Taro 2016 Comentado

Universidade Federal do Amazonas
Hospital Universitário Getúlio Vargas

Serviço de Ortopedia e Traumatologia
TARO 2016 – GABARITO BASEADO NAS REFERÊNCIAS
Pesquisado por:
Gustavo Pereira, Heyder Cabral, Talita Oliveira, Eduardo Ditzel, Luis Fernando Tupinambá, Marcelo
Gomes, Jaime Menezes e Luiz Felipe Tupinambá, Caio Capelasso, Carmem Mancinha, Jorge Acosta,
Suammy Barros, Tiane Dias.
Editado por:
José Henrique Peres dos Santos – TEOT - 14847
TARO 2016
1. Na discopatia lombar, a diminuição signitificativa da força do tríceps sural indica compressão da raiz
de:
A)L4
B)L5
C)S1
DS2
R= With unilateral rupture of the disc between L5 and S1,

the findings of an S1 radiculopathy are noted. Pain and
numbness involve the dermatome of S1. The S1 dermatome
includes the lateral malleolus and the lateral and plantar
surface of the foot, occasionally including the heel. There is numbness over the lateral aspect of the leg and, more
important, over the lateral aspect of the foot, including the lateral three toes. The autonomous zone for this root
is the dorsum of the fifth toe. Weakness may be shown in the peroneus longus and brevis (S1), gastrocnemius-
soleus (S1), or gluteus maximus (S1). In general, weakness is not a usual finding in S1 radiculopathy.
Occasionally, mild weakness may be shown by asymmetrical fatigue with exercise of these motor groups. The
ankle jerk usually is reduced or absent.
Fonte: Canale & Beaty: Campbell´s Operative Orthopaedics 12th ed. pag 1937
2. Na fratura do enforcado a lesão de C2 localiza-se:
A) na massa lateral
B) no corpo anterior
C) na pars interarticularis
D) no processo espinhoso
R= Hangman’s Fractures (Traumatic Spondylolisthesis, C2–C3) Mechanism of Injury
First described by Haughton in the 19th century,262 the term “hangman’s fracture” as a synonym for traumatic
disruption of the C2 pars interarticularis is a misnomer. Postmortem examination of corpses following judicial
hanging has shown that the characteristic hangman’s fracture was a rare occurrence, with most victims
exhibiting no fracture at all. In a critique based on semantics, Niijima177 objected to the term because it is the
“hanged man” and not the hangman, or executioner, who sustains the fracture.
The mechanism of injury in hangman’s fractures has been presumed to be a flexion force. However, recent
biomechanical evidence suggests that the varying fracture patterns are the result of different forces imparted to
the C2 pars with the neck in different postures.232
Fonte: Rockwood and Green’s Fractures in Adults 8th Ed. Pg 1729
3. na estenose lombar central dos sintomas são:
A) bilateral, respeitando o dermátomo
B) bilateral, não respeitando o dermátomo
C) unilateral, respeitando o dermátomo
D) unilateral, respeitando o dermátomo
R= In patients with spinal stenosis, symptoms include back pain (95%), sciatica (91%), sensory disturbance in
the legs (70%), motor weakness (33%), and urinary disturbance (12%). In patients with central spinal stenosis,
symptoms usually are bilateral and involve the buttocks and posterior thighs in a nondermatomal distribution. With
lateral recess stenosis, symptoms usually are dermatomal because they are related to a specific nerve being
compressed. Patients with lateral recess stenosis may have more pain during rest and at night but more walking
tolerance than patients with central stenosis.
4. A maior estabilidade da articulação esternoclavicular, no que diz respeito à translação posterior, é
fornecida:
A) pela cápsula anterior
B) pela cápsula posterior
C) pelo ligamento interclavicular
D) pelo liogamento esternoclavicular posterior
R= Ligamentous Anatomy of the Clavicle
Medial
There is relatively little motion at the SC joint, and the supporting soft tissue structures are correspondingly thick.
Medially the clavicle is secured to the sternum by the SC capsule, and although there are not easily demonstrable
“ligaments,” the thickening of the posterior capsule has been determined to be the single most important soft
tissue constraint to anterior or posterior translation of the medial clavicle. There is also an interclavicular ligament
which runs from the medial end of one clavicle, gains purchase from the superior aspect of the sternum at the
sternal notch, and attaches to the medial end of the contralateral clavicle. Acting as a tension wire at the base of
the clavicle, this ligament helps prevent inferior angulation or translation of the clavicle. In addition, there are
extremely stout ligaments that originate on the first rib and insert on the undersurface or the inferior aspect of the
19
clavicle. A small fossa inferomedially, the rhomboid fossa, has been described as an attachment point for these
ligaments, which primarily resist translation of the medial clavicle.
Fonte: Rockwood and Green’s Fractures in Adults 8th Ed. Pg 1441 (está equivocado no gabarito oficial)
5. Para um paciente com escoliose idiopática do adolescente, cuja angulo é de 10° e o RISSER grau
1, a probabilidade de progressão da curva é de:
A) 18%
B) 22%
C)26%
D) 30%
Curve Magnitude
The size of the existing curve when scoliosis is recognized is helpful in predicting curve progression. The
combination of this factor and assessment of remaining growth is used to predict the natural history in young
patients with scoliosis.
Immature patients (premenarchal, Risser grade 0) with curves greater than 20 degrees are at substantial risk for
progression of spinal deformity (Table 12-1).96,265,450,451,534,650 For immature patients with curves
exceeding 25 to 30 degrees, the risk for curve progression is believed to be significant enough to recommend
orthotic management atthe time of initial evaluation
Fonte: Herring: Tachdjian`s Pediatric Orthopaedics 5ª Ed. Pg 208

6. Na doença de SCHEUERMANN, o ápice da curva toracica ocorre entre:
A) T5-T7
B)T7-T9
C)T9-T11
D)T11-L1
R= Typical Scheuermann disease consists of a rigid thoracic kyphosis in a juvenile or adolescent spine.
The apex of kyphosis is located between T7 and T9 (11). The reported incidence of Scheuermann deformities in
the general population ranges from 0.4% to 10% (85-89).
Fonte: Lovell and Winter’s Pediatric Orthopaedics 7ª Ed, Pg 757
7. Nos tendões flexores superficiais dos dedos da mão, uma área isquêmica está presente sob a polia
A) A1
B)A2
C)A3
D)A4
A basic knowledge of the anatomy of the flexor tendons, especially in

the forearm, wrist, and hand, is assumed, as is an understanding of the
essential biomechanical aspects of flexor digitorum profundus and
sublimis function in the fingers. Tendon nutrition is believed to derive
from two basic sources: (1) the synovial fluid produced within the
tenosynovial sheath and (2) the blood supply provided through longi-
tudinal vessels in the paratenon, intraosseous vessels at the tendon
insertion, and vincular circulation (Fig. 66-1). An ischemic area is present
in the flexor digitorum superficialis beneath the A2 pulley at the proximal phalanx. Two zones of ischemia are
present in the flexor digitorum profundus— beneath the A2 pulley and beneath the A4 pulley. Tendon healing is
believed to occur through the activity of extrinsic and intrinsic mechanisms, occurring in three phases: inflam-
matory (48 to 72 hours), fibroblastic (5 days to 4 weeks), and remodeling (4 weeks to about 3.5 months). The
extrinsic mechanism occurs through the activity of peripheral fibroblasts and seems to be the dominant
mechanism contributing to the formation of scar and adhesions. Intrinsic healing seems to occur through the
activity of the fibroblasts derived from the tendon..
8) A fratura do odontóide na criança, quando classificada por SALTER-HARRIS, apresenta-se
usualmente como tipo
A) I
B) II
C) III
D) IV
Fonte: Skeletal Trauma in Children 5th Pg 293
9) Na anatomia do cotovelo, a estrutura ligamentar que se insere no tubérculo sublime da ulna é?
A) o ligamento anular
B) o ligamento transverso
C) o ligamento collateral lateral ulnar
D) a porção anterior do ligamento collateral medial
R= In the normal elbow joint, stability is maintained by the combination of highly

congruent joint geometry, capsuloligamentous integrity, and balanced intact
musculature. The biceps, brachialis, anconeus, and triceps muscles are
especially important. the medial collateral ligament complex consists of anterior,
posterior, and transverse components (Fig. 12-20A). The anterior bundle is the most easily identificable and is
the major portion of the medial collateral ligament complex. The anterior bundle inserts along the medial aspect
of the coronoid process (sublime tubercle) and is taut with the elbow in flexion and extension.The posterior bundle
is taut during flexion.
10. Na fratura do terço distal do úmero no adulto, o nervo mais comumente acometido é o:
A) Ulnar
B) Radial
C) interósseo anterior
D) interósseo posterior
Union rates for distal humeral fractures have improved significantly over the years. e most frequent complication
is stiffness, which o en requires a second procedure. McKee et al. reported an average motion arc of 108 degrees,
74% strength compared with the opposite side, and a mean DASH (Disability of the Arm, Shoulder, and Hand)
score of 20 (0 = perfect and 100 = complete disability) in 25 patients at an average 3 years after medial and lateral
plate fixation of intraarticular distal humeral fractures. Other complications include ulnar neuropathy, posttraumatic
arthritis, osteonecrosis, and symptomatic hardware (see Fig. 57-50)
11. A síndrome de BROWN-SÈQUARD é caracterizada por

déficit motor e
A) proprioceptivo contra-lateral; perda ipsilateral da

sensibilidade dolorosa e da temperatura
B) proprioceptivo ipsilateral; perda contra-lateral da

sensibilidade dolorosa e da temperatura.
C) térmico contra-lateral; perda ipsilateral da sensibilidade dolorosa e da temperatura
D) térmico ipsilateral; perda contra-lateral da sensibilidade dolorosa e da propriocepção
Brown-Séquard syndrome is an injury to either side of the spinal cord (see Fig. 38-7C) and usually is the result of
a unilateral laminar or pedicle fracture, penetrating injury, or rotational injury resulting in a subluxation. It is
characterized by motor weakness on the side of the lesion and the contra- lateral loss of pain and temperature
sensation. Prognosis for recovery is good, with signi cant neurological improvement o en occurring. Pollard and
Apple noted that only central cord and Brown-Séquard syndromes were statistically associated with improved
recovery at 2 years a er injury.
12. Na hernia de disco cervical que comprime a raiz de C6, o exame físico do paciente revela
A) sinal de HOFFMAN positivo

