2. Trauma MCQs

A 4-year-old boy sustains an isolated, closed, length-stable spiral fracture of the femoral shaft. Which of the following is the optimal position for hip and knee immobilization in a spica cast?

A 35-year-old male sustains a high-energy varus and axial load injury to his knee, resulting in a medial tibial plateau fracture with coronal extension. Which surgical approach and fixation strategy is most critical to prevent displacement of this fracture pattern?

A 12-year-old gymnast falls during a tumbling routine and sustains an acute right elbow dislocation. In the emergency department, a closed reduction is performed successfully. Post-reduction radiographs reveal a medial epicondyle fracture. Which of the following is considered an absolute indication for open reduction and internal fixation (ORIF) of the medial epicondyle?

A 28-year-old competitive weightlifter feels a sudden 'pop' and sharp pain in his anterior chest wall while performing a heavy bench press. On examination, he has extensive ecchymosis over the anterior axillary fold and weakness in internal rotation and adduction. The vast majority of pectoralis major muscle ruptures occur at which specific anatomical location?

A 30-year-old cyclist falls directly onto the point of his shoulder. Radiographs demonstrate an acromioclavicular (AC) joint separation where the clavicle is elevated by 150% relative to the acromion. He is diagnosed with a Rockwood Type V injury. Which of the following structures are disrupted in this specific injury grade?

A 65-year-old osteoporotic female sustains a proximal humerus fracture.

According to the Hertel criteria, which combination of radiographic findings provides the most accurate and sensitive prediction of subsequent humeral head avascular necrosis (ischemia)?

A 45-year-old male presents with acute posterior elbow pain and an inability to actively extend his elbow against gravity after decelerating a heavy barbell. A lateral elbow radiograph demonstrates a small osseous avulsion fragment ('fleck sign') located 2 cm proximal to the olecranon fossa. What is the most appropriate surgical treatment consideration to avoid a common postoperative complication?

A 40-year-old male undergoes operative fixation of a complex, comminuted distal humerus fracture. To effectively prevent the formation of heterotopic ossification, which of the following prophylactic regimens is most appropriate?

A 38-year-old female sustains a fall on an outstretched hand and presents with elbow pain. A lateral elbow radiograph demonstrates the "double-arc sign." What specific injury pattern does this radiographic finding indicate?

A 35-year-old male sustains a high-energy anterior transolecranon fracture-dislocation. What is the most critical surgical step to restore elbow stability in this specific injury pattern?

A 10-year-old gymnast falls and sustains a displaced medial epicondyle fracture. Which of the following is an absolute indication for open reduction and internal fixation?

A 45-year-old male is involved in an MVA and sustains a "floating shoulder" (ipsilateral displaced midshaft clavicle fracture and a displaced extra-articular scapular neck fracture). What is a primary radiographic indication for surgical fixation of this injury complex?

A 38-year-old male sustains a fall resulting in elbow trauma. CT imaging reveals an isolated anteromedial facet fracture of the coronoid process. This specific fracture pattern is most strongly associated with which of the following mechanisms and instability patterns?

During surgical approach and fixation of a displaced 4-part proximal humerus fracture, preservation of the primary blood supply to the humeral head is critical. Recent anatomical studies indicate that the predominant blood supply to the humeral head is derived from which vessel?

Following operative fixation of a terrible triad elbow injury involving LCL repair, coronoid fixation, and radial head arthroplasty, what is the most appropriate early postoperative rehabilitation protocol to permit motion while minimizing the risk of subluxation?

A 25-year-old cyclist falls directly onto his shoulder. Radiographs demonstrate a 150% superior displacement of the clavicle relative to the acromion, consistent with a Rockwood Type V injury. Which ligaments must be surgically reconstructed to properly restore superior-inferior stability?