ABOS Part I Comprehensive Review - Batch 31

Question 1

A 35-year-old male sustains a high-energy injury resulting in a proximal tibia fracture. Clinical exam reveals an intact neurovascular status and no signs of compartment syndrome. What is the most appropriate initial imaging study to fully characteri

Accepted Answer

C. Computed Tomography (CT) scan of the proximal tibia with sagittal and coronal reconstructions

Question 2

A 48-year-old male presents with an AO/OTA 41-A3 fracture of the proximal tibia. The fracture is extra-articular, comminuted in the metaphysis, but the articular surface is intact. Soft tissues are amenable to surgery. Which of the following is the m

Accepted Answer

C. Intramedullary nailing (IMN)

Question 3

During intramedullary nailing of a proximal tibia fracture, the most common and challenging malalignment to prevent is procurvatum (apex anterior angulation). Which of the following biomechanical factors is the primary contributor to this specific de

Accepted Answer

C. The anterior cortical bow of the tibia and the straight trajectory of the nail

Question 4

A surgeon is preparing for intramedullary nailing of a proximal tibia fracture. The image shows an intraoperative fluoroscopic view during guidewire placement. To minimize the risk of procurvatum and anterior knee pain, which entry point and approach

Accepted Answer

C. Suprapatellar approach, through the quadriceps tendon

Question 5

During IMN for a proximal tibia fracture, the surgeon notes persistent procurvatum (apex anterior angulation) on the lateral fluoroscopic view, similar to the malalignment seen in the provided image (lateral view). The guidewire is already in place.

Accepted Answer

D. Insert a blocking screw (Poller screw) on the anterior side of the proximal fragment, just anterior to the nail trajectory

Question 6

A 62-year-old patient undergoes IMN for a proximal tibia fracture. Intraoperatively, despite traction and manual reduction, the AP fluoroscopic view reveals persistent valgus malalignment of the proximal fragment, similar to the malalignment seen in

Accepted Answer

C. Insert a blocking screw (Poller screw) on the lateral side of the proximal fragment, just lateral to the nail path

Question 7

A 55-year-old male sustains a comminuted extra-articular proximal tibia fracture (AO/OTA 41-A3) with a significant medial metaphyseal wall defect. After achieving provisional reduction and inserting an intramedullary nail, the surgeon is concerned ab

Accepted Answer

C. Application of a small anti-glide or buttress plate on the medial side

Question 8

A 30-year-old patient undergoes IMN for a proximal tibia fracture. Eighteen months post-surgery, the fracture is fully united, but the patient complains of persistent, debilitating anterior knee pain, especially with kneeling and squatting. Clinical

Accepted Answer

C. Symptomatic anterior knee pain requiring hardware removal

Question 9

A 70-year-old female presents for follow-up 6 months after intramedullary nailing of a proximal tibia fracture. She complains of persistent knee pain and an altered gait. The provided radiographs show the post-operative result. Based on these images,

Accepted Answer

D. Procurvatum (apex anterior) and valgus malunion

Question 10

A 40-year-old male undergoes IMN for a stable, extra-articular proximal tibia fracture (AO/OTA 41-A1) with rigid fixation. The soft tissues are healthy, and there are no signs of compartment syndrome. What is the most appropriate initial post-operati

Accepted Answer

C. Weight-bearing as tolerated (WBAT) immediately post-operatively

ABOS Part I Orthopaedic Deformity Correction, Limb Reconstruction & Gait Analysis Review | Part 21914

Advanced ABOS Part I Orthopaedic Review: Tibia & Osteoporotic Fracture Fixation | Part 21584

Key Takeaway