Ankle Trauma & Sports MCQs

A 30-year-old man undergoes ORIF for a Weber C ankle fracture. After fibular fixation, the surgeon suspects a concomitant syndesmotic injury. Which of the following intraoperative tests is most reliable for dynamically assessing the integrity of the distal tibiofibular syndesmosis?

Which ligament is anatomically the strongest component of the distal tibiofibular syndesmotic complex?

In a severe high ankle sprain requiring surgical fixation, the surgeon aims to restore syndesmotic stability. Which ligament is anatomically considered the strongest and most substantial stabilizer of the distal tibiofibular syndesmosis?

The distal tibiofibular syndesmosis is primarily stabilized by three main ligaments. Which of the following ligaments provides the greatest mechanical resistance to diastasis of the syndesmosis?

A 28-year-old male sustains a severe rotational ankle injury resulting in a syndesmotic rupture. Which of the following ligaments provides the greatest resistance to diastasis and is considered the strongest component of the distal tibiofibular syndesmosis?

Which of the following ligaments is most critical for maintaining stability of the distal tibiofibular syndesmosis?

Which specific ligament is most commonly injured in an isolated high ankle sprain (syndesmotic injury)?

Which ligament is most commonly injured in an inversion ankle sprain?

During the surgical planning for a complex pilon fracture, the surgeon identifies an avulsed bone fragment from the anterolateral aspect of the distal tibia. This is classically known as the Chaput fragment. Which syndesmotic ligament is attached to this specific fragment?

A 28-year-old soccer player is diagnosed with a syndesmotic injury (high ankle sprain). If plain radiographs are equivocal, what is the most sensitive imaging modality to assess the integrity and dynamic reduction of the distal tibiofibular syndesmosis?

A 28-year-old soccer player sustains a twisting injury to his ankle. Radiographs show a spiral fracture of the proximal third of the fibula. An external rotation stress view shows widening of the medial clear space to 6 mm. Which of the following structures is most likely to be completely disrupted?

During open reduction and internal fixation of a pronation-external rotation ankle fracture, the surgeon is evaluating the syndesmosis. What intraoperative step provides the most reliable assessment to ensure anatomic reduction of the syndesmosis?

The stability of the distal tibiofibular syndesmosis is dependent on several ligamentous structures. Which of the following ligaments provides the greatest contribution to the strength of the syndesmotic complex?

In evaluating a high ankle sprain, a surgeon assesses the tibiofibular syndesmosis. Which ligament is the primary restraint to anterior translation of the distal fibula relative to the tibia?

The distal tibiofibular syndesmosis relies on several ligaments for stability. Which of the following ligaments provides the greatest resistance to diastasis (accounts for the greatest percentage of syndesmotic strength)?

A 35-year-old male sustains a pronation-external rotation (Weber C) ankle fracture.

Intraoperatively, after rigid internal fixation of the fibula, the surgeon performs a 'Cotton test' by applying a lateral pull on the fibula using a bone hook. What ligamentous structure is primarily being assessed for integrity?

A 35-year-old male sustains an ankle fracture. Radiographs show a vertical medial malleolus fracture and a transverse lateral malleolus fracture below the level of the syndesmosis. According to the Lauge-Hansen classification, which of the following is the mechanism of injury?