9. Shoulder and Elbow MCQs

A 40-year-old male presents with a severely comminuted, non-reconstructable radial head fracture after a fall from a height. He also complains of severe ipsilateral wrist pain. Radiographs reveal a shortened radius and disruption of the distal radioulnar joint (Essex-Lopresti injury). What is the most appropriate management?

In the surgical management of a 'terrible triad' injury of the elbow (elbow dislocation, radial head fracture, coronoid fracture), what is the recommended order of reconstruction to methodically restore joint stability?

According to the Hamada classification for rotator cuff arthropathy, a shoulder radiograph showing acetabularization of the coracoacromial arch and femoralization of the humeral head without glenohumeral arthritis is classified as:

A 45-year-old male feels a pop in his elbow while lifting a heavy box. On examination, the examiner's finger cannot hook beneath the tendon in the antecubital fossa from the lateral side. What structure is evaluated by this 'hook test'?

Posterolateral rotatory instability (PLRI) of the elbow, which classically presents with a positive pivot-shift test and apprehension when pushing up from a chair, is primarily caused by a deficiency of which ligamentous structure?

In reverse total shoulder arthroplasty, which of the following baseplate and glenosphere configurations is most effective in preventing scapular notching?

To minimize scapular notching in Reverse Total Shoulder Arthroplasty (RSA), what is the optimal positioning of the glenoid baseplate?

A 65-year-old male presents with primary glenohumeral osteoarthritis. A preoperative CT scan identifies a Walch B2 glenoid. What defines this specific glenoid morphology?

During ORIF of a comminuted radial head fracture, the "safe zone" for hardware placement is utilized to prevent impingement. Which anatomical landmarks define this safe zone?

A 45-year-old tennis player presents with refractory lateral epicondylitis despite 12 months of conservative treatment. Surgical debridement is planned. Which tendon is the primary pathological structure targeted during this procedure?

In reverse total shoulder arthroplasty (RTSA), scapular notching is a recognized complication. Which of the following surgical techniques or implant designs is most effective in minimizing the incidence of inferior scapular notching?

A 35-year-old woman sustains a terrible triad injury of the elbow. Intraoperatively, the coronoid fracture is secured with a lasso technique, the radial head is replaced, and the lateral ulnar collateral ligament (LUCL) is primarily repaired to its anatomic footprint on the lateral epicondyle. Upon fluoroscopic stress testing, the elbow readily dislocates at 30 degrees of extension.

What is the next most appropriate step in surgical management?

A 30-year-old female undergoes open reduction and internal fixation for a displaced Mason type II radial head fracture that caused a mechanical block to forearm rotation. To avoid impingement of the hardware on the proximal radioulnar joint during pronation and supination, the plate must be placed within the radial head 'safe zone'. Which of the following accurately describes this anatomic safe zone?

A 42-year-old male presents with a traumatic elbow injury. Radiographs and CT scan reveal a fracture of the anteromedial facet of the coronoid process. On examination, the elbow demonstrates instability when a varus stress is applied. Which of the following ligamentous structures is almost invariably disrupted in this specific injury pattern?

A surgeon plans to repair a retracted distal biceps tendon rupture using a two-incision (modified Boyd-Anderson) approach. This approach was historically developed to minimize the risk to the posterior interosseous nerve (PIN). However, compared to the single-incision anterior approach, the two-incision technique carries a higher risk of which of the following complications?

A 45-year-old female presents with a highly comminuted radial head fracture, acute wrist pain, and distal radioulnar joint (DRUJ) instability. A diagnosis of an Essex-Lopresti injury is made. If the radial head is simply excised and not replaced, what is the most likely biomechanical consequence?

During the surgical reconstruction of a "terrible triad" injury of the elbow, the surgeon follows a standard protocol to restore elbow stability. After addressing the deep articular structures, which of the following represents the most appropriate sequence of repair?