This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Orthopaedics
[{'content': 'Long bone fracture fixation done with -a) Intramedullary nailb) Compression platec) External fixationd) Screwe) Tension band wiring \nSelect and explain. \nA. abc, B. bc, C. acd, D. bcd', 'role': 'user'}, {'content': 'Answer: A \nExplanation: There are so many options in fracture management and it is useless to explain them here. I am giving only brief description.\n\nManagement of fracture \n\nThe principles in fracture management are : -\n\t1)Reduction\n\n\nIn displaced fractures, fracture site is reduced to proper alignment first.\nReduction may be : -\n\nA) Closed : - Without opening the fracture site. This can be done by : -\n\nClosed manipulation of fracture site.\nContinuous traction to counteract the forces which prevent reduction.\n\nB) Open : - Fracture site is opened and then the fracture is reduced.\n2) Immobilization of fractured bone\n\nAfter reduction, immobilization is necessary to maintain the bones in reduced position.\nThis may be dony by : -\n\n\nPlaster of paris (cast or slab)\nUsing implant : -\n\n\xa0i)\xa0For long Bones\n\n\nIntramedullary nailing eg K nail, interlocking nail, Rush nail, reconstruction nail etc.\nPlating eg. DCP\nExternal fixator\nDynamic hip screw (DHS) & Dynamic condylar screw CDCS\nPlaster cast\n\nii) For short bones\n\nScrews\nK-wire\nTension band wiring\nHere I would like to explain one fact, which may otherwise cause confusion : -\n\n\nClosed reduction does not mean that treatment is always non-operative (conservative).\n\n\nClosed reduction may be : -\n\n\nConservative : - When reduction is done without opening of fracture site and the fracture site is immobilized without fixing by implant but by plaster or splints.\nSurgical : - When reduction is done without opening of fracture site and the fracture site is fixed by implants, e.g., by percutaneous K-wire or screw.\n\n\nOpen reduction is always surgical; no confusion about that.', 'role': 'assistant'}]