2. Trauma MCQs

When performing a decompressive fasciotomy for acute compartment syndrome of the foot, the surgeon intentionally opens the medial compartment. Which of the following muscles is located exclusively within this specific compartment?

A 22-year-old collegiate basketball player sustains a fracture of the fifth metatarsal at the metaphyseal-diaphyseal junction extending into the intermetatarsal facet. What is the most appropriate management to ensure optimal outcome and return to play?

A 20-year-old track athlete is diagnosed with a mid-body tarsal navicular stress fracture. Non-operative management is chosen. Why is this specific anatomical location at high risk for delayed union or nonunion?

A 35-year-old male sustains a severe crush injury to the foot from heavy machinery. Clinical examination demonstrates tense swelling and excruciating pain with passive toe extension, raising strong clinical suspicion for compartment syndrome. How many distinct fascial compartments are generally recognized in the foot?

A 25-year-old skier sustains an inversion injury to the ankle. Examination reveals tenderness over the posterior margin of the distal fibula. Radiographs show a small cortical avulsion fracture from the lateral ridge of the distal fibula (Fleck sign). What is the most likely diagnosis?

In the operative management of a trimalleolar ankle fracture, what constitutes a widely accepted modern indication for direct internal fixation of the posterior malleolus?

A 38-year-old female presents with a closed spiral fracture of the distal third of the tibial shaft following a skiing fall. Initial anteroposterior and lateral radiographs of the tibia demonstrate the diaphyseal fracture but are otherwise unremarkable. What is the most appropriate next step in radiographic evaluation to rule out a commonly associated, yet frequently missed, injury?

A 27-year-old male sustains a Hawkins II talar neck fracture and undergoes urgent open reduction and internal fixation. At the 8-week postoperative visit, an anteroposterior radiograph of the ankle demonstrates a subchondral radiolucent band across the talar dome. What does this radiographic finding indicate?

A 32-year-old male sustains a severe ankle fracture-dislocation. Closed reduction in the emergency department is unsuccessful despite adequate sedation and muscle relaxation. Post-reduction radiographs reveal that the distal fibula remains entrapped posterior to the posterior tubercle of the distal tibia. Which of the following best describes this specific injury pattern?

A 21-year-old collegiate track athlete presents with insidious onset dorsal midfoot pain. A CT scan confirms a stress fracture of the tarsal navicular. Which specific region of the navicular is at the highest risk for delayed union or nonunion due to its inherently poor vascularity?

A 68-year-old diabetic female with a history of peripheral neuropathy sustains a closed avulsion fracture of the calcaneal tuberosity following a fall. The posterior skin over the heel is severely blanched and tented by the fracture fragment. What is the most appropriate initial management?

A 28-year-old soccer player experiences sudden lateral ankle pain accompanied by a popping sensation during a rapid cutting maneuver. Physical examination reveals subluxation of the peroneal tendons anterior to the lateral malleolus with resisted eversion. Insufficiency of which of the following structures is most likely responsible?

A 30-year-old construction worker sustains a severe crush injury to the foot from a falling steel beam. Acute compartment syndrome of the foot is suspected. Anatomically, how many distinct fascial compartments are generally recognized within the foot?

A 20-year-old elite basketball player sustains a fracture of the fifth metatarsal at the metaphyseal-diaphyseal junction, with the fracture line extending into the fourth-fifth intermetatarsal facet. To minimize the risk of nonunion and expedite return to play, what is the most appropriate definitive management?

During an extensile lateral approach for a displaced intra-articular calcaneus fracture, the surgeon must be careful to protect the primary vascular supply to the lateral soft tissue flap. Which artery provides this primary supply?

A 32-year-old female presents with an isolated lateral malleolus fracture. A gravity stress radiograph demonstrates a medial clear space of 6 mm. This finding is indicative of a complete disruption of which of the following structures?

A 21-year-old collegiate basketball player sustains a fracture at the metaphyseal-diaphyseal junction of the fifth metatarsal base. What is the most appropriate management to minimize the risk of nonunion and allow early return to sport?

A 22-year-old man falls 30 feet from a roof, landing on his buttocks. He complains of severe sacral pain, perineal numbness, and inability to void. Radiographs and CT demonstrate a transverse sacral fracture at the S2 level connecting bilateral longitudinal sacral fractures. Which of the following terms best describes this fracture pattern, and what is the primary neurovascular concern?