femurs versus intact controls.

🔍 Key Findings

  • In an ex vivo study of 20 canine femur pairs, implantation of a novel hip resurfacing arthroplasty (HRA) prosthesis reduced maximum load (ML) by 22% and load at collapse (LC) by 27% vs. intact controls (p ≤ 0.05).
  • Displacement at maximum load (DML), displacement at collapse (DC), and stiffness (k) were not significantly different between prosthesis and control groups.
  • Both groups showed similar failure patterns, with 92% failing at the femoral neck.
  • All prosthetic femurs still withstood ~6.2× body weight — exceeding estimated in vivo peak loads (~1.64× BW).
  • Prosthesis positioning (neutral vs valgus) had no significant effect on biomechanical outcomes.
  • Implant design preserved more metaphyseal bone stock than total hip replacement, possibly explaining the smaller load reduction compared to other short-stem prostheses.
  • The press-fit cobalt–chromium design with conical stem allowed full contact and stress distribution over the femoral head/neck.
  • Authors conclude the device has adequate immediate biomechanical strength for clinical use, though long-term in vivo studies are needed.

Perez Neto

Veterinary and Comparative Orthopaedics and Traumatology

4

2025

Biomechanical Evaluation of a Femoral Implant for Hip Resurfacing Arthroplasty in Dogs: An Ex Vivo Study

2025-4-VCOT-perezneto-1

Article Title: Biomechanical Evaluation of a Femoral Implant for Hip Resurfacing Arthroplasty in Dogs: An Ex Vivo Study

Journal: Veterinary and Comparative Orthopaedics and Traumatology

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In Sisk 2024 et al., on intramedullary nails, what biomechanical property is most affected by increasing nail diameter?

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Correct. Stiffness increases with the 4th power of diameter (∝ D⁴), greatly improving resistance to deformation:contentReference[oaicite:0]{index=0}
Incorrect. The correct answer is Torsional and bending stiffness.
Stiffness increases with the 4th power of diameter (∝ D⁴), greatly improving resistance to deformation:contentReference[oaicite:0]{index=0}

🔍 Key Findings Summary

  • IMN provides relative stability, resists bending/torsion due to central axis alignment
  • Larger diameter nails = exponentially greater stiffness (∝ D⁴)
  • Trade-off: Larger interlocking holes weaken fatigue strength of the nail
  • Reaming increases contact/stability but has pros/cons:
    • Improves outcomes in closed fractures
    • May reduce endosteal blood flow in thin-walled bones (e.g., cats)
  • Design advances:
    • Angle-stable IMN reduce rotational slack
    • Expandable nails simplify insertion but may compromise removal or compressive load resistance
    • Precontoured nails match bone curvature but lack consistent clinical superiority
  • Material debates continue (e.g., titanium vs. stainless steel vs. magnesium)

Sisk

Veterinary and Comparative Orthopedics and Traumatology

6

2024

Biomechanical Principles of Intramedullary Nails in Veterinary and Human Medicine

2024-6-VCOT-sisk-1

Article Title: Biomechanical Principles of Intramedullary Nails in Veterinary and Human Medicine

Journal: Veterinary and Comparative Orthopedics and Traumatology

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In Gutbrod 2024 et al., on feline tibial stabilization, what intramedullary pin diameter was associated with the highest biomechanical performance?

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Correct. Group 2 used a 1.6 mm pin filling ~50% of the tibial canal, yielding superior stiffness.
Incorrect. The correct answer is 1.6 mm (50% fill).
Group 2 used a 1.6 mm pin filling ~50% of the tibial canal, yielding superior stiffness.

🔍 Key Findings

  • 2.4 mm LCP with a 1.6 mm IM pin had the highest axial stiffness and yield strength among the tested constructs.
  • Axial stiffness was significantly higher in the 2.4 mm LCP + 1.6 mm IM pin group compared to 2.7 mm LCP alone (p = .013).
  • No significant difference in torsional stiffness was found among groups.
  • 2.4 mm LCP + 1.0 mm pin had the lowest stiffness and failure load, underperforming both other constructs.
  • All constructs failed via valgus bending, consistent with clinical observations in feline tibial fractures.
  • A 1.6 mm pin (~50% canal fill) resulted in superior construct performance vs. 1.0 mm (~30% fill).
  • Group 2 (2.4 LCP + 1.6 mm pin) outperformed the 2.7 mm LCP alone in stiffness, despite using a smaller plate.
  • Plate–rod constructs may better preserve periosteal blood supply and support minimally invasive stabilization strategies.

