ABOS Part I Comprehensive Review - Batch 44

Question 1

A 2-year-old obese African American male presents to your clinic with bilateral bowing of the legs, which his parents report has been progressively worsening since he started walking at 10 months of age. Physical examination reveals significant varus

Accepted Answer

Lateral hemiepiphysiodesis of the proximal tibias using an eight-plate system.

Question 2

A 14-year-old obese male presents with progressive unilateral left genu varum. Radiographs confirm adolescent Blount disease with a Medial Proximal Tibial Angle (MPTA) of 78 degrees and a Mechanical Axis Deviation (MAD) of 25 mm medial to the center

Accepted Answer

Common peroneal nerve

Question 3

A 7-year-old female with progressive right tibia vara is undergoing lateral hemiepiphysiodesis of the proximal tibia. The surgeon places an eight-plate across the lateral physis. Post-operatively, the limb gradually corrects into neutral alignment ov

Accepted Answer

Temporary arrest of growth on the lateral physis, allowing the medial physis to continue growing and correct the varus.

Question 4

A 6-year-old male presents with progressive bilateral tibia vara. Radiographic evaluation reveals Langenskiöld Stage V changes in the right proximal tibia, characterized by a significant physeal bar and epiphyseal wedging, and Stage III changes in th

Accepted Answer

Right proximal tibial varus-producing osteotomy and left lateral hemiepiphysiodesis.

Question 5

A 10-year-old male with adolescent Blount disease undergoes lateral hemiepiphysiodesis of the proximal tibia. During the procedure, after drilling the pilot holes for the eight-plate screws, the surgeon performs fluoroscopic checks. Which of the foll

Accepted Answer

The screw threads are seen crossing the physis on both AP and lateral views.

Question 6

A 5-year-old child with progressive infantile Blount disease is being evaluated for lateral hemiepiphysiodesis. Pre-operative planning includes a comprehensive radiographic assessment. Which of the following radiographic measurements is most crucial

Accepted Answer

Mechanical Axis Deviation (MAD) on a standing full-length AP radiograph.

Question 7

A 12-year-old female underwent lateral hemiepiphysiodesis for progressive adolescent Blount disease. She is now 18 months post-surgery and presents for a follow-up. Standing full-length AP radiographs show a mechanical axis that passes 6 mm lateral t

Accepted Answer

Remove the eight-plate now to prevent further overcorrection and allow for potential rebound into neutral.

Question 8

A 9-year-old male with progressive right tibia vara (MPTA 75 degrees) undergoes lateral hemiepiphysiodesis. Post-operatively, he is allowed weight-bearing as tolerated. Which of the following statements accurately describes the typical post-operative

Accepted Answer

Regular clinical and radiographic follow-up every 3-6 months until slight overcorrection into valgus is achieved.

Question 9

A 15-year-old male presents with severe, progressive adolescent Blount disease. Radiographs show an MPTA of 65 degrees, a significant medial physeal bar spanning 60% of the physis, and a skeletal age of 15 years, indicating limited remaining growth.

Accepted Answer

Proximal tibial varus-producing osteotomy.

Question 10

The shift in surgical management of Blount disease from acute osteotomies to guided growth techniques, particularly using tension band plates, has been significantly influenced by the work of which orthopedic surgeon, who extensively documented the e

Accepted Answer

Peter Stevens

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Key Takeaway