9. Shoulder and Elbow MCQs

A 65-year-old man with chronic massive rotator cuff tear presents with pseudo-paralysis of the shoulder and severe glenohumeral arthritis. Which of the following structures must remain intact for a reverse total shoulder arthroplasty to be successful?

In a patient with a 'terrible triad' injury of the elbow (elbow dislocation, radial head fracture, coronoid fracture), what is the most appropriate surgical sequence to restore elbow stability?

A patient falls on an outstretched hand and complains of lateral elbow pain. Radiographs show a comminuted radial head fracture. There is also marked tenderness over the distal radioulnar joint (DRUJ). If the radial head is excised without replacement, what complication is most likely to occur?

A 72-year-old man presents with chronic right shoulder pain, an inability to actively elevate his arm past 45 degrees, and a preserved passive range of motion. Radiographs demonstrate superior migration of the humeral head with articulation against the acromion. What is the most appropriate surgical management to restore active elevation in this patient?

A 45-year-old woman falls on an outstretched hand and sustains a comminuted radial head fracture, wrist pain, and instability of the distal radioulnar joint (DRUJ). Radial head excision is contraindicated in this setting primarily due to the risk of:

A 45-year-old laborer undergoes surgical repair of a distal biceps tendon rupture using a two-incision technique. Compared to a single anterior incision technique, the two-incision approach is associated with a higher risk of which specific complication?

During surgical reconstruction of a 'terrible triad' injury of the elbow, which of the following is the generally recommended sequence of repair to best restore stability?

A 40-year-old bodybuilder feels a 'pop' in his antecubital fossa during a heavy deadlift, accompanied by bruising and a positive hook test. If a single-incision anterior approach is used for repair, which nerve is at the highest risk of iatrogenic injury?

A 72-year-old female presents with severe right shoulder pain, pseudoparalysis, and radiographic evidence of superior humeral head migration with acetabularization of the acromion. What is the most reliable definitive surgical treatment to restore active elevation?

A 72-year-old man presents with severe right shoulder pain and an inability to actively elevate his arm above 60 degrees. Radiographs demonstrate a massive, retracted rotator cuff tear with an acromiohumeral interval of 2 mm and advanced glenohumeral arthritis. What is the most reliable definitive surgical treatment for this patient?

A 45-year-old man feels a 'pop' in his antecubital fossa while lifting a heavy box and experiences weakness in forearm supination. He undergoes a distal biceps tendon repair using a traditional two-incision technique. Compared to a single anterior incision approach, this technique carries a historically higher risk of which of the following complications?

A 28-year-old bodybuilder complains of vague shoulder weakness. Physical examination demonstrates prominent medial winging of the scapula when the patient performs a wall push-up. Which nerve is most likely injured?

A 20-year-old collegiate baseball pitcher has persistent deep shoulder pain. Examination reveals normal strength, 130 degrees of external rotation in abduction, 10 degrees of internal rotation in abduction, mild dynamic scapular winging, and equivocal findings on provocative tests for labral tears. Management should consist of

A 35-year-old male falls from a ladder and sustains a 'terrible triad' injury of the elbow. Operative fixation is planned. What is the most widely accepted sequence of surgical reconstruction to restore elbow stability?

A 65-year-old woman is scheduled to undergo a reverse total shoulder arthroplasty for cuff tear arthropathy. To minimize the risk of scapular notching, how should the glenosphere baseplate optimally be positioned?

A 21-year-old collegiate baseball pitcher reports sudden medial elbow pain and an audible pop during the acceleration phase of throwing. Valgus stress testing reveals gross laxity. In surgical reconstruction of the ulnar collateral ligament (UCL), which specific anatomic bundle is the primary restraint to valgus stress from 30 to 120 degrees of elbow flexion?

A 19-year-old motorcyclist sustains a traction injury to his right shoulder. On examination, his arm hangs at his side with the shoulder adducted, internally rotated, and the forearm pronated (waiter's tip posture). Hand and wrist flexion remain intact. This presentation is most consistent with an injury to which anatomic region of the brachial plexus?

A 35-year-old woman sustains a "terrible triad" injury of the elbow after a fall from a ladder. She is scheduled for operative fixation. To optimally restore elbow stability, what is the generally accepted sequence of surgical reconstruction?

A 70-year-old woman is 3 years out from a reverse total shoulder arthroplasty. Radiographs demonstrate significant inferior scapular notching. Which of the following technical errors during the index procedure is most strongly associated with this complication?