Gutbrod

Veterinary Surgery

4

2024

Ex vivo biomechanical evaluation of 2.4 mm LCP plate rod constructs versus 2.7 mm LCP applied to the feline tibia

2024-4-VS-gutbrod-3

Article Title: Ex vivo biomechanical evaluation of 2.4 mm LCP plate rod constructs versus 2.7 mm LCP applied to the feline tibia

Journal: Veterinary Surgery

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In Carvajal 2025 et al., on femoral stem breakage, what was the most common site of stem failure?

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Correct. All failures occurred at the proximolateral shoulder, consistent with high stress concentration and fatigue location.
Incorrect. The correct answer is Proximolateral shoulder.
All failures occurred at the proximolateral shoulder, consistent with high stress concentration and fatigue location.

🔍 Key Findings

Incidence of BFX lateral bolt stem breakage: 2.95% (13 dogs, 14 stems)

Implant factors:

  • 13/14 were BFX lateral bolt stems (sizes #5–7)
  • +9 necks used in 5/11 of 17 mm heads
  • 10/14 stems undersized based on radiographs
  • 10/13 dogs exceeded weight limits for implanted stem size

Malalignment:

  • 10/14 had varus alignment (median 3.9°)
  • 8/14 had insufficient proximodistal seating

Breakage site: Proximolateral shoulder in all cases

Revision outcomes:

  • 11 revised (7 CFX, 3 larger BFX, 1 collared)
  • 9/10 revised dogs regained full function
  • Complications: 1 rebreakage, 1 periprosthetic fracture, 1 fixation failure

Histopathology:

  • Electron microscopy showed fatigue striations and incomplete bead fusion

Conclusion: Avoid small BFX lateral bolt stems if undersized or if long necks required; use weight guidelines to prevent fatigue failure.

Carvajal

Veterinary Surgery

3

2025

Breakage of cementless press‐fit femoral stems following total hip arthroplasty in dogs: 14 cases (2013–2023)

2025-3-VS-carvajal-4

Article Title: Breakage of cementless press‐fit femoral stems following total hip arthroplasty in dogs: 14 cases (2013–2023)

Journal: Veterinary Surgery

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In Trefny 2025 et al., on plate length and stiffness, which biomechanical testing method was used to measure stiffness and strain?

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Correct. Four-point bending was applied in two planes to mimic relevant long bone loading.
Incorrect. The correct answer is 4-point bending in compression and tension.
Four-point bending was applied in two planes to mimic relevant long bone loading.

🔍 Key Findings

  • 12-hole LCPs (80% plate–bone ratio) showed significantly higher construct stiffness than 6-, 8-, or 10-hole plates in both compression and tension bending.
  • Strain on the plate was significantly lower in 12-hole vs 6-hole plates at all regions of interest (ROIs), especially around the fracture gap.
  • No incremental increases in stiffness or decreases in strain were observed between 6-, 8-, and 10-hole plates—only when comparing to 12-hole plates.
  • Bone model strain adjacent to the plate end was significantly lower for 10- and 12-hole plates vs 6-hole plates under both loading conditions.
  • The threshold effect suggests biomechanical benefits only emerge beyond a plate–bone ratio of ~80%.
  • Working length increased from 9.4 mm (6-hole) to 13 mm (others), potentially influencing strain/stiffness differences.
  • Four-point bending was used, as it replicates the most biomechanically relevant force on plated long bones.
  • Clinical implication: Longer plates may reduce plate strain and peri-implant bone strain, potentially lowering risk of fatigue failure or stress risers.

Trefny

Veterinary and Comparative Orthopaedics and Traumatology

2

2025

Effect of Plate Length on Construct Stiffness and Strain in a Synthetic Short-Fragment Fracture Gap Model Stabilized with a 3.5-mm Locking Compression Plate

2025-2-VCOT-trefny-4

Article Title: Effect of Plate Length on Construct Stiffness and Strain in a Synthetic Short-Fragment Fracture Gap Model Stabilized with a 3.5-mm Locking Compression Plate

Journal: Veterinary and Comparative Orthopaedics and Traumatology

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In Walter de Bruyn 2024 et al., how did orthogonal plate application affect strain in four-point bending?

