Surgical Anatomy & Approaches MCQs

During the surgical fixation of an anterior column acetabular fracture via an ilioinguinal approach, significant arterial hemorrhage is encountered posterior to the superior pubic ramus. This bleeding is most likely originating from an anastomosis between the obturator vessels and which of the following?

During the surgical management of an anterior column acetabular fracture via the modified Stoppa approach, a retropubic vascular anastomosis is encountered. Injury to this structure, often called the "corona mortis," can cause massive hemorrhage. This structure typically represents an anastomosis between which of the following vessels?

A 26-year-old man sustains an anterior shoulder dislocation. After successful closed reduction, he is noted to have weakness with shoulder abduction and decreased sensation over the lateral aspect of the deltoid. Which nerve is most likely injured?

A 32-year-old woman sustains a closed, isolated midshaft humerus fracture. She presents with a wrist drop and inability to extend her metacarpophalangeal joints. What is the most appropriate initial management of her nerve injury?

A 65-year-old woman sustains a volar-displaced distal radius fracture. Which nerve is at greatest risk of iatrogenic injury during a standard Henry (volar) surgical approach for plate osteosynthesis?

A 28-year-old male suffers a closed, mid-shaft humeral fracture. Neurological examination reveals a wrist drop and inability to extend the metacarpophalangeal joints. The fracture is treated with a functional brace. At 12 weeks, there is no clinical or electromyographic (EMG) evidence of radial nerve recovery. What is the next best step?

A 45-year-old male laborer falls from a height and sustains a completely displaced, closed transverse fracture of the acetabulum with a large posterior wall component. Which surgical approach provides the most direct access to visualize and reduce the posterior wall and posterior column?

An orthopaedic surgeon is performing an anterolateral approach for a pilon fracture. The surgical interval is developed between the extensor digitorum longus (EDL) and the extensor hallucis longus (EHL). Which nerve must be identified and protected in this interval?

A patient with a mid-shaft humeral fracture treated non-operatively in a functional brace develops a new-onset radial nerve palsy 3 weeks post-injury. What is the most appropriate next step in management?

A patient sustains an anterior shoulder dislocation that is reduced in the ER. Post-reduction, there is a large area of numbness over the lateral aspect of the shoulder, and the patient cannot contract the deltoid muscle. Which nerve is most likely injured?

A 30-year-old man sustains a closed, spiral fracture of the distal third of the humeral shaft. Upon presentation in the emergency department, his radial nerve function is completely intact. Following closed reduction and splinting, he immediately exhibits a dense wrist drop and loss of finger extension. What is the most appropriate next step in management?

A 35-year-old mechanic presents with vague posterior shoulder pain. MRI demonstrates isolated muscle edema and early atrophy isolated to the teres minor muscle. Which anatomic space is most likely compromised?

A 40-year-old man presents with a volar shear fracture of the distal radius (Barton's fracture). The surgeon elects to perform open reduction and internal fixation utilizing the standard volar Henry approach. The internervous plane for this approach is found between which two muscles?

A 35-year-old cyclist sustains a comminuted midshaft clavicle fracture. Open reduction and internal fixation with superior plating is performed. Postoperatively, the patient notes a well-demarcated area of numbness over the anterior chest wall just inferior to the incision. Which nerve was most likely injured during the surgical exposure?

A 45-year-old woman presents with elbow pain after a fall. Imaging shown in

reveals a fracture of the capitellum involving the lateral trochlear ridge. Which surgical approach is most appropriate for direct visualization and fixation of this specific fracture pattern?

A 55-year-old woman presents with a severely displaced 4-part proximal humerus fracture after a fall. Examination reveals profound weakness in active arm abduction and numbness over the lateral aspect of the shoulder. Which nerve is most likely injured?

A 5-year-old boy falls from monkey bars and sustains a significantly displaced extension-type supracondylar humerus fracture with posteromedial displacement. Which nerve is at the greatest risk of injury?

A 30-year-old man sustains a closed midshaft humerus fracture. Initial examination shows intact radial nerve function. A closed reduction is performed, and a coaptation splint is applied. Immediately after reduction, the patient is unable to extend his wrist or fingers. What is the most appropriate next step?

A 35-year-old male sustains a closed diaphyseal fracture of the humerus. On initial evaluation, he is unable to actively extend his wrist or fingers. He undergoes closed reduction and functional bracing. At 12 weeks, there is no clinical or electromyographic (EMG) evidence of radial nerve recovery. What is the most appropriate next step in management?

A 65-year-old woman sustains an intra-articular distal humerus fracture (AO/OTA type 13-C3). During open reduction and internal fixation utilizing a transolecranon osteotomy, the surgeon must routinely identify and protect which of the following structures?