9. Shoulder and Elbow MCQs

A 34-year-old female hairdresser presents with paresthesias in her medial forearm and hand, worsening when she works with her arms elevated. She is diagnosed with neurogenic thoracic outlet syndrome. Compression of the brachial plexus most commonly occurs at which of the following anatomical locations?

A 40-year-old bodybuilder sustains an acute distal biceps tendon rupture. He elects to undergo surgical repair. A two-incision (modified Boyd-Anderson) approach is chosen over a single anterior incision. The two-incision approach carries a higher historical risk of which of the following complications?

A 72-year-old woman presents with severe shoulder pain, poor active elevation, and "pseudoparalysis" of the right arm. Radiographs demonstrate severe glenohumeral osteoarthritis with high-riding of the humeral head. MRI confirms a massive, retracted, and fatty-infiltrated tear of the supraspinatus and infraspinatus. What is the most appropriate definitive surgical management?

A 40-year-old woman complains of a "snapping" sensation and apprehension in her elbow when pushing herself up from a chair. She has a history of an elbow dislocation treated nonoperatively 2 years ago. On examination, a pivot-shift test reproduces her symptoms. Which structure is most likely deficient?

A 28-year-old weightlifter presents with a dull ache in his right shoulder and noticeable weakness. On examination, performing a wall push-up causes his right scapula to exhibit significant medial winging. Injury to which of the following nerves is the primary cause of this finding?

When performing a surgical repair of a distal biceps tendon rupture, the choice between a single-incision anterior approach and a two-incision approach affects the complication profile. The single-incision approach carries a significantly higher risk of which of the following complications compared to the two-incision technique?

A 55-year-old man sustains a "terrible triad" injury of the elbow after a fall. Surgical management is planned. What is the standard recommended sequence of surgical repair for this specific injury pattern?

A 19-year-old collegiate pitcher complains of medial elbow pain during the late cocking and early acceleration phases of throwing. A moving valgus stress test is positive. Which specific bundle of the ulnar collateral ligament (UCL) is the primary restraint to valgus stress and is most likely injured?

A 42-year-old bodybuilder feels a pop in his anterior elbow while lifting heavy weights. He exhibits weakness in supination and flexion, and the "hook test" is positive. What is the most common complication of a single-incision anterior approach repair for this injury?

A 65-year-old woman is undergoing preoperative CT planning for an anatomic total shoulder arthroplasty. Imaging demonstrates a Walch B2 glenoid with 20 degrees of retroversion. If this excessive retroversion is left uncorrected during the procedure, what is the most likely mode of failure?

A 40-year-old man sustains a "terrible triad" injury to his elbow following a fall. According to standard biomechanical principles of reconstruction for this specific injury pattern, what is the most widely accepted surgical sequence?

A 72-year-old man is 3 years post-operative from a reverse total shoulder arthroplasty (rTSA) for massive cuff tear arthropathy. Radiographs demonstrate a large radiolucent area at the inferior aspect of the glenoid neck. Which surgical technique during the index procedure most effectively minimizes this complication?

A 35-year-old woman falls from a ladder and sustains a 'terrible triad' injury of the elbow. Which of the following describes the standard sequence of surgical reconstruction to restore elbow stability?

A 78-year-old woman with severe osteoporosis presents with a 4-part proximal humerus fracture after a mechanical fall. The humeral head is entirely devoid of soft tissue attachments, and the tuberosities are comminuted. What is the preferred surgical treatment to maximize functional outcome and pain relief in this patient?

A 30-year-old man presents with a highly comminuted, un-reconstructable radial head fracture and severe ipsilateral wrist pain following a fall. Examination reveals distal radioulnar joint (DRUJ) instability. If the radial head is excised and not replaced, which of the following complications is most likely to occur?

A 22-year-old gymnast falls on an outstretched arm and sustains a Type I (Hahn-Steinthal) capitellum fracture. Which of the following best describes this fracture pattern?

A 45-year-old male bodybuilder feels a sudden "pop" in his anterior elbow while performing heavy bicep curls. He presents with weakness in forearm supination and elbow flexion. During an anatomic repair of the distal biceps tendon using a single-incision anterior approach, which nerve is at greatest risk of iatrogenic injury?

A 35-year-old man falls on an outstretched hand and sustains the injury shown in

. The injury includes a posterior elbow dislocation, radial head fracture, and coronoid fracture. During operative management, what is the most appropriate sequence of repair?

After closed reduction of a simple posterior elbow dislocation, the elbow is stable in pronation but subluxates when extended in supination. This finding indicates insufficiency of which of the following structures?

A 22-year-old motorcyclist is brought in after a high-speed collision. He has an entirely flail, pulseless upper extremity. Radiographs shown in

demonstrate significant lateral displacement of the scapula. What is the most critical immediate step in management?