9. Shoulder and Elbow MCQs

Which of the following patient populations has the highest incidence and worst prognosis for developing adhesive capsulitis (frozen shoulder)?

A 6-year-old child sustains a plastic deformation fracture of the proximal ulna with an anterior dislocation of the radial head. What is the most appropriate management?

In a patient with a chronic radial nerve palsy, which tendon transfer is most commonly utilized to restore active wrist extension?

A 40-year-old man presents after a fall onto an outstretched hand. He sustains a posterolateral elbow dislocation with associated fractures of the radial head and coronoid process. After closed reduction, the elbow remains persistently unstable at 45 degrees of extension. In what order should the surgical reconstruction of this 'terrible triad' injury generally proceed?

A 76-year-old female sustains a 4-part proximal humerus fracture after a mechanical fall. Radiographs demonstrate severe valgus impaction, disruption of the medial hinge, and metaphyseal extension less than 8 mm. Which surgical option is shown to provide the most predictable improvement in functional outcome and pain relief in this specific demographic?

A 42-year-old man sustains an isolated fracture of the proximal third of the ulna with an associated anterior dislocation of the radial head. Regarding the definitive management of this specific injury pattern in an adult, which of the following statements is most accurate?

A 48-year-old bodybuilder feels a sudden pop in his antecubital fossa while performing heavy bicep curls. He has weakness in supination and an abnormal Hook test. If the surgeon chooses to repair this injury using a single-incision anterior approach, which nerve is at highest risk of iatrogenic injury?

A 55-year-old woman with poorly controlled type II diabetes presents with an insidious onset of diffuse shoulder pain and profound restriction of both active and passive range of motion. Radiographs are unremarkable. Which specific anatomic structure is primarily responsible for the loss of external rotation observed in this condition?

A 38-year-old female falls onto her outstretched hand and sustains a coronal shear fracture of the distal humerus. Radiographs demonstrate a 'double arc' sign on the lateral view. Which of the following best describes the anatomy of this specific fracture pattern (McKee Type IV)?

A 70-year-old woman undergoes a reverse total shoulder arthroplasty for rotator cuff tear arthropathy. To minimize the risk of postoperative scapular notching, which of the following intraoperative techniques regarding glenosphere placement is most appropriate?

A 42-year-old man falls on an outstretched hand and sustains a "terrible triad" injury of the elbow. During surgical reconstruction, after stable fixation of the coronoid and radial head, the elbow remains persistently unstable in extension. What is the next most appropriate step in management?

A 38-year-old male bodybuilder undergoes a two-incision surgical repair of a complete distal biceps tendon rupture. Compared to a single anterior incision technique, this patient is at an increased risk for which of the following postoperative complications?

A 78-year-old woman sustains a severely comminuted 4-part proximal humerus fracture. Her history is notable for severe osteoporosis and chronic, massive rotator cuff tearing. Which surgical option is most likely to provide her with reliable forward elevation and the best functional outcome?

A 42-year-old man falls from a ladder and sustains a 'terrible triad' injury to his elbow. During surgical reconstruction, after addressing the coronoid and replacing the radial head, the elbow remains unstable. Repair of the lateral collateral ligament (LCL) complex is performed. The primary isometric stabilizer of the LCL complex originates from the lateral epicondyle and inserts on which of the following structures?

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

Which of the following best describes the biomechanical rationale for utilizing a reverse total shoulder arthroplasty in a patient with massive, irreparable rotator cuff tear arthropathy?

A 24-year-old pitcher presents with vague shoulder pain and a prominent medial border of the right scapula, especially when performing a wall push-up. EMG confirms an isolated nerve palsy. Which of the following statements regarding the affected nerve is accurate?

A 55-year-old woman with type 1 diabetes mellitus presents with progressively worsening, severe shoulder pain that awakens her at night. Active and passive range of motion are moderately restricted globally. Intra-articular corticosteroid injections are being considered. She is currently in the classic 'freezing' phase of adhesive capsulitis. What is the predominant histological characteristic of the joint capsule during this phase?

A 28-year-old overhead athlete undergoes arthroscopic bursectomy for refractory snapping scapula syndrome. Which of the following bursae is most commonly implicated and located between the serratus anterior and the subscapularis?