Elbow & Forearm MCQs

A 45-year-old female presents with a comminuted radial head fracture, acute wrist pain, and tenderness along the forearm interosseous membrane following a fall on an outstretched hand. Which of the following treatments is contraindicated in this patient?

In the surgical management of a 'terrible triad' injury of the elbow, what is the generally accepted and most biomechanically sound sequence of repair?

A 25-year-old sustains a highly comminuted Essex-Lopresti injury. The radial head is deemed unreconstructible. What is the most appropriate management to prevent proximal migration of the radius?

In the surgical treatment of a Dubberley Type IV capitellum fracture, which surgical approach provides optimal visualization of the capitellum, lateral trochlea, and the posterior aspect of the lateral column?

A patient presents with a Type I Monteggia fracture-dislocation. Following anatomic open reduction and internal fixation of the ulna, the radial head remains subluxated. What is the most common anatomical structure blocking the reduction of the radial head?

A 38-year-old female presents after a fall on an outstretched hand. Radiographs demonstrate a coronal shear fracture of the distal humerus. The lateral radiograph displays a 'double arc' sign. Based on this radiographic finding, which of the following anatomical structures are involved?

A 24-year-old male sustained a highly displaced midshaft fracture of the radius. The surgeon elects to use the dorsal Thompson approach. During the deep dissection to expose the proximal half of the radius, the intermuscular interval lies between which of the following muscle bellies?

A 42-year-old woman falls from a height and sustains a severely comminuted, unfixable radial head fracture along with acute, severe wrist pain. Clinical exam reveals gross instability of the distal radioulnar joint (DRUJ). Which of the following is the most appropriate management of the proximal injury to prevent chronic disability?

Restoration of the forearm's axis of rotation is critical during ORIF of both-bone forearm fractures. Anatomically and biomechanically, the normal axis of forearm pronation and supination passes through which of the following landmarks?

A 31-year-old female presents with a 'terrible triad' injury of the elbow. Surgical management is planned. According to standard treatment algorithms for this injury pattern, what is the most widely accepted sequence of reconstruction to restore elbow stability?

A 42-year-old female presents with a Bado Type I Monteggia fracture-dislocation. She undergoes anatomic rigid plate fixation of the ulnar shaft, but intraoperatively the radial head remains anteriorly dislocated. What is the most appropriate next step in management?

During ORIF of a middle-third diaphyseal fracture of the radius using a dorsal (Thompson) approach, the surgeon must identify and protect the posterior interosseous nerve (PIN). The PIN typically exits the supinator muscle and runs distally between which two muscle bellies in the proximal forearm?

A 38-year-old male presents to the emergency department after a fall onto an outstretched hand with his forearm supinated, experiencing an axial load and valgus stress on his elbow. Clinical examination and imaging confirm a terrible triad injury. Based on the described mechanism, which of the following structures is most likely the *initial* ligamentous injury to occur in this sequential pattern?

A terrible triad injury involves a combination of radial head fracture, coronoid process fracture, and disruption of the lateral ulnar collateral ligament (LUCL) complex. Each of these components contributes to elbow stability. Which of the following bony structures is described as a key anterior stabilizer, primarily resisting posterior displacement of the ulna relative to the humerus?

A 55-year-old patient presents with a suspected terrible triad injury after a fall. Initial plain radiographs confirm an elbow dislocation and a comminuted radial head fracture. The surgeon is planning for operative intervention.

Based on the provided image and the case description, which imaging modality is *absolutely essential* for comprehensive pre-operative planning in this case, and what specific information does it provide?

Following successful repair of the coronoid and radial head in a terrible triad injury, the surgeon proceeds to address the lateral ulnar collateral ligament (LUCL). The LUCL is found to be avulsed from its humeral origin at the lateral epicondyle, with good tissue quality.

Based on the typical surgical sequence and the principles outlined in the case, which of the following best describes the next step for LUCL repair and its appropriate tensioning?

A patient has undergone successful surgical repair of a terrible triad injury, including coronoid fixation, radial head arthroplasty, and LUCL repair. Post-operatively, the elbow is initially immobilized in a posterior splint. In the immediate post-operative protective phase (Weeks 0-6), which of the following rehabilitation principles is most critical for optimizing outcomes while protecting the surgical repairs?