B) fraqueza do biceps
C) hipoestesia do dedo mínimo
D) diminuição do reflexo do tríceps
Fonte: Canale & Beaty: Campbell´s Operative Orthopaedics

12th ed. pag 1920
13. As fraturas do capitulo umeral em adultos são classificadas pela AO como
A) A1
B) B1
C) B2
D) B3
14. Na fratura completa do tendão distal do bíceps braquial, o teste físico que apresenta 100% de
sensibilidade e especificidade para o diagnóstico é o (TEOT 2015)
A) hook test
B) de SPEED
C) de YERGASON
D) Biceps squeeze
The hook test can be used for the diagnosis of complete biceps tendon
avulsions: with the elbow actively exed and supinated, the examiner
should be able to “hook” an index nger under a cordlike structure in the
antecubital fossa if the tendon is intact (Fig. 48-41). is test was reported
to have 100% sensitivity and speci city; however, the examiner must
be sure to hook the lateral edge of the biceps tendon, not the medial
edge, because the lacertus brosus might be mistaken for an intact biceps tendon.
15. A ruptura do tendão do glúteo médio é mais frequente em
A) Homens acima de 50 anos de idade
B) mulheres acima de 50 anos de idade
C) homens abaixo de 50 anos de idade
D) mulheres abaixo de 50 anos de idade
Most reported gluteus medius ruptures have been in women older than age 50 years. The two most reliable signs
of a gluteus medius rupture are a Trendelenburg gait and pain on resisted hip abduction, both of which are
reported to have a more than 70% specificity and sensitivity.
16. O cisto ósseo unicameral é mais frequente:
A) na tíbia
B) no homem
C) nos ossos chatos
D) na 3° e 4° década
Unicameral bone cysts are common lesions of childhood more consistent with a developmental or reactive lesion
than a true tumor. Eighty- ve percent occur in the rst 2 decades with a 2 : 1 male predominance. Any bone of the
extremities can be a ected, but unicameral bone cysts are most common in the proximal humerus and femur.
17. Na artrite reumatoide, o paciente que está limitado, a exercutar pouca atividade diária é
caracterizado, segundo o escore de capacidade funcional da AAR, como classe
A) I
B) II
C)III
DIV
Fonte: European Surgical, Orthopaedics and Traumatology – The EFORT textbook 2014. Pg 426
18. Na paralisia cerebral, o nível funcional mais frequente segundo o Gross Motor and Funcional
Classification System (GMFCS) é o:
A) I
B) II
C) III
D) IV
A comprehensive review of nine CP registries throughout the world revealed the following proportion of GMFCS
levels: level 1, 34.2%; level 2, 25.6%; level 3, 11.5%; level 4, 13.7%, and level 5, 15.6%
Fonte: Herring: Tachdjian`s Pediatric Orthopaedics 5ª Ed. Pg 1776 (na referência está errado)
19. Na fase inicial da histiocitose de células de LANGERHANS, a imagem radiográfica assemelha-se

a:
A) plasmocitoma
B) condrossarcoma
C) tumor de EWING
D) tumor de células gigantes
In the early phase of the disease, the lesion may appear aggressive, with a permeative pattern of osteolysis and
laminated periosteal reaction mimicking Ewing sarcoma.
Fonte: Lovell and Winter’s Pediatric Orthopaedics 7ª Ed, Pg 330.
20. Na osteogênese imperfeita, o aminoácido envolvido no defeito do colágeno tipo I é a:

A) lisina
B) glicina
C) cisteína
D) arginina
Alternatively, there can be na error in substitution or deletion, usually involving a glycine peptide residue
somewhere along the polypeptide chain. In such a case, the affected pacient will produce a structurally or
qualitatively abnormal, less effectual collagen, generally in reduced amounts.
Fonte: Herring: Tachdjian`s Pediatric Orthopaedics 5ª Ed. Pg 208
21. Na fixação externa circular, o aumento da estabilidade é obtido com:
A) o uso de fios olivados

B) o aumento no diâmetro dos anéis
C) a menor angulação entre os pinos
D) o posicionamento excêntrico do osso
There are several component-related factors which can be manipulated to increase the stability of the ring fixation
construct.
1. Increase wire diameter; 2. Increase wire tension; 3. Increase pin-crossing angle to approach 90 degrees; 4.
Decrease ring size (distance of ring to bone); 5. Increase number of wires; 6. Use of olive wires/drop wires; 7.
Close ring position to either side of the fracture (pathology) site; 8. Centering bone in the middle of the ring
Fonte: Rockwood and Green Fractures in Adults 8th, cap 8, p 252
22. No tratamento da infecção pós-osteossíntese, o uso local de antibiótico associado ao

polimetilmetacrilato (cimento) requer que a droga escolhida seja:
A) termolábil
B) lipossolúvel
C) termoestável
D) hidrossolúvel
The key issue of the polymethylmethacrylate (PMMA) antibiotic depot is the need for a heat-stable antibiotic agent,
because during the cement-hardening process, the exothermic reaction can render heat-labile antibiotics
ineffective
Fonte: Rockwood and Green Fractures in Adults 7th, cap 24, p 633
23. A fratura da clavícula na criança em idade escolar resulta frequentemente de:
A) trauma em alta energia

B) queda sobre a mão estendida
C) trauma direto sobre a clavícula
D) força de compressão lateral no ombro
School age clavicle fractures occurring in children are typically the result of a fall where the child sustains a lateral
compressive force to the shoulder.
FonteRockwood and Wilkins Fracture in children 8th, cap 22, p 809 (na referência está errado)
24. A maior parte da vascularização do polo proximal do escafoide entra pela crista:
A) medial
B) lateral
C) dorsal
D) palmar
Vessels enter the scaphoid from the radial artery laterovolarly, dorsally, and distally.
The laterovolar and dorsal systems share in the blood supply to the proximal two thirds
of the scaphoid. Vascularity of the proximal pole and 70% to 80% of the interosseous circulation are provided
through branches of the radial artery, entering through the dorsal ridge. In the distal tuberosity region, 20% to
30% of the bone receives its blood supply from volar branches of the radial artery.
Fonte: Canale & Beaty: Campbell´s Operative Orthopaedics 12th ed., p 3396
25. No polegar trifalângico, a diminuição da primeira comissura e a ausência da musculatura tenar
caracterizam o tipo:
A) I
B) II
C) III
D) IV
Classification and pathoanatomy are dependent on the type of triphalangism. Type I involves a delta middle
phalanx with radial deviation deformity. Type II involves a normal middle phalanx, but an opposable thumb. Type
III is an index-finger duplication with all digits in the same plane.
In type I and II triphalangism, the first web space is normal. In the five-fingered hand (type lll), there is a contracted
first web space that limits prehension. Similarly, usually the thenar musculature is normal in type I and ll
triphalangeal thumbs, whereas it is absent in type Ill triphalangism. In addition, the
triphalangeal thumb may be hypoplastic and have associated intrinsic musculature weakness
Fonte: Lovell and Winter’s Pediatric Orthopaedics 7ª Ed, p 963
26. Na biomecânica do quadril, o ligamento isquiofemoral controla a:
A) adução
B) abdução
C) rotação lateral
D) rotação medial
The hip joint capsule extends down to the intertrochanteric line over the anterior aspect of the femoral neck, but
posteriorly the lateral half of the femoral neck is extracapsular. Three important condensations of the hip joint
capsule are considered ligamentous stabilizers of the hip. The ischiofemoral ligament controls internal rotation in
flexion and extension. The lateral arm of the iliofemoral ligament has dual control of external rotation in flexion
and both internal and external rotation in extension. The pubofemoral ligament controls external rotation in
extension.
27 . Na abordagem emergencial das lesões do

anel pélvico, a instabilidade posterior é mais
bem tratada com:
A) fixador externo supra-acetabular.
B) fixador externo na crista ilíaca.
C) clampe pélvico (“C – clamp”).
D) placa na sínfise púbica.

