5. Sports Medicine MCQs

An NFL lineman sustains a severe hyperextension injury to his great toe. MRI shows a complete tear of the plantar plate with proximal retraction of the medial sesamoid. Which of the following is an absolute indication for primary surgical repair of this "turf toe" injury?

A 22-year-old collegiate wide receiver sustains an acute injury to his great toe when he is tackled from behind while his foot is planted and the metatarsophalangeal (MTP) joint is forcefully dorsiflexed. He has severe pain, swelling, and ecchymosis at the plantar aspect of the first MTP joint. Which structure is most likely disrupted?

A 32-year-old male sustains a trimalleolar ankle fracture. Recent biomechanical and clinical studies regarding the posterior malleolar fragment suggest that open reduction and internal fixation is indicated primarily:

A 35-year-old elite basketball player sustains a zone 2 fracture of the proximal fifth metatarsal.

He desires the fastest return to play. Which of the following screw characteristics is biomechanically optimal for intramedullary screw fixation of this injury?

A 24-year-old soccer player sustains a forced dorsiflexion injury to her great toe.

MRI confirms a complete tear of the plantar plate with proximal retraction of the sesamoids. What is the most appropriate management?

A 24-year-old female presents with persistent ankle pain 8 months following an inversion ankle sprain. MRI demonstrates a 1.2 cm x 1.0 cm osteochondral lesion on the posteromedial talar dome with intact overlying cartilage. What is the most appropriate initial surgical treatment?

A 28-year-old football running back injures his great toe during a forceful push-off on artificial turf. He has severe pain at the first MTP joint. Radiographs show proximal migration of the medial sesamoid compared to the lateral sesamoid. What is the diagnosis?

A 24-year-old man presents with persistent deep ankle pain 8 months after a severe ankle sprain. MRI demonstrates a 1.8 square centimeter osteochondral lesion on the medial talar dome with subchondral cystic changes. After failing conservative management, what is the most appropriate surgical treatment?

A 28-year-old woman has chronic medial ankle pain after an inversion injury 1 year ago. MRI demonstrates an 8-mm isolated osteochondral lesion of the posteromedial talar dome. Nonoperative management has failed. What is the most appropriate initial surgical treatment?

A 45-year-old man presents to the emergency department after a first-time seizure. He is unable to externally rotate his right arm. Radiographs reveal a posterior shoulder dislocation with an anteromedial humeral head defect involving 30% of the articular surface. Closed reduction is successful, but the shoulder remains unstable in internal rotation. What is the most appropriate definitive management?

A 32-year-old professional volleyball player presents with posterior shoulder pain and weakness in external rotation. Forward elevation and internal rotation strength are normal. MRI demonstrates an isolated paralabral cyst at the spinoglenoid notch. Which physical examination finding is most likely present?

A 22-year-old rugby player has recurrent anterior shoulder dislocations. CT scan with 3D reconstruction reveals 25% anterior glenoid bone loss. A Latarjet procedure is performed. Which of the following structures creates the 'sling effect' stabilizing the shoulder in abduction and external rotation after this procedure?

A 45-year-old recreational tennis player has deep shoulder pain with overhead serving. MRI shows a Type II SLAP tear. He has failed 6 months of physical therapy. What is the most appropriate surgical treatment for this patient given his age and activity profile?

A 21-year-old collegiate baseball pitcher complains of posterior shoulder pain during the late cocking phase of throwing. He has a positive posterior impingement sign and GIRD (glenohumeral internal rotation deficit) of 25 degrees. What is the primary pathophysiologic mechanism of this condition?

A 55-year-old active manual laborer presents with chronic shoulder pain and weakness. MRI demonstrates a massive, retracted, and irreparable tear of the supraspinatus and infraspinatus with advanced fatty infiltration (Goutallier stage 4). The subscapularis and teres minor are completely intact. He has a positive external rotation lag sign. Which of the following surgical interventions is most appropriate?

A 40-year-old man undergoes shoulder arthroscopy for chronic anterior shoulder pain. Intraoperatively, the long head of the biceps tendon is found to be medially subluxated out of the bicipital groove. This finding is most strongly associated with a tear of which of the following structures?

A 21-year-old rugby player undergoes a Latarjet procedure for recurrent anterior shoulder instability with 25% glenoid bone loss. Postoperatively, he exhibits profound weakness in elbow flexion and supination, along with sensory loss over the lateral forearm. Which nerve was most likely injured during the procedure?