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Correct. Orthogonal plates significantly reduced plate strain across all working lengths in bending:contentReference[oaicite:1]{index=1}
Incorrect. The correct answer is Decreased it.
Orthogonal plates significantly reduced plate strain across all working lengths in bending:contentReference[oaicite:1]{index=1}

🔍 Key Findings Summary

  • Primary 3.5-mm LCP used with short (SWL), medium (MWL), and long (LWL) working lengths
  • Addition of orthogonal 2.7-mm LCP resulted in:
    • Significantly higher bending stiffness for SWL, MWL, and LWL (p < 0.0001)
    • Higher torsional stiffness for MWL and LWL (not for SWL)
    • Significantly lower strain across all working lengths in bending (p < 0.01)
  • Working length inversely related to construct stiffness and directly to plate strain
  • Orthogonal plates eliminated stiffness differences across working lengths in bending
  • Suggests orthogonal plates can improve implant fatigue life and allow compensation when short working lengths are unachievable

Walterdebruyn

Veterinary and Comparative Orthopedics and Traumatology

4

2024

Effect of an Orthogonal Locking Plate and Primary Plate Working Length on Construct Stiffness and Plate Strain in an In vitro Fracture-Gap Model

2024-4-VCOT-walterdebruyn-2

Article Title: Effect of an Orthogonal Locking Plate and Primary Plate Working Length on Construct Stiffness and Plate Strain in an In vitro Fracture-Gap Model

Journal: Veterinary and Comparative Orthopedics and Traumatology

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In Huels 2025 et al., on second-generation screw cup THA, what design feature of the SCSL was intended to reduce acetabular fractures?

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Correct. These were developed to reduce insertion torque and thereby lower risk of acetabular fractures.
Incorrect. The correct answer is Finer, self-tapping threads.
These were developed to reduce insertion torque and thereby lower risk of acetabular fractures.

🔍 Key Findings

  • Total complication rate was 16.7%, with 5/30 hips experiencing major complications, mostly related to the femoral component.
  • Cup-associated complications were rare (3.3%), with only one case of acetabular cup luxation attributed to surgical technique rather than implant failure.
  • No cases of late aseptic loosening were observed during a median follow-up of 17.5 months.
  • Implant stability was attributed to the SCSL's porous, trabecular titanium surface, enhancing osseointegration.
  • Three femoral stem fractures occurred in a single dog, leading to implant removal; material testing was not performed.
  • Most complications were femoral in origin (6/7), not acetabular, suggesting improved performance of the SCSL.
  • Explantation rate was 13% (4/30), but some removals were due to owner preference against revision.
  • Subjective functional outcome was full recovery in 26/30 hips, including one with successful revision of stem subsidence.

Huels

Veterinary and Comparative Orthopaedics and Traumatology

2

2025

Complications and Long-Term Outcome in 30 Canine Total Hip Arthroplasties Using a Second-Generation Selective Laser Melted Screw Cup

2025-2-VCOT-huels-3

Article Title: Complications and Long-Term Outcome in 30 Canine Total Hip Arthroplasties Using a Second-Generation Selective Laser Melted Screw Cup

Journal: Veterinary and Comparative Orthopaedics and Traumatology

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In Hawker 2025 et al., on locking head inserts, what did the authors conclude regarding high-strain construct scenarios?

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Correct. LHI did not reduce strain in this model; authors recommend considering other methods for high load conditions.
Incorrect. The correct answer is Consider alternate strain-reduction strategies.
LHI did not reduce strain in this model; authors recommend considering other methods for high load conditions.

🔍 Key Findings

  • Adding Locking Head Inserts (LHI) to a 3.5-mm LCP had no effect on plate strain, stiffness, or deformation in an open fracture gap model.
  • Peak strain consistently occurred at the Combi-hole over the fracture gap, with values up to ~1837 µε.
  • No significant difference in strain was found across configurations with 0, 3, or 9 LHI (p = 0.847).
  • Construct stiffness and compressive displacement also remained unchanged regardless of LHI count (p = 0.311 and 0.069 respectively).
  • Study contradicted the hypothesis that LHI would reduce strain and increase stiffness under biologic loading.
  • Combi-hole design may limit the efficacy of LHI, as LHI only fill the locking portion, not the compression side where strain peaks.
  • Implant fatigue risk remains highest over unfilled screw holes, especially over fracture sites—confirming previous failure patterns.
  • Surgeons should consider alternative methods to reduce strain when facing high implant load scenarios.

Hawker

Veterinary and Comparative Orthopaedics and Traumatology

4

2025

The Effect of Locking Head Inserts on the Biomechanical Properties of a 3.5-mm Broad Locking Compression Plate When Used in an Open Fracture-Gap Model

2025-4-VCOT-hawker-5

Article Title: The Effect of Locking Head Inserts on the Biomechanical Properties of a 3.5-mm Broad Locking Compression Plate When Used in an Open Fracture-Gap Model

Journal: Veterinary and Comparative Orthopaedics and Traumatology

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Topic: Material Science & Engineering Concepts
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