Ankle Trauma & Sports MCQs

A 28-year-old male sustains an acute high ankle sprain. Examination reveals a positive external rotation stress test and positive squeeze test. An MRI confirms an isolated full-thickness tear of the anterior inferior tibiofibular ligament (AITFL) and the interosseous membrane up to 5 cm proximal to the joint line. Intraoperatively, the syndesmosis is unstable to the hook test. If dynamic suture-button fixation is chosen over static syndesmotic screw fixation, what is an established clinical advantage?

A 26-year-old male sustains a pronation-external rotation ankle injury. Radiographs show a high fibular fracture (Maisonneuve). During surgical fixation, a syndesmotic injury is confirmed. The surgeon elects to use a flexible, suture-button construct rather than static syndesmotic screws. According to recent literature, what is the primary biomechanical and clinical advantage of using a suture-button construct for syndesmotic fixation?

A football player sustains a high ankle sprain. This injury typically involves damage to which of the following ligamentous complexes?

A patient sustains an inversion ankle injury with associated avulsion fracture of the anterior aspect of the distal fibula. Which ligament is not considered part of the lateral collateral ligament complex of the ankle?

A 14-year-old boy presents to the emergency department after sustaining a twisting injury to his right ankle while skateboarding. Radiographs and a subsequent CT scan demonstrate a Salter-Harris III fracture of the anterolateral distal tibial epiphysis.

Which of the following ligamentous structures is responsible for avulsing this bony fragment?

A 45-year-old woman with chronic lateral ankle instability is scheduled for a Brostrom-Gould procedure. This procedure involves direct repair of the anterior talofibular and calcaneofibular ligaments, augmented by mobilization and advancement of which structure?

A 25-year-old professional soccer player undergoes operative fixation for a syndesmotic injury utilizing a flexible suture-button construct. Compared to traditional rigid syndesmotic screw fixation, what is a recognized clinical or biomechanical advantage of the suture-button construct?

A 25-year-old male sustains a severe twisting injury to his ankle. Radiographs reveal a medial clear space of 6 mm and a tibiofibular clear space of 7 mm on the AP view. A fracture of the proximal third of the fibula is also noted. What is the diagnosis and most appropriate management?

While operatively stabilizing a syndesmotic injury of the ankle, the surgeon places a syndesmotic screw from the fibula to the tibia. Anatomically, the distal tibiofibular syndesmosis relies on multiple ligamentous structures for stability. Which of the following is considered the strongest and thickest primary stabilizer of this complex?

A 13-year-old sustains a juvenile Tillaux fracture of the ankle. The specific mechanism involves an avulsion of the anterolateral distal tibial epiphysis. Which ligament is responsible for the avulsive force causing this fracture pattern?

The distal tibiofibular syndesmosis is stabilized by a complex of multiple ligaments. Based on biomechanical sectioning studies, which structure provides the greatest resistance to lateral displacement of the fibula?

A 24-year-old rugby player sustains an external rotation injury to the ankle. Examination reveals tenderness over the anterior syndesmosis, and radiographs demonstrate widening of the tibiofibular clear space.

Which ligament provides the greatest absolute resistance to diastasis of the distal tibiofibular syndesmosis?

A 21-year-old collegiate soccer player presents with a high ankle sprain (syndesmotic injury) confirmed by an increased tibiofibular clear space. He undergoes dynamic fixation using a suture-button construct. Compared to traditional syndesmotic screw fixation, the suture-button construct has been shown to:

Intraoperatively, following fixation of a Weber C ankle fracture, the cotton test demonstrates widening of the syndesmosis. Which of the following radiographic parameters best assesses the adequacy of syndesmotic reduction on a standard AP or mortise radiograph?

During the open reduction and internal fixation of a pronation-external rotation (Weber C) ankle fracture, the surgeon decides to place a syndesmotic position screw. Which of the following is the strongest predictor of long-term functional outcome in this patient?

A 28-year-old male sustains an isolated lateral malleolus fracture with a syndesmotic rupture. Intraoperatively, after fibular fixation, the syndesmosis is reduced with a clamp. What is the most common malreduction of the distal fibula within the incisura if the clamp is placed too anteriorly on the tibia?

A 25-year-old soccer player sustains an ankle inversion and external rotation injury. Anteroposterior and mortise radiographs show no fracture, but the tibiofibular clear space is 7 mm. What ligament is primarily responsible for the anterior stability of the distal tibiofibular syndesmosis?

A 28-year-old athlete sustains an external rotation injury to the ankle. Intraoperatively, the syndesmosis is evaluated. Which of the following ligaments contributes the greatest percentage of mechanical stability to the distal tibiofibular syndesmosis?