Elbow & Forearm MCQs

A 40-year-old male falls from a height, sustaining a comminuted radial head fracture, wrist pain, and positive ulnar variance on wrist radiographs. Diagnosis of an Essex-Lopresti injury is made. What is the most appropriate surgical management for the proximal radioulnar injury?

A 40-year-old female undergoes open reduction and internal fixation of a Type IV (Dubberley) capitellum fracture via an extensile lateral approach. Which associated soft tissue injury is frequently encountered and must be addressed to restore elbow stability?

A 40-year-old construction worker presents with chronic, severe lateral epicondylitis refractory to 9 months of conservative management, including rest, NSAIDs, physical therapy, and multiple steroid injections. Clinical examination reveals tenderness over the lateral epicondyle and pain with resisted wrist extension. Imaging confirms degenerative changes at the ECRB origin. Which surgical approach is indicated for debridement of the degenerative tissue and release of the ECRB origin?

A 50-year-old male undergoes ORIF of a radial head fracture via the Kaplan anterolateral approach. The surgeon carefully identifies the internervous plane between the ECRB and EDC. Deep to these muscles, the supinator is encountered. To safely expose the radial head and neck while protecting the Posterior Interosseous Nerve (PIN), which of the following deep dissection techniques is described as the safest method?

During the surgical management of a terrible triad injury of the elbow (radial head fracture, coronoid fracture, and elbow dislocation), what is the most widely accepted sequential order of repair to systematically restore elbow stability?

A 35-year-old male requires surgical intervention for a chronic thumb UCL injury that occurred 6 months ago. Intraoperatively, the native UCL tissue is found to be deficient and cannot be primarily repaired. What is the most appropriate surgical technique?

A 33-year-old male undergoes open reduction and internal fixation of a terrible triad injury of the elbow. The standard surgical sequence involves fixing the coronoid, then the radial head. What is the crucial final step in restoring stability to this elbow?

A 2-year-old child presents with a Blauth Type II hypoplastic thumb. Which combination of surgical procedures is most typically indicated for optimal functional restoration?

Which muscle is most commonly implicated in the pathology of lateral epicondylitis?

During surgical debridement for refractory lateral epicondylitis, the surgeon must identify and excise the pathologic tissue. Which of the following muscles is the primary site of pathology in this condition?

A 45-year-old female undergoes open debridement for lateral epicondylitis. Postoperatively, she reports a new clicking sensation and elbow instability when attempting to push herself off a chair. Iatrogenic injury to which structure is most likely responsible for this complication?

A 50-year-old male undergoes surgical excision of diseased tissue for chronic, refractory lateral epicondylitis. Histopathological examination of the excised tissue is most likely to demonstrate which of the following?

When evaluating a patient for suspected lateral epicondylitis, the examiner performs provocative testing. Resisted extension of which digit is most specific for stressing and isolating the extensor carpi radialis brevis (ECRB) origin?

A 42-year-old tennis player presents with lateral epicondylitis and is considering a corticosteroid injection versus physical therapy. Based on randomized controlled trials, what is the most likely long-term (1 year) outcome of corticosteroid injection compared to physical therapy or watchful waiting?

During open surgery for lateral epicondylitis, the surgeon defines the interval between the extensor carpi radialis longus (ECRL) and the extensor digitorum communis (EDC) to access the ECRB. Where is the origin of the ECRL located relative to the lateral epicondyle?

To avoid posterolateral rotatory instability (PLRI) during surgical debridement of the lateral epicondyle, the surgeon must preserve the lateral ulnar collateral ligament (LUCL). The LUCL originates from the lateral epicondyle at which position relative to the ECRB origin?

A 40-year-old plumber with chronic lateral epicondylitis is prescribed a counterforce brace. To be mechanically effective and properly offload the diseased tendon, where should the brace be positioned relative to the lateral epicondyle?

The susceptibility of the capitellum to osteochondritis dissecans in adolescent throwers is largely attributed to its tenuous blood supply. Which of the following best describes the vascular anatomy of the capitellum?

A 15-year-old baseball pitcher presents with pain in the posterior aspect of the elbow during the deceleration phase of throwing. He denies lateral pain. Exam shows a flexion contracture of 15 degrees and tenderness over the posteromedial olecranon. What is the most likely diagnosis?

What is the primary histological finding in the extensor carpi radialis brevis (ECRB) tendon in a patient with chronic lateral epicondylitis?