Discuss the aetiology of extensor pollicis longus tendon rupture

A 45 year old forestry worker presents to hospital three hours after his tractor overturned. His injuries are isolated to the left lower limb. None of the injuries is open. The injuries are an unreduced posterior dislocation of the hip with a posterior wall fracture, a comminuted fracture limited to the central third of the femoral shaft, and displaced fractures involving the tibial plateau on medial and lateral sides. X-rays available include an Antero Posterior (AP) of the pelvis, Antero Posterior (AP) and lateral views of the left femur and knee. The man is a practising Jehovah’s Witness.

  1. Given this clinical context, discuss the treatment options (30%).
  2. Discuss any further imaging studies which may assist (10%).
  3. Discuss the question of informed consent (20%)
  4. List the lower limb complications which may arise and discuss their management (40%).

(30 minutes)

A 24 year old plumber presents to you with a 24 hour history of a very painful and weak right shoulder. One week ago, despite feeling unwell with a cold, he played rugby league football. He could not recall any specific shoulder injury.

Discuss:

  1. The differential diagnosis
  2. Any investigations
  3. The treatment

(30 minutes)

  1. Discuss the aetiology of extensor pollicis longus tendon rupture. (30%)
  2. Discuss treatment and the complications that may arise as result of the treatment (70%).
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(550 words)

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