Surgical Anatomy & Approaches MCQs

A surgeon plans an open reduction and internal fixation of a proximal third radial shaft fracture utilizing the Thompson approach. This surgical exposure develops an internervous plane between which two muscles?

When performing the Thompson (dorsal) approach to the proximal radius, the surgeon develops the interval between which two muscles?

During ORIF of a proximal radius fracture utilizing the volar Henry approach, the surgeon must identify and protect the radial artery and the superficial radial nerve. In the proximal third of the forearm, the posterior interosseous nerve (PIN) is protected by keeping the forearm in which position?

A 35-year-old male undergoes open reduction and internal fixation (ORIF) of a displaced two-part surgical neck fracture of the humerus via a deltopectoral approach. Post-operatively, the patient complains of numbness and weakness in his shoulder. On examination, he has difficulty initiating abduction and has sensory loss over the lateral aspect of his deltoid. Which of the following nerves was most likely injured during the surgical procedure or due to the initial trauma?

A 55-year-old male is undergoing open reduction and internal fixation of a displaced three-part proximal humerus fracture via a deltopectoral approach. The surgical team has positioned the patient as shown in the image below. During the approach, the surgeon identifies the cephalic vein in the deltopectoral groove. Which of the following statements accurately describes the management of the cephalic vein and the anatomical plane it defines?

During the surgical approach for a severely comminuted proximal humerus fracture, the surgeon utilizes the deltopectoral interval. Which of the following accurately describes the primary neural supply to the muscles forming this true internervous plane?

A 68-year-old female undergoes open reduction and internal fixation (ORIF) with a locked compression plate for a 3-part proximal humerus fracture. Postoperatively, she develops profound weakness in external rotation and a loss of contour over the lateral shoulder. Injury to which of the following nerves is the most likely cause?

A surgeon is planning definitive ORIF for a G-A Type B, Subtype 2 pilon fracture with significant anterolateral articular involvement. The chosen approach is the anterolateral approach. Which of the following describes the correct internervous plane and key neurovascular structures to protect during this approach?

A 42-year-old male undergoes open reduction and internal fixation of a mid-shaft humeral fracture using a posterior approach (triceps-sparing). During the procedure, the surgeon is particularly cautious when dissecting in the spiral groove. Which of the following structures is most at risk of iatrogenic injury in this specific anatomical region during this approach?

A 45-year-old male presents with a pilon fracture featuring a large, displaced anterolateral (Chaput) fragment and central articular impaction. Which surgical approach provides the most direct visualization and access for reducing this specific fracture pattern?

During a deltopectoral approach for open reduction internal fixation of a proximal humerus fracture, excessive distal retraction of the deltoid risks injury to the axillary nerve. On average, how far distal to the lateral edge of the acromion does the axillary nerve travel?

During the anterolateral approach to the humeral shaft, the brachialis muscle is split. To minimize the risk of denervating portions of the brachialis, how should the muscle be split?

A 28-year-old male sustains a closed midshaft humerus fracture and presents with an inability to extend his wrist and fingers. Sensation is decreased over the dorsal first web space. The fracture is acceptably aligned in a coaptation splint. What is the most appropriate initial management for his neurologic deficit?

A 45-year-old man sustains a severe pilon fracture following a fall from height. Preoperative CT imaging demonstrates a dominant anterolateral articular fragment. Which surgical approach provides the most direct access and optimal trajectory for fixation of this specific fragment?

During a lateral approach to the distal humerus (Kocher approach) for a capitellar fracture, the surgeon must extend the dissection distally. Which nerve is at greatest risk during the distal extension of the interval between the extensor carpi ulnaris (ECU) and the anconeus?

During a Kaplan anterolateral approach for a radial head fracture, the surgeon identifies the internervous plane. Which two muscles define the superficial internervous plane utilized in this approach, and what is their common innervation?

A surgeon approaches the radial head via the Kaplan (anterolateral) approach. To safely expose the joint capsule, the deep dissection must exploit a specific internervous plane. Which two muscles define this deep interval?

A 45-year-old female presents with a terrible triad injury of the elbow. A lateral (Kocher) approach is planned to address the radial head fracture. During this approach, the surgical interval is between which two muscles, and what nerve is most at risk if the dissection proceeds too far distally?

A 72-year-old female with severe rheumatoid arthritis undergoes a primary linked semi-constrained total elbow arthroplasty. Postoperatively, she develops progressive weakness in active elbow extension. Which of the following surgical approaches is most strongly associated with this specific complication?