ABOS Part I Comprehensive Review - Batch 34

Question 1

A 48-year-old male sustains a transverse olecranon fracture after a fall onto a flexed elbow. The surgeon plans to perform a tension band wiring. Based on the biomechanical principles described in the case, what is the primary mechanism by which the

Accepted Answer

It converts distracting tensile forces on the dorsal aspect into compressive forces on the articular surface.

Question 2

A 62-year-old patient is undergoing tension band wiring for a displaced olecranon fracture. During the posterior approach to the elbow, the surgical team must be particularly vigilant about identifying and protecting a specific neurovascular structur

Accepted Answer

Ulnar nerve

Question 3

A 78-year-old female presents with a displaced olecranon fracture following a low-energy fall. Radiographs and a CT scan reveal severe comminution of the proximal olecranon fragment with significant metaphyseal bone loss and severely osteoporotic bon

Accepted Answer

Severe comminution of the proximal fragment and severely osteoporotic bone.

Question 4

During the definitive fixation phase of tension band wiring for an olecranon fracture, as depicted in the image, the surgeon is placing the two K-wires. According to the detailed surgical technique described, what is a critical requirement for the pr

Accepted Answer

The K-wires must engage the anterior cortex of the ulna.

Question 5

A 32-year-old male undergoes tension band wiring for a simple transverse olecranon fracture. Six months post-operatively, he presents with localized pain and tenderness over the posterior aspect of his elbow, particularly when leaning on it or during

Accepted Answer

Hardware prominence/irritation requiring elective removal.

Question 6

A 55-year-old patient has undergone tension band wiring for a displaced olecranon fracture. In the immediate post-operative phase (first 1-2 weeks), the rehabilitation protocol emphasizes specific goals. Which of the following best describes the prim

Accepted Answer

To protect the fixation, control pain and swelling, and initiate gentle, protected active and passive range of motion.

Question 7

A 40-year-old construction worker sustains a displaced transverse olecranon fracture. He undergoes open reduction and internal fixation with tension band wiring. The image below illustrates the final construct. Based on the biomechanical principles o

Accepted Answer

To convert the tensile forces generated by the triceps muscle into compressive forces across the fracture site.

Question 8

Consider the tension band wiring construct shown in the image, used for an olecranon fracture. In the context of this specific fixation method, what is the primary role of the two parallel K-wires within the overall construct?

Accepted Answer

To provide stable axial alignment and anti-rotation for the fracture fragments.

Question 9

A 68-year-old male presents to the emergency department after a fall, complaining of severe elbow pain and inability to extend his arm. Initial AP and lateral radiographs show a comminuted olecranon fracture with significant articular involvement. To

Accepted Answer

Computed Tomography (CT) scan

Question 10

An 85-year-old frail patient with severe osteoporosis sustains a displaced olecranon fracture. The surgeon is evaluating the suitability of tension band wiring for this patient. Based on the case's discussion of contraindications, which of the follow

Accepted Answer

Poor K-wire purchase in severely osteoporotic bone, leading to early construct failure.

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Key Takeaway