28. A OTTO pelvis é caracterizada por ser:
A) primária e bilateral.
B) primária e unilateral.
C) secundária e bilateral.
D) secundária e unilateral.
Intrapelvic protrusio acetabuli can be primary or secondary. The primary form, arthrokatadysis (Otto pelvis),
involves both hips, occurs most often in younger women, and causes pain and limitation of motion at a relatively
early age (Fig. 3-67). The secondary form can be caused by migration of an endoprosthesis, septic arthritis, or
prior acetabular fracture. It can be present bilaterally in Paget disease, arachnodactyly (Marfan syndrome),
rheumatoid arthritis, ankylosing spondylitis, and osteomalacia. The radiographic hallmark of protrusio acetabuli is
the medial migration of the femoral head beyond the ilioischial (Kohler) line. The deformity may progress until the
greater trochanter impinges on the side of the pelvis. Frequently, there is an associated varus deformity of the
femoral neck.
29. O quadril em ressalto interno decorre do atrito entre a

eminência iliopectínea e o tendão do:
A) iliopsoas
B) pectíneo
C) adutor longo
D) obturador interno
The internal snapping hip is a result of the iliopsoas tendon snapping over the
iliopectineal eminence or the anterior hip capsule. In flexion, the psoas tendon
is lateral to the iliopectineal eminence. As the hip is extended, the tendon slides
across the iliopectineal eminence and anterior hip capsule, producing a snapping sensation in up to 10% of the normal
population (Fig. 6-36). When symptomatic, the snapping sensation is accompanied by groin pain and usually an audible
low-pitched characteristic “thunk.” The patient usually is able to reproduce the snapping while lying supine and actively
ranging the hip from a position of flexion, abduction, and external rotation to a position of extension, adduction, and
internal rotation. In thinner patients, the snapping can be palpated in the inguinal crease.
30 . Na fratura do acetábulo, o sinal radiográfico da “asa
de gaivota” caracteriza a presença de:
A) fratura da parede posterior
B) fratura de ambas as colunas
C) impacção do teto acetabular
D) subluxação medial da cabeça
Fonte: Rockwood and Green’s Fractures in Adults 8th Ed. Pg1914
31. As fraturas periprotéticas do fêmur classificadas como B2 (VANCOUVER) têm como tratamento
preferencial a:
A) imobilização e repouso
B) fixação in situ com fios ou cabos de cerclagem
C) redução aberta e osteossíntese com placa bloqueada
D) revisão com troca por componente femoral mais longo
If the stem is loose, as in type B2 fractures, revision with a long-stem femoral

component is preferable. This approach not only restores stability to the
femoral component but also provides reliable intramedullary fixation of the
fracture. Many reports in the literature support the use of cemented long-
stem femoral components for this purpose (Fig. 3-109). If cement is to be
used for femoral component fixation in the presence of a femoral fracture,
the fracture must be reduced anatomically and held with bone-holding forceps or cerclage wires to prevent
extrusion of cement between the fracture fragments; otherwise, nonunion can result (Fig. 3-110). If the fracture is
transverse, reduction can be maintained by spanning the fracture with a plate secured to each fragment with
bone-holding forceps to stabilize the fracture temporarily
Fonte: Canale & Beaty: Campbell´s Operative Orthopaedics 12th ed. pag244-246
32. No impacto femoroacetabular do tipo CAM, a lesão em contragolpe é mais comumente encontrada
nas regiões:
A) anterior da cabeça do fêmur e anterior do acetábulo

B) lateral da cabeça do fêmur e anterolateral do acetábulo
C) lateral da cabeça do fêmur e posterolateral do acetábulo
D) posterior da cabeça do fêmur e posteroinferior do acetábulo
Two basic types of impingement have been described. Cam impingement occurs when the anterosuperior
femoral head-neck junction is prominent or the femoral neck has a diminished offset from the adjacent femoral
head (Fig. 6-20). With flexion and particularly flexion combined with internal rotation, the nonspherical portion of
the femoral head-neck junction rotates into the acetabulum. A typical injury pattern with cam impingement is a
tear at the base of the labrum at the labral-chondral junction. The adjacent articular cartilage then becomes injured
because of compression from the femoral head with its relatively larger radius of curvature rotating into the
acetabulum. Frequently, the articular cartilage delaminates from the underlying subchondral bone, progressing
from the acetabular rim (Fig. 6-21). In this process, the acetabular labrum is relatively spared, with more injury
incurred within the adjacent articular cartilage. A “contrecoup” injury frequently is seen on the posterior femoral
head and posteroinferior acetabulum owing to anterior cam impingement with subsequent increased pressure on
the posterior hip cartilage. Cam morphology is more common in young athletic males. The etiology of the deformity
is unknown,
Fonte: Canale & Beaty: Campbell´s Operative Orthopaedics 12th ed. Pag 341
33. Na osteonecrose da cabeça do

fêmur classificada segundo
STEINBERG, o sinal do crescente
acometendo 20% da superfície
articular corresponde ao estágio:
A) IIB
B) IIC
C) IIIB
D) IIIC
34 – Na osteíte do pubis, um dos achados na imagem da ressonância magnética é a tendinose do:
A) grácil
B) pectíneo
C) adutor magno
D) reto abdominal
Disorders of the pubic symphysis and the adjoining musculotendinous structures can occur in athletic adults and
must be distinguished from the other musculoskeletal sources of groin and pubic pain covered in this chapter.
Genitourinary and gynecological origins of pain should be considered as well. Osteitis pubis is seen in athletes
involved in running and cutting sports such as soccer and hockey, as well as with trauma or pregnancy and vaginal
delivery. The typical radiographic appearance is that of widening of the symphysis with blurring of the cortical
margins and occasionally a cyst within the pubic body adjacent to the fibrocartilaginous disc of the symphysis
(Fig. 6-37). This probably represents a stress reaction to overuse or excessive mobility. On a bone scan, the
symphysis demonstrates increased uptake, whereas MRI can show bone marrow edema. Notably, some
asymptomatic athletes demonstrate bone marrow edema in the pubis as well. A cleft sign is seen on MRI when
there is a tear of the ligamentous capsule that envelops the fibrocartilaginous disc of the symphysis. Other related
MRI findings include tendinosis of the rectus abdominis and adductor longus insertions into the pubis; chronic
strains of these tendons frequently are confused with true osteitis pubis. Treatment of osteitis pubis is primarily
conservative because the condition tends to be self-limiting when the inciting stress of overuse is withdrawn.
Rehabilitation aimed at strengthening of the patient’s abdomen and hip adductors should be done in a graded
fashion. Operative intervention has been described for recalcitrant cases, including symphysis curettage,
resection of the symphysis, and symphysis fusion. Our experience with these surgical techniques is limited, and
we favor nonoperative treatment.
Fonte: Canale & Beaty: Campbell´s Operative Orthopaedics 12th ed. Pag 357-358
35. Na artrodese do tornozelo, o tálus deve ser posicionado em:
a) Varo de 5 graus
b) Translação posterior
c) Dorsiflexão de 10 graus
d) rotação medial de 5 graus
TECHNIQUES OF ANKLE ARTHRODESIS
Common to all techniques is the desire to position the ankle in the proper orientation: neutral flexion/extension,
external rotation of 5 degrees or so, 5 degrees of valgus, and slight posterior translation of the talus under the
tibia. Although slight flexion may be tolerated, extension is not and may result in excessive pressure and
intractable pain under the heel.
36. Na fratura multifragmentária da região anterior do pilão tibial é mais frequentemente associada ao
mecanismo de trauma:
a) em rotação lateral do tornozelo

b) em rotação medial do tornozelo
c) axial, com dorsiflexão do tornozelo
d) axial com flexão plantar do tornozelo
As initially hypothesized by Bohler19 and detailed by Ruedi,160 the ultimate fracture pattern depends on the
direction and rate of application of the injurious force, and the position of the foot at the time of loading. Because
of this, wide variations in fracture patterns occur. A vertical impact while the foot is in dorsiflexion results in
cephalad and anterior force, resulting in significant anterior plafond comminution, although impact with the foot in
the neutral position results in significant central comminution. These injury patterns are much more common than
those of the posterior plafond, which are thought to occur during plantarflexion
Rockwood and Green’s Fractures in Adults 8th Ed. 2475 Pg
37. Na insuficiência do tendão tibial posterior é evidenciada clinicamente pelo
a) Sinal de McBride
b) Sinal dos “muitos dedos”
c) Teste da hipermobilidade do primeiro raio
d) Teste da compressão látero-lateral do antepé
Fonte: Tarcisio et.al Exame Físico 2 Ed. 290 Pg
38. Na anatomia do terço médio do antebraço , o ramo profundo do nervo radial encontra-se junto à :
a) Membrane interóssea
b) Artéria interóssea posterior
c) Borda anteromedial da ulna
d) Borda anterolateral do radio
Anatomic Considerations 1. The radial, ulnar, and median nerves remain in relatively constant position throughout
zone B. 2. The anterior interosseous artery and nerve lie on the anterior surface of the interosseous
membrane. 3. The deep branch of the radial nerve lies adjacent to the posterior interosseous artery, posterior to
the interosseous membrane and separated from it by muscle. 
Fonte: Jupiter J: Skeletal trauma 5Th Ed. 201 Pg

39- A sinostose radioulnar congênita geralmente é uma alteração :
a) Isolada e bilateral
b) Isolada e unilateral
c) Associada a malformações e bilateral
d) Associada a malformações e unilateral
Congenital radioulnar synostosis is usually an isolated event. There is a 3:2 ratio of boys to girls. Positive family
histories have been reported (102,137,138). It is a bilateral occurrence 80% of the time (139).
Fonte: Lovell and winter’s Pediatric orthopaedics 6th Ed. 937 Pg
40-Na criança com deformidade plastica do antebraço e limitação da pronossupinação, o tratamento

indicado é:
a) Redução cruenta com fixação intramedular

b) Redução cruenta com imobilização gessada
c) Redução incruenta com imobilização gessada
d) Imobilização gessada com supinação máxima
Generally, a plastic deformation injury with restricted forearm pronation and supination requires a reduction with
conscious sedation or general anesthesia. Considerable reduction force is required and applied over a solid
bolster for several minutes
Fonte: Skeletal Trauma in Children 5th Ed. 143 Pg
41- Na rotação axial da coluna cervical, a articulação atlanto-axial é responsável por aproximadamente:
a) 10%
b) 25%
c) 50%
d) 75%
Atlantoaxial Region
The upper cervical vertebrae are unique compared with the sub- axial spine (Fig. 44-18). The atlas has large
broad-based articular processes to interface with the occipital condyles superiorly and the axis inferiorly. An
articular surface on the posterior aspect of the anterior arch faces the odontoid process of the axis. The posterior
ring of C1 is quite thin with no discrete spinous process. The axis articulates with C1 at three points: two broad
bilateral superior articular surfaces and the odontoid process. Its morphology allows approximately 47 degrees of
rotation (50% of axial rotation of the entire cervical spine)
Fonte: Rockwood and Green’s Fractures in Adults 8th Ed. 1692 Pg

