9. Shoulder and Elbow MCQs

A 35-year-old male falls on an outstretched hand and sustains a 'terrible triad' injury to the elbow. Operative management is planned. Following a standard deep-to-superficial surgical approach, what is the accepted sequence of structural repair to restore elbow stability?

A 65-year-old woman with advanced rheumatoid arthritis presents with a massive, irreparable rotator cuff tear, severe glenohumeral osteoarthritis, and pseudoparalysis of the shoulder. Physical exam confirms an intact and functioning deltoid muscle.

Which of the following is the most appropriate definitive management?

A 19-year-old collegiate baseball pitcher presents with medial elbow pain during the late cocking phase of throwing. MRI arthrogram confirms a high-grade ulnar collateral ligament (UCL) tear. During UCL reconstruction (e.g., using the docking technique), the graft is primarily designed to replicate which specific structure?

A 24-year-old male sustains a posterior elbow dislocation. After closed reduction, the elbow is stable in 90 degrees of flexion but immediately subluxates when extended with the forearm in supination. This specific pattern of instability indicates insufficiency of which of the following structures?

A 72-year-old woman presents with chronic right shoulder pain and an inability to raise her arm above the horizontal plane. Physical examination reveals active forward elevation to 40 degrees and passive elevation to 150 degrees. Radiographs demonstrate superior migration of the humeral head with articulation against the acromion

. Which of the following is the most appropriate surgical treatment?

A 42-year-old woman falls on an outstretched hand and sustains a "terrible triad" injury of the elbow. Which of the following structures is the primary restraint to posterolateral rotatory instability (PLRI) and must be meticulously repaired or reconstructed during surgery?

A 45-year-old man complains of elbow pain and a "clunking" sensation when pushing himself out of a chair. On examination, a positive pivot-shift test of the elbow is elicited. Which mechanism of injury is most commonly associated with this specific condition?

A 44-year-old weightlifter sustained an acute complete distal biceps tendon rupture and underwent surgical repair using a two-incision technique. Postoperatively, he has profound restriction of forearm pronation and supination but full elbow flexion and extension. What is the most likely complication responsible for his restricted motion?

A 55-year-old woman presents with a 6-month history of progressive, severe, global loss of both active and passive shoulder range of motion. She denies any preceding trauma. Which of the following systemic conditions is most strongly associated with the development and refractoriness of her most likely diagnosis?

A 72-year-old female presents with severe right shoulder pain and an inability to actively elevate her arm above 40 degrees. Radiographs demonstrate superior migration of the humeral head with an acromiohumeral distance of 3 mm. Examination reveals intact deltoid function but positive lag signs. What is the most appropriate surgical treatment?

A 42-year-old male presents with a "terrible triad" injury of the elbow following a fall onto an outstretched hand. When performing the surgical reconstruction, what is the most widely accepted sequence of repair?

A 35-year-old bodybuilder feels a sudden pop in his anterior elbow during a heavy bicep curl. The hook test is positive. The surgeon utilizes a single-incision anterior approach to repair the distal biceps tendon. Which of the following nerves is at highest risk of iatrogenic injury with this specific approach?

A 45-year-old female sustains a coronal shear fracture of the capitellum that extends medially to include the majority of the trochlea (McKee modification Type IV). Open reduction and internal fixation with headless compression screws is planned. What is the most common complication following surgical management of this injury?

A 42-year-old man falls from a height and sustains a complex elbow dislocation.

Imaging reveals a posterolateral elbow dislocation, a comminuted radial head fracture, and a type II coronoid fracture. During operative management, what is the most appropriate sequence of reconstruction?

A 45-year-old man undergoes a single-incision anterior approach for repair of an acute distal biceps tendon rupture. Postoperatively, he notes numbness along the lateral aspect of his forearm. Which nerve was most likely injured during the exposure?

A 78-year-old woman with severe osteoporosis sustains a comminuted 4-part proximal humerus fracture. The humeral head is split, and the tuberosities are widely displaced. She is treated with a reverse total shoulder arthroplasty (RTSA). Healing of which structure is most critical to restore active external rotation?

A 40-year-old weightlifter felt a sudden pop in his antecubital fossa and presents with weakness in supination. The Hook test is positive. If he undergoes a single-incision anterior approach for distal biceps tendon repair, which nerve is most at risk of injury?

A 35-year-old woman falls on an outstretched hand, sustaining an elbow dislocation with associated fractures of the radial head and the coronoid process. During surgical reconstruction, what is the most widely accepted sequence of repair?

A 75-year-old osteoporotic woman sustains a displaced 4-part proximal humerus fracture. The articular surface is subluxated, and the tuberosities are widely displaced. Which treatment modality is associated with the most reliable return of forward elevation?

A 40-year-old man falls onto an outstretched hand and sustains a 'terrible triad' injury of the elbow. He is taken to the operating room for surgical stabilization. After repairing the coronoid and stabilizing the radial head, the elbow remains unstable. According to the standard stepwise surgical protocol, which structure is typically addressed next?