2. Trauma MCQs

In the context of guided growth (hemiepiphysiodesis) using a tension band plate for a skeletally immature patient with severe genu valgum, where is the hardware typically positioned?

A 32-year-old male is undergoing correction of a complex multiplanar tibial deformity using a Taylor Spatial Frame (hexapod). The software requires the input of deformity, frame, and mounting parameters. Which of the following best defines the "mounting parameters"?

A 28-year-old patient has a distal third femoral shaft fracture being treated with a retrograde intramedullary nail. There is a tendency for the distal fragment to fall into a valgus and apex posterior (procurvatum) deformity. Where should Poller (blocking) screws be placed in the distal fragment to correct this trajectory?

A 14-year-old boy is undergoing a 4 cm tibial lengthening over an intramedullary nail (LON). At 3 cm of length gained, he develops an inability to actively extend his great toe and reports decreased sensation over the first web space. What is the most appropriate initial management?

A 50-year-old woman presents with knee pain. Standing full-length radiographs reveal a medial mechanical axis deviation (MAD). The mLDFA is 88 degrees and the MPTA is 87 degrees. However, the joint line convergence angle (JLCA) is measured at 7 degrees open laterally. What is the primary cause of her varus alignment?

A 22-year-old with a tibial malunion undergoes an osteotomy. The osteotomy is performed at a level separate from the Center of Rotation of Angulation (CORA), but the angulation correction axis (ACA) is maintained at the CORA. What is the expected result after the angular correction is performed?

A 55-year-old female presents with severe knee osteoarthritis and a varus thrust. Full-length standing radiographs reveal a joint line convergence angle (JLCA) of 6 degrees. An abnormal JLCA most strongly suggests which of the following?

During radiographic analysis of a lower extremity deformity, the surgeon evaluates the mechanical lateral distal femoral angle (mLDFA). What is the accepted normal range for this angle?

A surgeon is considering lengthening over a nail (LON) rather than classic external fixation for a femoral lengthening procedure. What is the primary advantage of the LON technique?

A deformity analysis of a malunited tibial shaft fracture reveals that the proximal and distal anatomical axes are strictly parallel to each other but do not intersect within the bone. This geometric presentation characterizes which type of deformity?

Reviewing an anteroposterior long-leg radiograph to determine the mechanical axis of the femur, a line is drawn connecting which two specific anatomical landmarks?

A patient undergoing bone transport for a 7 cm tibial defect achieves successful transport of the intercalary segment. However, the docking site frequently requires a secondary procedure to achieve solid union. Which of the following is the most standard secondary intervention at the docking site?

In the terminology of lower extremity deformity analysis, how is "malalignment" strictly differentiated from "malorientation"?

A 40-year-old patient with an Ilizarov frame applied 6 weeks ago for a tibial nonunion presents with erythema, mild swelling, and serous drainage at a proximal half-pin site. The pin remains rigidly fixed in the bone with no radiographic osteolysis. What is the most appropriate initial management?

When calculating the deformity of a malunited tibia, drawing the proximal and distal mechanical axes reveals they intersect far outside the actual bone limits. This finding is most characteristic of which of the following?

The patient's plain radiographs demonstrated a moderate to large joint effusion and relatively preserved tibiofemoral and patellofemoral joint spaces. However, close inspection revealed subtle, well-marginated radiolucent lesions at the margins of the medial femoral condyle and the posterior aspect of the tibial plateau. Which of the following terms best describes these specific radiographic findings in the context of this patient's likely diagnosis?

A 45-year-old patient presents with monoarticular knee swelling, stiffness, and brown-colored joint aspirate. Plain radiographs are ordered. What is the most characteristic radiographic finding in the later stages of Pigmented Villonodular Synovitis (PVNS)?

A 32-year-old patient undergoes a full-length weight-bearing radiograph of the lower extremity. The mechanical axis is drawn from the center of the femoral head to the center of the tibial plafond. In a perfectly aligned, non-pathological limb, where should this mechanical axis pass?

A surgeon is evaluating a patient for a distal femoral deformity. Which of the following joint orientation angles is the primary indicator for assessing a deformity originating in the distal femur?