42. No choque neurogênico ocorre :
a) taquicardia e débito urinário baixo

b) taquicardia e débito urinário normal
c) bradicardia e débito urinário baixo
d) bradicardia e débito urinário normal
Fonte:Rockwood and Green’s Fractures in Adults 8th Ed. 1655 Pg
43- Na fratura do sacro classificada por DENIS como zona III, a probabilidade de lesão neurológica é
de :
a) 10-20%
b) 30-40%
c) 50-60%
d) 70-80%
Although several sacral fracture classification systems were proposed earlier, none was widely adopted until
1988 when Denis and colleagues described an anatomic classification that correlated fracture location with the
presence of neurologic injury.11 This classification divides the sacrum into three zones (Fig. 40-23). Zone I (alar
zone) fractures remain lateral to the neuroforamina, zone II (foraminal zone) fractures involve one or more
neuroforamina while remaining lateral to the spinal canal, and zone III (central zone) fractures involve the spinal
canal. The likelihood of neurologic injury increases as fractures occur in more medial zones. In their series, zone
I fractures had a 5.9% incidence of neurologic injury, primarily to the L5 nerve root as it courses over the ala. Zone
II fractures had a 28.4% incidence of neurologic injury caused by either foraminal displacement with resulting
impingement on the exiting nerve root or the “traumatic far-out syndrome” in which the L5 nerve root is caught
between the L5 transverse process and the displaced sacral ala. Zone III fractures had a 56.7% incidence of
neurologic deficits resulting from injury within the spinal canal, with 76.1% of these individuals having bowel,
bladder, and sexual dysfunction.
Fonte: Jupiter J: Skeletal trauma 5Th Ed. 1040
44. Na epicondilite lateral do cotovelo, as alterações patológicas envolvem principalmente a origem do

músculo
A) extensor ulnar do carpo

B) extensor comum dos dedos
C) extensor radial curto do carpo
D) extensor radial longo do carpo
LATERALEPICONDYLITIS
Lateral epicondylitis (tennis elbow), a familiar term used to describe myriad symptoms around the lateral aspect
of the elbow, occurs more frequently in nonathletes than athletes, with a peak incidence in the early h decade
and a nearly equal gender incidence. Lateral epicondylitis can occur during activities that require repetitive
supination and pronation of the forearm with the elbow in near full extension. Runge rst described the clinical
entity in 1873, and since then almost 30 di erent conditions have been proposed as causes. Although originally
described as an in ammatory process, the current consensus is that lateral epicondylitis is initiated as a
microtear, most often within the origin of the extensor carpi radialis brevis. Microscopic ndings show immature
reparative tissue that resembles angio broblastic hyperplasia. e pathological process mainly involves the origin
of the extensor carpi radialis brevis but can involve the tendons of the extensor carpi radialis longus and the
extensor digitorum communis.
45 - No tratamento cirurgico do cotovelo rígido, o “procedimento da coluna”é realizado através do

acesso
A) medial
B) lateral
C) anterior
D) posterior
A variety of surgical release procedures have been described for treatment of elbow contractures. Anterior release
without biceps lengthening works best in patients with exion contractures but is unlikely to improve function in
patients with concomitant articular surface damage. Candi- dates for this treatment have a relatively well-
preserved ulno- humeral joint and minimal or no osteophytes in the olecranon fossa. Combined anterior and
posterior releases, as well as combined medial and lateral approaches, also have been described for treatment
of elbow contractures.
We believe that the lateral approach (the so-called column procedure) has several advantages over the anterior
approach.
46. Na sindrome do tuner cubital classificada por McGOWAN, a categoria III é caracterizada por
A) parestesia intermitente e fraqueza subjetiva.
B) parestesia permanente e fraqueza subjetiva
C) parestesia intermitente e fraqueza mensurável
D) parestesia permanente e fraqueza mensurável
The severity of cubital tunnel syndrome was divided into three categories by McGowan and later revised by Dellon.
Mild dysfunction implies intermittent paresthesias and subjective weakness; moderate dysfunction presents as
intermittent paresthesias and measurable weakness; and severe dysfunction is characterized by persistent
paresthesias and measurable weakness.
47. A luxação congênita da cabeça do rádio geralmente é
A) anterior, com limitação em flexão
B) posterior, com limitação em flexão
C) anterior, com limitação da extensão
D) posterior, com limitação da extensão
Congenital radial head dislocation may be bilateral or unilateral (162). It is defined by the din:ction ofsubluxation
or dislocation. Most congenital dislocations are posterior or posterolateral.. Children with radial head dislocations
often present after infancy. The most common reasons for presentation are (a) limited dhow extension; (b)
posterolateral dhow mass/prominence; and (c) pain with activities, especially athletics (107, 172).
Fonte: Lovell and Winter’s Pediatric Orthopaedics 7ª Ed, Pg 934-35
48 - Na amputação por vasculopatia periferica, a complicação mais comum é a
A) dor
B) infecção
C) necrose da pele
D) contratura do coto
INFECTION
Infection is considerably more common in amputations for peripheral vascular disease, especially in diabetic
patients, than in amputations secondary to trauma or tumor.
49) O anel pericondral de LaCROIX é uma estrutura

A) fibrosa, localizada na epífise
B) cartilaginosa, localizada na epífise
C) fibrosa, que prende a epífise à metáfise
D) cartilaginosa, que prende a epífise à metáfise
The physis is connected to the epiphysis and metaphysis peripherally via the zone of Ranvier and the perichondral
ring of LaCroix. The zone of Ranvier is a circumferential notch containing cells (i.e., osteoblasts, chondrocytes,
and fibroblasts), fibers, and a bony lamina located at the periphery of the physis. It also contributes to latitudinal
or appositional growth. The periosteal sleeve is firmly attached to each end of a bone at the zone of Ranvier and
the perichondrium of the epiphysis and is thought to be an anatomic restraint to rapid, uncontrolled longitudinal
growth. The perichondral ring of LaCroix is a strong fibrous structure that secures the epiphysis to the metaphysis.
Fonte: Skeletal Trauma in Children 5th Ed. 16 Pg.
50) Na retirada de aparelhos gessados recomenda-se a utilização de serras

A) afiadas, movendo-se a lâmina de forma contínua
B) afiadas, movendo-se a lâmina de forma intermitente
C) pouco afiadas, movendo-se a lâmina de forma contínua
D) pouco afiadas, movendo-se a lâmina de forma intermitente
Practical tips for minimizing the risk of cutting or burning the skin during cast removal include the following:
(1) Padding should be adequate when the cast is applied. (2) A sharp saw blade should always be used. Dull
blades have been shown to generate significantly more heat that sharp ones. (3) The technique of overlapping
circles rather than “running” the blade when cutting should be used so that binding, which generates heat, is
avoided. (4) Periodically stopping and allowing the blade to leave the cast and cool is recommended,
particularly when hard material such as fiberglass is cut and when the cast is thick. (5) When feasible, bony
prominences should be cut around rather than over so that the risk of direct blade contact and thermal injury
is minimized. It is important to remember that, other than the situation in which a patient is uncooperative, all
causes of castsaw injury are physician or equipment dependent and thus are potentially avoidable with
attention to technique and detail.
Fonte: Skeletal Trauma in Children 5th Ed. 42 Pg.

51. Na osteoporose pós menopausa, a diminuição abrupta da massa óssea tem relação com níveis
decrescentes de
A) tiroxina
B) estrogênio
C) calcitonina
D) progesterona
Women reach skeletal maturity some- what earlier than men. After the peak bone mass has been achieved
there is a plateau phase with Bone Mass slow bone losses until the menopause at the age around 50 years
when the bone mass decreases rapidly over 5–10 years due to diminishing levels of oestrogen hormone.
After 70 years of age different factors linked to age such as lack of vitamin D, decreasing levels of other
anabolic hormones and decreased physical activity play an increasing role in the bone loss, which then is
similar in magnitude for men and women and affects both trabecular and cortical bone.
Fonte: European Surgical, Orthopaedics and Traumatology – The EFORT textbook 2014. Pg285.
52. Na síndrome dolorosa regional complexa a presença de pele úmida, cianótica e fria caracteriza o
estágio
A) 1
B) 2
C) 3
D) 4
Stage two: There is gradual decrease in pain with increasing stiffness of the joints and muscle wasting. The edema
worsens and spreads to proximal areas. The skin is moist, cyanotic and cold…
Fonte: Jupiter J: Skeletal Trauma 5th Ed. 391 Pg.
53) A neurofibromatose do tipo 1 é
A) central e apresenta frequentemente manifestações ortopédicas
B) central e apresenta raramente manifestações ortopédicas
C) periférica e apresenta frequentemente manifestações ortopédicas
D) periférica e apresenta raramente manifestações ortopédicas

