Surgical Anatomy & Approaches MCQs

A patient undergoes a Kocher-Langenbeck approach for a posterior wall acetabular fracture. Postoperatively, the patient demonstrates an asymmetric foot drop and absent sensation over the anterolateral leg and dorsum of the foot, with intact plantar sensation. Which portion of the sciatic nerve was most likely injured during retraction?

A surgeon performs a deltoid-splitting anterolateral approach for plate fixation of a proximal humerus fracture. To prevent denervation of the anterior deltoid, the distal split must not exceed what distance from the lateral edge of the acromion?

A 42-year-old male presents with an unstable pelvic ring injury after a fall from a height. The surgeon plans an anterior intrapelvic (modified Stoppa) approach. Which of the following anatomic structures must be carefully identified and ligated to prevent catastrophic hemorrhage near the superior pubic ramus?

A 40-year-old male requires an ilioinguinal approach for open reduction and internal fixation of an anterior column acetabular fracture. During the dissection, massive hemorrhage occurs near the superior pubic ramus. The injured vessel is most likely an anastomosis between which two vascular systems?

During meticulous repair of a germinal matrix laceration in a 28-year-old patient, which of the following suture materials and sizes is most appropriate for optimal anatomical restoration and minimal scarring?

Following a complex nail bed repair and distal phalanx fracture stabilization, the surgeon decides to use a splint to maintain the patency of the eponychial fold and provide a scaffold for new nail growth. If the original nail plate is too damaged, which of the following is the most appropriate alternative material and duration for this splint?

What is the most common serious complication following posterior hip dislocation, even after successful reduction?

A 27-year-old triathlete undergoes an isolated deep posterior compartment release for CECS using a single medial longitudinal incision. Postoperatively, he notes a burning numbness along the medial aspect of his distal lower leg and medial foot. Which nerve was most likely injured during the surgical approach?

During arthroscopic removal of a loose body in the anterior elbow compartment, the surgeon establishes the anterolateral portal. Which nerve is most at risk during the establishment of this specific portal?

A 45-year-old male undergoes elbow arthroscopy for removal of multiple loose bodies. Which standard arthroscopic portal places the radial nerve at the highest risk of injury?

A patient with multiple radiocapitellar loose bodies undergoes an anterior capsulotomy and loose body excision via a lateral approach. Postoperatively, they cannot actively extend their fingers at the metacarpophalangeal joints, but wrist extension is preserved with radial deviation. Which nerve was most likely injured?

When performing elbow arthroscopy to remove loose bodies, establishing the anteromedial portal places which neurological structure at the greatest superficial risk of iatrogenic injury?

A patient demonstrates a positive "lift-off" test and a positive "belly-press" test after a traumatic shoulder injury. These tests isolate the subscapularis muscle. Which of the following nerves supplies the isolated muscle?

During a total hip arthroplasty via the direct anterior approach, the surgeon utilizes the internervous plane between the tensor fasciae latae (TFL) and the sartorius. Which nerves supply these two muscles, respectively?

The direct anterior approach (DAA) to the hip is frequently utilized for primary total hip arthroplasty due to its true internervous plane. Which two nerves supply the muscles that define the primary superficial internervous plane of this approach?

A patient sustains a midshaft humerus fracture and is noted to have a wrist drop on physical examination. Sensation is decreased over the dorsal web space between the thumb and index finger. Which nerve is most likely injured?

In an oral examination, you are handed an AP pelvis radiograph of a trauma patient. What is the most appropriate first step in your structured response?

An examiner asks you to describe the anterior (Smith-Petersen) approach to the hip. To maximize your score by demonstrating anatomical safety, you must explicitly name the internervous plane. This superficial plane lies between which two muscles?

A surgeon is planning to correct a complex, multi-apical femoral deformity involving both diaphyseal varus and distal metaphyseal valgus, along with significant procurvatum. Due to time constraints and a desire to minimize surgical invasiveness, the surgeon decides to perform a single osteotomy at the mid-diaphysis, attempting to correct all frontal and sagittal plane deformities simultaneously by angulating the bone around this single cut. Based on Paley's Three Osteotomy Rules, what is the most likely outcome of this surgical approach?