2. Trauma MCQs

A 19-year-old male is brought to the trauma bay after a rugby tackle. He complains of severe pain over the medial clavicle, dysphagia, and a sensation of choking. Which of the following is the most appropriate immediate diagnostic imaging step to guide management?

During internal fixation of a diaphyseal femur fracture, a surgeon aims to maximize the pullout strength of a cortical screw. Which of the following alterations to screw design or insertion technique most effectively increases pullout strength in dense cortical bone?

A 9-year-old boy presents with a pathologic fracture of the proximal humerus after throwing a baseball. Radiographs show a centrally located, completely lytic, expansile lesion in the metaphysis of the proximal humerus with a 'fallen leaf' sign. No periosteal reaction is noted outside the fracture site. What is the most appropriate initial surgical management after the fracture has healed?

Fracture healing can occur via different biologic pathways depending on the mechanical environment. Which of the following clinical scenarios primarily utilizes intramembranous ossification rather than endochondral ossification?

During fracture fixation, the mechanical properties of the implants must be considered. The torsional strength (resistance to breaking upon insertion) of a cortical bone screw is most closely proportional to the cube of which of the following screw parameters?

When preparing a diaphyseal femur fracture for intramedullary nailing, the surgeon reams the canal, allowing insertion of a larger diameter nail. If the radius of the chosen solid cylindrical nail is doubled, its bending rigidity (area moment of inertia) increases by what factor?

Which of the following fracture fixation methods most heavily relies on primary bone healing (intramembranous ossification) without an intermediate cartilaginous phase?

A 22-year-old male sustains a proximal pole scaphoid fracture. Which of the following anatomical features best explains the high rate of avascular necrosis and nonunion in this specific region?

A 19-year-old collegiate baseball pitcher requires ulnar collateral ligament reconstruction. The primary restraint to valgus stress at 30 to 90 degrees of elbow flexion is the anterior bundle. Where does this bundle anatomically originate?

During a posterolateral approach to the tibial plateau, an osteotomy of the fibular head may be performed for extended access. Which of the following nerves is at greatest risk during this maneuver, and where is it typically located?

A 22-year-old runner requires a four-compartment fasciotomy for acute exertional compartment syndrome. Which of the following structures is entirely contained within the deep posterior compartment of the lower leg?

The primary blood supply to the proximal pole of the scaphoid is derived from vessels entering at which of the following locations?

In the surgical treatment of chronic exertional compartment syndrome, the lateral compartment of the leg is released. The superficial peroneal nerve exits the deep crural fascia to become subcutaneous at approximately what location?

A 21-year-old soccer player injures his knee. Radiographs reveal a small avulsion fracture of the lateral tibial plateau, known as a Segond fracture. This pathognomonic sign represents an avulsion of which anatomical structure?

A 34-year-old male sustains a distal third humeral shaft fracture (Holstein-Lewis) and presents with a wrist drop. The nerve at risk pierces the lateral intermuscular septum to pass from the posterior to the anterior compartment of the arm. Approximately how far proximal to the lateral epicondyle does this anatomic transition occur?

A 22-year-old male presents with a proximal pole scaphoid nonunion. The vulnerability of the proximal pole to avascular necrosis is due to its retrograde blood supply. The principal vessel supplying the proximal pole enters the scaphoid at which of the following anatomic locations?

In a skeletally mature patient, an intracapsular femoral neck fracture significantly compromises the blood supply to the femoral head. Which vessel supplies the majority of blood to the adult femoral head?

During a modified Weaver-Dunn procedure for acromioclavicular joint separation, the coracoacromial (CA) ligament is transferred to the distal clavicle. Which anatomic structure attaches to the medial border of the coracoid process?

When performing open reduction and internal fixation of a calcaneus fracture via a medial approach, the surgeon visualizes a prominent bony shelf, the sustentaculum tali. Which tendon runs immediately inferior to this structure?