Two distinct types of the disorder exist. Neurofibromatosis type 1 (NF-1), also known as von Recklinghausen
disease or peripheral neurofibromatosis, is caused by a defect in chromosome 17. Neurofibromatosis type 2 (NF-
2), previously known as bilateral acoustic neurofibromatosis or central neurofibromatosis, results from a defect in
the long arm of chromosome 22. Children with orthopaedic manifestations of the disease, such as spinal
deformities or congenital tibial pseudarthrosis, almost always have NF-1. Children with NF-2 rarely require
orthopaedic intervention.
Fonte: Herring: Tachdjian`s Pediatric Orthopaedics 5ª Ed. Pg 514 Pg
54. Nas lesões fisárias tipo VI, segundo a classificação de PETERSON, ocorre
A) lesão do anel pericondral
B) esmagamento complexo da fise
C) fratura exposta com perda de parte da fise
D) diminuição acentuada do crescimento longitudinal
Although the Salter-Harris classification of physeal fractures is the most widely used system, there are a few
physeal injuries that do not fit into this classification scheme. The first is an injury to the perichondral ring.
Salter’s colleague Mercer Rang, termed this a type VI physeal injury. Basing his system on a review of 951
fractures, Peterson proposed a new classification scheme. Although this classification system has many
similarities to that of Salter-Harris, its important addition is the Peterson type I fracture, a transverse fracture
of the metaphysis with extension longitudinally into the physis. Clinically this fracture is commonly seen in the
distal radius. Peterson also described a type VI injury, which is an open injury associated with loss of the
physis
Fonte: Herring: Tachdjian`s Pediatric Orthopaedics 5ª Ed. Pg 1203 Pg.
55) Na ATJ, o defeito ósseo extenso na região metafisária com cortical íntegra é classificado, segundo
RAND, como tipo
A) I
B) II
C) III
D) IV
Bone deficiencies encountered during total knee replacement can have multiple causes, including arthritic
angular deformity, condylar hypoplasia, osteonecrosis, trauma, and previous surgery such as HTO and previous
total knee replacement. The method used to compensate for a given bone defect depends on the size and the
location of the defect. Contained or cavitary defects have an intact rim of cortical bone surrounding the deficient
area, whereas noncontained or segmental defects are more peripheral and lack a bony cortical rim.
Rand classified these defects into three types:
Type I: focal metaphyseal defect, intact cortical rim
Type II: extensive metaphyseal defect, intact cortical rim
Type III: combined metaphyseal and cortical defect
Small defects (<5 mm) typically are filled with cement
56. A lesão meniscal mais comum é a
A) Oblíqua
B) Transversa
C) Combinada
D) Longitudinal
Traumatic lesions of the menisci are produced most commonly by rotation as the flexed knee moves toward
an extended position. The medial meniscus, being far less mobile on the tibia, can become impaled between the
condyles, and injury can result. The most common location for injury is the posterior horn of the meniscus, and
longitudinal tears are the most common type of injury. The length, depth, and position of the tear depend on the
position of the posterior horn in relation to the femoral and tibial condyles at the time of injury. Menisci with
peripheral cystic formation or menisci that have been rendered less mobile from previous injury or disease may
sustain tears from less trauma. Congenital anomalies of the menisci, especially discoid lateral meniscus, may
predispose to either degeneration or traumatic laceration. Likewise, areas of degeneration that develop as a result
of aging cannot withstand as much trauma as healthy fibrocartilage. Abnormal mechanical axes in a joint with
incongruities or ligamentous disruptions expose the menisci to abnormal mechanics and thus can lead to a greater
incidence of injury. Congenitally relaxed joints and those with inadequate musculature, especially the quadriceps,
probably are at significantly greater risk of meniscal injuries as well as other internal derangements.
Fonte: Canale & Beaty: Campbell´s Operative Orthopaedics 12th ed. pag. 412 Pg.
57) Na reconstrução do LCP, a complicação mais comum é a
A) lesão nervosa
B) perda da flexão
C) dor patelofemoral
D) instabilidade residual
A side from the usual postoperative complications, the most common problem associated with posterior
cruciate ligament reconstruction is loss of motion. Flexion loss is more common than extension loss. Many studies
report between 10 and 20 degrees loss of flexion, most likely caused by improper graft placement or inadequate
rehabilitation. The position of the femoral tunnel is more critical than that of the tibial tunnel. Femoral attachments
anterior and distal to the most isometric region result in increased graft tension, with flexion loss resulting from an
increase in distance between the femoral and tibial attachment sites. Loss of extension or a flexion contracture
most likely is caused by prolonged immobilization in flexion.
Fonte: Canale & Beaty: Campbell´s Operative Orthopaedics 12th ed. pag2176 Pg.
58) A ruptura do ligamento patelar é mais comum em pacientes
A) acima de 40 anos, na tuberosidade da tíbia
B) abaixo de 40 anos, na tuberosidade da tíbia
C) acima de 40 anos, no polo inferior da patela
D) abaixo de 40 anos, no polo inferior da patela

Disruption of the extensor mechanism of the knee most commonly is caused by fracture of the patella.
Disruption of the quadriceps mechanism and disruption of the patellar tendon are the next most common causes.
The mechanism of injury usually is an eccentric overload to the extensor mechanism with the foot planted and
the knee partially flexed. Patellar tendon rupture or avulsion is more common in patients younger than 40 years
old, especially athletes…
…Rupture of the patellar tendon usually occurs at the inferior pole of the patella…
Fonte: Canale & Beaty: Campbell´s Operative Orthopaedics 12th ed. Pag 2338 Pg. (referência oficial errada
- Páginas 2336 e 2337).
59) No joelho flutuante, a incidência de fratura exposta associada é de aproximadamente
A) 20%
B) 40%
C) 60%
D) 80%
Locally, vascular damage, nerve lesions, and open fractures are common, the incidence of the latter
approaching 50% to 70%.
Fonte: Jupiter J: Skeletal Trauma 5th Ed. 1817 Pg.
60) Na fratura do terço distal do fêmur na criança a lesão associada mais comum é a
A) fratura da pelve
B) síndrome compartimental
C) fratura da coluna vertebral
D) lesão ligamentar do joelho
Because many of these injuries are the result of high-energy mechanisms such as traffic accidents and
motor sports, associated visceral injuries occur in approximately 5% of patients. Other musculoskeletal injuries
are seen in association with distal femoral physeal fractures in 10% to 15% of patients. Other long bone fractures,
as well as pelvic and spine fractures, must be ruled out, especially if the mechanism of injury is highenergy motor
trauma. Knee ligament disruption, however, is the most common concomitant musculoskeletal injury.
Fonte: Rockwood and Wilkins fractures in Children 8th Ed. 1404 Pg. (Referencia oficial equivocada – resposta
na página 1029)
61) A artroplastia reversa do ombro tem como contra-indicação a:
A) artropatia neuropática
B) falha da artroplastia parcial
C) fratura em 4 partes no paciente idoso
D) lesão maciça do manguito com pseudoparalisia
INDICATIONS
The primary indication for reverse total shoulder arthroplasty is a nonfunctional rotator cuff. This encompasses a number of
disease processes, including cuff tear arthropathy, pseudoparalysis due to massive rotator cuff tear without arthritis, multiple
failed rotator cuff repairs with poor function and anterosuperior instability, three- and four-part proximal humeral fractures
in the elderly, proximal humeral nonunions, greater tuberosity malunions, and failed shoulder hemiarthroplasty with
anterosuperior instability. Reverse shoulder arthroplasty is appropriate for patients with an intact deltoid, adequate bone stock
to support the glenoid component, no evidence of infection, no severe neurological deficiency (Parkinson disease, Charcot
joints, syringomyelia), and no excessive demands on the shoulder joint (Box 12-1). Contraindications include loss or
inactivity of the deltoid and excessive glenoid bone loss that would not allow secure implantation of the glenoid component.
Some authors have suggested that the procedure is unsuitable for patients younger than 70 years old. Surgeon inexperience
is also a relative contraindication
Fonte: Canale & Beaty: Campbell´s Operative Orthopaedics 12th ed. pag549
62) Na capsulite adesiva do ombro, o aumento da sua incidencia está relacionado com:
A) hipertireoidismo
B) arritmia cardíaca
C) gênero masculino
D) idade menor que 50 anos
The incidence of frozen shoulder in the general population is approximately 2%, but several conditions are associated with
an increased incidence, including female gender, age older than 49 years, diabetes mellitus (five times more), cervical disc
disease, prolonged immobilization, hyperthyroidism, stroke or myocardial infarction, the presence of autoimmune
diseases, and trauma. Individuals between the ages of 40 and 70 are more commonly affected. Approximately 70% of
patients are women. Twenty percent to 30% of affected individuals develop adhesive capsulitis in the opposite shoulder.
The condition rarely recurs in the same shoulder. Common to almost all patients is a period of immobility, the causes of
which are diverse; this probably is the most significant factor related to the development of the condition.
Fonte: Canale & Beaty: Campbell´s Operative Orthopaedics 12th ed. pag 2235 pg
63. Na tendinite calcarea do ombro, a fase II de SARKAR-UHTHOFF é:
A) metaplasia fibrocartilaginosa
B) tecido de granulação maduro
C) migração de células inflamatórias
D) deposição de cálcio nas vesículas celulares
CHRONOLOGICAL PROGRESSION
Calcific tendinitis follows a definite progression in most patients, and resolution is seen in almost all of them, with
the length of time required being the only true variable. The following three-phase chronology described by Sarkar
and Uhthoff is useful in planning treatment:
Phase I—precalcification stage. In the precalcification stage, the site of predilection for calcification (possibly a
site with a diminished blood supply) undergoes fibrocartilaginous metaplasia. At this stage, patients generally
are asymptomatic.
Phase II—calcification stage. During this stage, calcium is deposited into matrix vesicles, which are excreted by
the cells and coalesce into larger calcium deposits (Fig. 46-13). This initial part of the calcification stage is
known as the phase of formation. At this time, the deposits on gross inspection are dry and chalky. As the
matrix vesicles coalesce into larger deposits, the fibrocartilage gradually is replaced and eroded. The patient
enters a resting phase, during which the pain may be minimal, and the radiographic appearance is one of well-
marginated, mature-appearing deposits. This resting phase is of variable length and ends with the beginning
of the resorptive phase. During the resorptive phase, vascular channels appear at the periphery of the deposit
and calcium resorption ensues. This stage can be exceedingly painful, and many patients seek treatment at
this time. The calcium deposits at this time resemble cream or toothpaste. As the calcium is resorbed, the
dead space is filled with granulation tissue.
Phase III—postcalcification phase. During this phase, the granulation tissue matures into mature collagen aligned
along stress lines with the longitudinal axis of the tendon, reconstituting the tendon. Pain subsides markedly
during this phase.
Fonte: Canale & Beaty: Campbell´s Operative Orthopaedics 12th ed. pag 2237 pg
64. Na correção de uma deformidade na diáfise da tíbia, se o CORA, o eixo de correção e a linha da
osteotomia estão no mesmo ponto devemos realizar: (TEOT 2016)
a) rotação
b) angulação
c) translação
d) translação e angulação
Fonte: Rockwood and Green’s Fractures in Adults 7th Ed 880 Pg
65) Na sindrome compartimental após fratura exposta da tíbia,

a lesão de partes moles corresponde, segundo a classificação
de TSCHERNE ,ao grau:
a) 1
b) 2
c) 3
d) 4
66. Na instabilidade perilunar progressiva do carpo, o estágio III de MAYFIELD é carcaterizado

pela falha do ligamento:
A) escafo-semilunar
B) capitulo-seminular
C) radiocarpal dorsal
D) piramidal-semilunar
PROGRESSIVE PERILUNAR INSTABILITY

Mayfield, Johnson, and Kilcoyne described four stages of progressive disruption of ligament attachments and anatomical
relationships to the lunate resulting from forced wrist hyperextension (see Fig. 69-9). Stage I represents scapholunate failure;
stage II, capitolunate failure; stage III, triquetrolunate failure; and stage IV, dorsal radiocarpal ligament failure, allowing
lunate dislocation.
Fonte: Canale & Beaty: Campbell´s Operative Orthopaedics 12th ed. 3455 pg
67. A doença de KIENBOCK tem como fator de risco para sua ocorrência:
A) o gênero feminino
B) o punho dominante
C) a idade maior que 50 anos
D) a variancia ulnar tipo ulna plus
Kienböck disease is a painful disorder of the wrist of unknown cause in which radiographs eventually show osteo-
necrosis of the carpal lunate. It occurs more frequently between the ages of 15 and 40 years and in the dominant
wrist of men engaged in manual labor. Armistead et al., using CT, showed occult fractures of the lunate in some
patients (Fig. 69-52A).
68. A lesão do tendão extensor do dedo médio na região

metacarpofalângica corresponde, na classificação
topográfica , à zona:
A) III
B) IV
C) V
D) VI
Fonte: European Surgical, Orthopaedics and Traumatology – The EFORT textbook 2014. Pg1967 Pg
69. A mão reumatoide apresenta como característica clinica o acometimento:
A) Bilateral
B) Assimétrico
C) Precoce das interfalângicas
D) Tardio das metacarpofalâmicas.
Rheumatoid hand deformities usually are bilateral and symmetrical. Each deformity must be analyzed in detail
before surgery is considered. Although combinations of deformities occur, involvement of the fingers, thumb, and
wrist is typical.
70. Na síndrome do túnel do carpo, o teste mais específico e sensível para o diagnóstico é o de: (
TARO 2014)
A) Tinel
B) Phalen
C) Durkan
D) Froment.
- - A carpal compression test (Durkan test), in which direct compression Is applied to the median nerve for 30
seconds with the thumbs or an atomizer bulb attached to a manometer, was found to be more specific (90%)
and more sensitive (87%) than either the Tinel or Phalen test. Patients with carpal tunnel syndrome usually
have symptoms of numbness, pain, or paresthesia in the median nerve distribution.
-
Fonte: Canale & Beaty: Campbell´s Operative Orthopaedics 12th ed. Pg 3638
71. O polegar em gatilho na criança é uma alteração:
A) Isolada que acomete a polia A1

B) Isolada que acomete a polia A2
C) Sindrômica que acomete a polia A1
D) Sindrômica que acomete a polia A2
Trigger thumb represents an abnormality of the flexor pollicis longus and its tendon sheath at
the A1 pulley, where there is a palpable mass (Notta nodule), representing the flexor pollicis
longus constriction at the A1 pulley. In the past, trigger thumbs were defined as congenital.
However, this condition is almost always acquired in the first 2 years of life, as indicated by a
prospective screening of neonates, which failed to record any trigger thumbs (316,317).
72 – Numa criança com limitação para o apoio do membro e leucocitose de 13.000/mL, a probabilidade
de artrite séptica do quadril é de aproximadamente
A) 10%
B) 40%
C) 70%
D) 90%
- Differentiating septic arthritis from benign conditions such as transient synovitis may be challenging. Kocher et
al. reviewed the cases of all children treated at Boston Children's Hospital from 1979 to 1996 for an acutely irritable
hip and developed a clinical prediction algorithm to differentiate between septic arthritis and toxic synovitis (108).
Although several variables differed significantly between septic arthritis and toxic synovitis, there was
considerable overlap, making diagnosis based on individual variables alone difficult. However, four independent
multivariate clinical predictorsâ€”history of fever, nonâ€“weight bearing, ESR of at least 40, and serum WBC count
of more than 12,000 per mLâ€”were identified that, when combined, improved diagnostic accuracy. The predicted
probability of septic arthritis was 3.0% if one predictor was present, 40.0% for two predictors, 93.1% for three
predictors, and 99.6% if all four predictors were present. Although the presence of three or more predictors was
very specific for septic arthritis, it was not highly sensitive.
73 – A fisiopatologia da artropatia de CHARCOT que acomete o pé, envolve
A) trauma de alta energia

B) aumento do fluxo sanguíneo local
C) aumento da atividade dos osteoblastos
D) diminuição da atividade dos osteoclastos
Increased local blood flow . Excessive osteoclastic activity without a concomitant increase in osteoblastic function
has also been documented in the Charcot foot .
Fonte: European Surgical, Orthopaedics and Traumatology – The EFORT textbook 2014. Pg Pg. 3549
74- A fasciíte plantar está relacionada à presença de:
A) dorsiflexão limitada do tornozelo e pronação excessiva do pé.

B) flexão plantar limitada do tornozelo e pronação excessiva do pé.
C) dorsiflexão limitada do tornozelo e supinação excessiva do pé.
D) flexão plantar limitada do tornozelo e supinação excessiva do pé
- Tightness of the Achilles tendon is thought to limit ankle dorsiflexion, which in turn results in an increased strain
within the plantar fascia. Excessive pronation of the foot also increases tensile loads on the plantar aponeurosis.
Fonte: European Surgical, Orthopaedics and Traumatology – The EFORT textbook 2014. Pg Pg. 3902
75) O halúx rígido está associado:
A) ao primeiro metarsal curto.

B) ao halúx valgo interfalângico .
C) à retração do tendão calcâneo.
D) à hipermobilidade do primeiro raio.
- Although metatarsus primus elevatus (dorsal position of the first metatarsal on a weight bearing lateral
radiograph) has been suggested as a primary causative factor in the pathogenesis of hallux rigidus, this has not
been clearly proven. No association has been identified between hallux rigidus and primus elevatus, first ray
hypermobility, a long first metatarsal, Achilles or gastrocnemius tendon tightness, abnormal foot posture,
symptomatic hallux valgus, adolescent onset, shoes, or occupation. It is associated with hallux valgus
interphalangeus, bilateral involvement in patients with a familial history, unilateral involvement in patients with a
history of trauma, and female gender.
Fonte: Canale & Beaty: Campbell´s Operative Orthopaedics 12th ed. Pg 3892
76. Na lesão osteocondral do tálus classificada segundo BERNDT E HARTY, o tratamento conservador
está indicado no tipo:
A). III lateral

B). III medial
C). IV lateral
D). IV medial
Surgery usually is required because of persistent symptoms or a loose body in the ankle joint, most often in lateral
stage III or IV lesions. Stage I and II lesions generally can be treated successfully without operation. Nonoperative
treatment of stage III medial lesions compares favorably with the results of surgical treatment; most are
asymptomatic after conservative treatment. Conversely, lateral stage III lesions generally have better results after
surgical excision than after conservative treatment. We recommend operative treatment of stage III lateral lesions
and all stage IV lesions; all stage I and II lesions and stage III medial lesions can be observed for healing,
especially in young children and adolescents.
Fonte: Canale & Beaty: Campbell´s Operative Orthopaedics 12th ed. Pag 1506 (referencia com pagina
equivocada)
77. O metatarso aduto está frequentemente associado com:
A). torção tibial interna

B). luxação congênita do joelho
C). valgismo acentuado do retropé
D). hipotonia do musculo abdutor do hálux
Fonte: Herring: Tachdjian`s Pediatric Orthopaedics 5ª Ed. Pg 770-71
78. a colisão tarsal envolve mais comumente as articulações
A). talonavicular e calcaneonavicular.

B). talonavicular e calcaniocuboidea
C). talocalcaneana e calcaneonavicular
D). calcaneonavicular e calcaneocuboidea.
On the basis of a cadaveric study by Phitzner in 1896, the rate of calcaneal navicular synostosis was found to be
2.9%, and if talocalcaneal coalitions are included as well, its incidence might reach 6% (245,246).

79. na instabilidade patelar o sinal do cruzamento é observado na tróclea do tipo.
A). I
B). II
C). III
D). IV
All imaging modalities have been used in the management of patellar instability [8]. Many are important research
tools e.g., dynamic MRI scans, but are not necessary or useful in the clinical management of most patients. The
single most useful image is the plain strict lateralX-ray. “Strict” means that the posterior condyles of the femur
perfectly overlap. From this image the patellar height and the shape of the trochlear groove can be defined (Figs.
1 and 3).
Fonte: European Surgical, Orthopaedics and Traumatology – The EFORT textbook 2014. Pg. 2793 Pg
80. A fratura da base da falange proximal do polegar tipo III de SH, ocorre por avulsao:
A). da placa volar

B). do ligamento colateral ulnar
C). do tendão adutor do polegar
D). do tendão flexor curto do polegar
The thumb proximal phalanx is particularly susceptible to injury. An ulnar collateral ligament (UCL) avulsion injury
at the base of the thumb proximal phalanx is similar to the adult gamekeeper’s or skier’s thumb. The mechanisms
of injury, clinical findings of UCL laxity at the MCP joint, and physical symptoms of instability with grip and pinch
will be similar to the adult soft tissue UCL injury. However, the fracture pattern is usually an S-H III injury, as the
ligament typically remains attached to the epiphyseal fracture fragment (Fig. 10-32). Displaced injuries with
articular incongruity or joint instability require open reduction and internal fixation (ORIF) to restore articular
alignment and joint stability.191
Fonte: Rockwood and Wilkins fractures in Children 8th Ed. 446 Pg

81. Na plexopatia neonatal classificada Segundo
NAKARAS, aquela que evolui com recuperação total
entre a primeira e oitava semana é do tipo
A). I
B). II
C). III
D). IV
Fonte: Fonte: Canale & Beaty: Campbell´s Operative

Orthopaedics 12th ed. Pag1323
82. Na doença de PAGET as atividades osteclasticas e osteoblasticas apresentam-se,

respectivamente:
A). diminuída na fase inicial e diminuída na fase tardia

B). aumentada na fase inicial e diminuída na fase tardia
C). diminuída na fase inicial e aumentada na fase tardia
D). aumentada na fase inicial e aumentada na fase tardia
Paget disease is a disorder of uncertain origin. The presence of virus-like inclusion bodies in the osteoclasts of
affected bone has led to the theory that it may be of viral origin, but this has not yet been proved. Paget disease
may affect 4% of people of Anglo-Saxon descent who are older than age 55 years, but it is rare in most other
populations. It is a disorder of unregulated bone turnover. Excessive osteoclastic resorption is followed by
increased osteoblastic activity. An early lytic phase is followed by excessive bone production with cortical and
trabecular thickening
Fonte: Fonte: Canale & Beaty: Campbell´s Operative Orthopaedics 12th ed. Pag880
83. Na fratura da doença femoral, o fragmento livre localiza-se mais comumente na posição
A). anterolateral
B). anteromedial
C). posterolateral
D). posteromedial
Mechanisms of Injury
The majority of these fractures occur in elderly female patients.
The usual cause is a simple fall with an applied force being
transmitted to the femoral neck via the greater trochanter,
resulting in the fracture.145 An alternative mechanism is external
rotation of the leg with increasing tension in the anterior capsule
and iliofemoral ligaments. As the neck rotates, the head remains
fixed and a fracture occurs. This mechanism accounts for the
posterior neck comminution observed in many of these fractures.
The usual site of the fracture is in the weakest part of the femoral
neck, located just below the articular surface. Quantitative
computed tomography (CT) has confirmed site-specific bone
loss within the femoral head and neck with maximal bone loss in
the more proximal and superolateral areas, which accounts for
the site of fracture.51
More rarely the fracture occurs as a result of higher energy
trauma. These injuries are more common in younger patients, in
whom much greater force is required to cause the fracture. 78
Head-on vehicle collisions may be responsible. The use of
clipless pedals on bikes has become popular, and these hamper
the ability to quickly disengage the foot in the event of an
accident, making a fall on the trochanter, and a hip fracture, more
likely. In younger patients, the injury more frequently affects
men. Finally the femoral neck is a well-recognized site for stress
fractures, and these occur as a result of repetitive cyclical
loading, which eventually exceeds the strength of normal boné
84. Na osteonecrose após fratura-luxação do tálus, o diagnóstico radiográfico é feito a partir de
A) 3 a 4 semanas.
B) 6 a 8 semanas.
C) 10 a 12 semanas.
D) 14 a 16 semanas.
The radiographic diagnosis of osteonecrosis is made when the avascular talar body demonstrates increased
density compared with the surrounding vascularized bone, which is undergoing disuse atrophy. Later, as
revascularization occurs, there can be partial or complete collapse of the subchondral bone, narrowing of the
joint space, and occasionally fragmentation of the talar body. The “Hawkins sign” is a well-described
radiographic indication of viability of the talar body (Fig. 60-20). As noted by Hawkins, “The time to recognize
the presence of avascular necrosis is between the sixth and the eighth week after the fracture-dislocation. By
this time, if the patient has been nonweight bearing, diffuse atrophy is evident by roentgenogram in the bones of
the foot in the distal part of the tibia. An anteroposterior roentgenogram of the ankle made with the foot out of
the plaster cast, reveals the presence or absence of subchondral atrophy in the dome of the talus. Subchondral
atrophy excludes the diagnosis of avascular necrosis

85. O fibroma não ossificante localiza-se caracteristicamente na região:
A) central da diáfise
B) central da metáfise
C) excêntrica da diáfise
D) excêntrica da metáfise
NONOSSIFYING FIBROMA
Nonossifying fibromas (also known as metaphyseal fibrous defects, fibrous cortical defects, and fibroxanthomas)
are common developmental abnormalities and are believed to occur in 35% of children. Usually they are found
incidentally.
Generally, these lesions occur in the metaphyseal region of long bones in individuals 2 to 20 years old. Although
any bone may be involved, approximately 40% of these lesions are found in the distal femur, 40% in the tibia, and
10% in the fibula. On plain radiographs, a nonossifying fibroma appears as a well-defined lobulated lesion located
eccentrically in the metaphysis (Fig. 25-9). Multilocular appearance or ridges in the bony wall, sclerotic scalloped
borders, and erosion of the cortex are frequent findings. There is no periosteal reaction in the absence of a
pathological fracture.
Fonte: Canale & Beaty: Campbell´s Operative Orthopaedics 12th ed. pag. 869
86. O cisto ósseo unicameral no adulto acomete principalmente o
A) ilíaco e o calcâneo
B) terço proximal do úmero e o ilíaco
C) terço proximal do fêmur e o calcâneo
D) terco proximal do úmero o terço proximal do fêmur
Unicameral bone cysts are common lesions of childhood more consistent with a developmental or reactive lesion
than a true tumor. Eighty-five percent occur in the first 2 decades with a 2 : 1 male predominance. Any bone of
the extremities can be affected, but unicameral bone cysts are most common in the proximal humerus and femur.
In adults, the ilium and calcaneus are more common locations. The lesions are most active during skeletal growth
and usually heal spontaneously at maturity. Unicameral bone cysts often are asymptomatic, unless a pathological
fracture has occurred. Two thirds of patients present with fractures, which can stimulate the cyst to heal.
Unicameral bone cysts in the flat bones usually are asymptomatic, are found incidentally, and rarely fracture.
Fonte: Canale & Beaty: Campbell´s Operative Orthopaedics 11th ed. pag866
87. o sarcoma de partes moles mais

comum na infância é o:
A) lipossarcoma
B) fibrossarcoma
C) sinoviossarcoma
D) rabdomiossarcoma
Fonte: Tachdjian’s 5th pg. 1152 (A referência original fornecida pela banca foi a 4th edição do
Tachdjian’s)
88. Nas rupturas crônicas do tendão do quadríceps,

a técnica de reparo com alongamento do tendão e
retalho em V invertido é a descrita por
A) ECKER
B) SCUDERI
C) CODVILLA
D) MANDELBAUM
Fonte: Canale & Beaty: Campbell´s Operative Orthopaedics 11th ed. pag. Pg 2477
89. Na fratura diafisária da clavícula, os desvios típicos do fragmento

lateral são:
A) translação inferior e rotação posterior

B) translação superior e rotação posterior
C) translação inferior e rotação anterior
D) translação superior e rotação anterior
FIGURE 36-4 Muscular and gravitational forces acting on the

clavicle with resultant deformity. The distal fragment is translated
anteriorly, medially, and inferiorly and rotated anteriorly. This
results in the scapula being protracted.
Fonte: Rockwood and Green’s Fractures in Adults 7th Ed. Pg.

1108
90. A fratura do colo da falange média com angulação de ápice volar ocorre por ação do músculo
A) lumbrical.
B) interósseo dorsal
C) interósseo palmar
D) flexor superficial dos dedos
FIGURE 28-23 The insertions of the flexor digitorum superficialis, the flexor digitorum profundus, and the
components of the extensor apparatus typically cause fractures in the distal fourth of the middle phalanx to
angulate apex volar and those in the proximal fourth of the middle phalanx to angulate apex dorsal.
Fonte: Rockwood and Green’s Fractures in Adults 7th Ed. Pg. 724
91. Na fratura de extremidade distal do fêmur, a complicação mais comum é
A) A pseudoartrose
B) A perda de movimento do joelho
C) O encurtamento maior que 5mm
D) A deformidade angular maior que 5 graus
Knee Stiffness
The most common complication following distal femur fractures is loss of knee motion. This untoward complication
invariably results from damage to the quadriceps mechanism and joint surface as a consequence of the initial
trauma or surgical exposure for fixation or both. Quadriceps scarring with or without arthrofibrosis of the knee or
patellofemoral joint is thought to restrict knee movement. These effects are greatly magnified by immobilization
after fracture or internal fixation. Immobilization of the knee for periods of more than 3 weeks usually results in
some degree of permanent stiffness.
Fonte: Rockwood and Green’s Fractures in Adults 7th Ed 3430-3431
92. Na fratura de BENNETT, o primeiro metacarpal e supinado por ação do
A) Adutor do polegar.
B) Oponente do polegar.
C) Abdutor longo do polegar.
D) Extensor curto do polegar.
Supination may also play a significant role in the

mechanism of this injury. Deformation of fractures at
the base of the thumb metacarpal occurs with a
complex motion (Fig. 28-99). The distal metacarpal
is adducted and supinated by the adductor pollicis.
Fonte: Rockwood and Green’s Fractures in Adults 7th Ed 767 Pg
93. Na lombalgia aguda, deve-se solicitar uma radiografia de coluna lombar em caso de
A) Nota superior a 5 na escala visual análoga de dor.

B) Parestesia de membros superiores associada.
C) Antecedente de Artrite reumatoide na família.
D) Segunda Visita ao médico em menos de 30 dias pelo mesmo motivo.
Fonte: Canale & Beaty: Campbell´s Operative Orthopaedics 12th ed. pag. 1901.
94. A técnica de MATTI-RUSSE para tratamento de pseudoartrose do escafoide utiliza enxerto ósseo.
A) Vascularizado, por via de acesso dorsal.

B) Vascularizado, por via de acesso ventral.
C) Não Vascularizado, por via de acesso dorsal.
D) Não Vascularizado, por via de acesso ventral.
Cancellous bone grafting for scaphoid nonunion, as first described by Matti and modified by Russe, has proved
to be a reliable procedure, producing bony union in 80% to 97% of patients. This technique is most useful for
ununited fractures that do not have associated shortening or angulation. Of 27 patients seen an average of 12
years after surgery, Stark et al. reported that 24 were satisfied with the result, and all but one had returned to
work. Mulder reported 97% bony union in 100 operations using the Matti-Russe technique.
Fonte: Canale & Beaty: Campbell´s Operative Orthopaedics 11th ed. pag. 402 Pg.
95. A fratura do odontoide mais comum e que cursa com pseudoartrose em 36% dos casos e, segundo
ANDERSON e DÁLONSO, a do tipo
A) I.
B) II.
C) III.
D) IV.
Dens Fracture
Anderson and D'Alonzo classified odontoid fractures into three types (Fig. 35-26). Type I fractures are uncommon,
and even if nonunion occurs after inadequate immobilization, no instability results. Type II fractures are the most
common, and Anderson and D'Alonzo reported a 36% nonunion rate for displaced and nondisplaced type II
fractures.
Fonte: Canale & Beaty: Campbell´s Operative Orthopaedics 11th ed. pag 1788 Pg.
96. Na fratura do acetábulo que acomete a parede anterior, a transmissão da energia do trauma se dá
pelo eixo
A) Do colo femoral, com o quadril em rotação lateral.

B) Do colo femoral, com o quadril em rotação medial.
C) Da Diafise femoral, com quadril em rotação lateral.
D) Da Diafise femoral, com quadril em rotação medial.
Fonte: Rockwood and Green’s Fractures in Adults 8th Ed. Pg 1465 Pg
97. A luxação aguda do Joelho com ruptura dos ligamentos cruzados e integridade dos
colaterais e classificada, segundo o SCHENCK, como
A) KD-I.
B) KD-II.
C) KD-III.
D) KD-IV.
Fonte: Canale & Beauty: Campbell´s Operative Orthopaedics 12th Ed. 1788
98. A instabilidade do complexo suspensório superior do ombro ocorre em caso da fratura do.
A) Colo da escapula e lesão do ligamento trapezoide.
B) Processo coracoide e lesão do ligamento
trapezoide.
C) Colo da escapula e lesão do ligamento
Acromioclavicular.
D) Processo coracoide e lesão do ligamento
Acromioclavicular.
The Superior Shoulder Suspensory Complex

Goss61 described the SSSC, consisting of the glenoid,
coracoid, acromion, distal clavicle, coracoclavicular ligaments,
and acromioclavicular ligaments (Fig. 37-16). This bone-soft
tissue ring maintains the normal, stable relationship between
the upper extremity and the axial skeleton. Single disruptions
of the SSSC, such as an isolated scapular neck fracture, are usually anatomically stable because the integrity of
the complex is preserved, and nonoperative management yields good functional results. When the complex is
disrupted in two places (double disruption), such as a scapular neck fracture with an acromioclavicular joint
disruption, a potentially unstable anatomic situation is created. Because the SSSC includes the glenoid, acromion,
and coracoid, many double disruption injuries involve the scapula. In the presence of a displaced fracture of the
acromion, coracoid process, glenoid, or scapular neck, the possibility of another lesion of the SSSC (i.e., a double
disruption) should be considered. According to Goss,61 open reduction is indicated for double disruptions that are
accompanied by significant displacement, which may lead to delayed union, malunion, or nonunion as well as
long-term functional deficits.
99. Na fratura da Clavícula de tipo IIB de CRAIG, ocorre ruptura do periósteo e do ligamento
A) Conoide.
B) Trapezoide.
C) Coracoacromial
D) Acromioclavicular.
Classification of Distal Clavicle Fractures

The most commonly utilized classification scheme for distal clavicle fractures is that proposed by Neer and
modified by Craig.33,104 This classification scheme includes five types based on the relationship of the fracture
line to the coracoclavicular ligaments, the AC ligaments, and the physis. Most lateral clavicle fractures in the
skeletally immature are periosteal disruptions in which the bone displaces away from the periosteal sleeve
whereas the ligaments remain attached to the intact inferior portion of the periosteum.
Type I fractures occur distal to the coracoclavicular ligaments but do not involve the AC joint. Minimal
displacement occurs due to the proximal fragment being stabilized by the intact coracoclavicular ligaments and
the distal fragment being stabilized by the AC joint capsule, the AC ligaments, and the deltotrapezial fascia.
Type II fractures are subdivided into type IIA and type IIB fractures, with type IIA fractures occurring medial to the
coracoclavicular ligaments and type IIB fractures occurring between the coracoclavicular ligaments with
concomitant injury to the conoid ligament. In type IIA injuries, the proximal fragmente loses the stability provided
by the coracoclavicular ligaments and displaces superiorly out of the periosteal sleeve. In contrast, the distal
fragment remains stable because of the attachments of the AC joint capsule, AC ligaments, and the
coracoclavicular ligament(s). This remains true for type IIB fractures as well, because even though the conoid
ligament is disrupted, the trapezoid ligament remains attached.
Type III fractures occur distal to the coracoclavicular ligaments and extend into the AC joint. As these fractures
do not disrupt the ligamentous structures, minimal displacement is the norm.
Type IV fractures occur in skeletally immature patients and involve a fracture medial to the physis. The epiphysis
and physis remain uninjured and attached to the AC joint. However, significant displacement can occur between
the physis and metaphyseal fragment, as the coracoclavicular ligaments are attached to the physis. This is
especially true if the periosteal sleeve is disrupted.
In essence, this is analogous to a type IIA fracture.
Type V fractures have a fracture line that leaves a free-floating inferior cortical fragment attached to the
coracoclavicular ligaments with an additional fracture line dividing the distal clavicle from the remainder of the
clavicle. Therefore, neither the proximal nor distal fragment is attached to the coracoclavicular ligaments. The end
result is instability with the potential for significant displacement of the distal end of the proximal fragment.
Fonte: Rockwood and Wilkins fractures in Children 8th Ed. 817 pg

100. O offset do componente femoral de uma prótese de Quadril e representado na figura pela
distancia
A) AD.
B) BD.
C) BC.
D) CD.
Fonte: Canale & Beauty: Campbell´s Operative Orthopaedics 12th Ed. 319 Pg.

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José Henrique Peres dos Santos – TEOT - 14847

R= With unilateral rupture of the disc between L5 and S1,

R= Hangman’s Fractures (Traumatic Spondylolisthesis, C2–C3) Mechanism of Injury

Fonte: Rockwood and Green’s Fractures in Adults 8th Ed. Pg 1729

3. na estenose lombar central dos sintomas são:

A) bilateral, respeitando o dermátomo

B) bilateral, não respeitando o dermátomo

C) unilateral, respeitando o dermátomo

D) unilateral, respeitando o dermátomo

A) pela cápsula anterior

B) pela cápsula posterior

C) pelo ligamento interclavicular

D) pelo liogamento esternoclavicular posterior

R= Ligamentous Anatomy of the Clavicle

Fonte: Herring: Tachdjian`s Pediatric Orthopaedics 5ª Ed. Pg 208

A basic knowledge of the anatomy of the flexor tendons, especially in

Fonte: Skeletal Trauma in Children 5th Pg 293

9) Na anatomia do cotovelo, a estrutura ligamentar que se insere no tubérculo sublime da ulna é?

C) o ligamento collateral lateral ulnar

D) a porção anterior do ligamento collateral medial

R= In the normal elbow joint, stability is maintained by the combination of highly

11. A síndrome de BROWN-SÈQUARD é caracterizada por

A) proprioceptivo contra-lateral; perda ipsilateral da

B) proprioceptivo ipsilateral; perda contra-lateral da

A) sinal de HOFFMAN positivo

Fonte: Canale & Beaty: Campbell´s Operative Orthopaedics

A) Homens acima de 50 anos de idade

B) mulheres acima de 50 anos de idade

C) homens abaixo de 50 anos de idade

D) mulheres abaixo de 50 anos de idade

16. O cisto ósseo unicameral é mais frequente:

C) nos ossos chatos

19. Na fase inicial da histiocitose de células de LANGERHANS, a imagem radiográfica assemelha-se

Fonte: Lovell and Winter’s Pediatric Orthopaedics 7ª Ed, Pg 330.

20. Na osteogênese imperfeita, o aminoácido envolvido no defeito do colágeno tipo I é a:

Fonte: Herring: Tachdjian`s Pediatric Orthopaedics 5ª Ed. Pg 208

21. Na fixação externa circular, o aumento da estabilidade é obtido com:

A) o uso de fios olivados

Fonte: Rockwood and Green Fractures in Adults 8th, cap 8, p 252

22. No tratamento da infecção pós-osteossíntese, o uso local de antibiótico associado ao

23. A fratura da clavícula na criança em idade escolar resulta frequentemente de:

A) trauma em alta energia

Fonte: Lovell and Winter’s Pediatric Orthopaedics 7ª Ed, p 963

26. Na biomecânica do quadril, o ligamento isquiofemoral controla a:

27 . Na abordagem emergencial das lesões do

A) fixador externo supra-acetabular.

B) fixador externo na crista ilíaca.

C) clampe pélvico (“C – clamp”).

D) placa na sínfise púbica.

Fonte: Rockwood and Green’s Fractures in Adults 8th Ed. Pg 1421

29. O quadril em ressalto interno decorre do atrito entre a

A) fratura da parede posterior

B) fratura de ambas as colunas

C) impacção do teto acetabular

D) subluxação medial da cabeça

Fonte: Rockwood and Green’s Fractures in Adults 8th Ed. Pg1914

B) fixação in situ com fios ou cabos de cerclagem

C) redução aberta e osteossíntese com placa bloqueada

D) revisão com troca por componente femoral mais longo

If the stem is loose, as in type B2 fractures, revision with a long-stem femoral