ABOS Part I Comprehensive Review - Batch 36

Question 1

A 38-year-old male sustains a high-energy ankle injury. Initial radiographs show a trimalleolar fracture with a large posterior malleolus fragment. A pre-operative CT scan, as depicted conceptually below, confirms a displaced posterior malleolus frag

Accepted Answer

Sural Nerve

Question 2

A 55-year-old female presents with an ankle fracture after a fall from a height. Initial radiographs are concerning for a pilon fracture. A pre-operative CT scan, as conceptually illustrated below, reveals a posterolateral pilon fracture with signifi

Accepted Answer

External fixation with delayed ORIF once soft tissue swelling subsides.

Question 3

A 28-year-old athlete sustains an ankle injury during a soccer match. Radiographs show a lateral malleolus fracture and a posterior malleolus fracture. A CT scan, as conceptually shown below, confirms a displaced posterior malleolus fragment involvin

Accepted Answer

Displaced posterior malleolus fractures imply disruption of the Posterior Inferior Tibiofibular Ligament (PITFL), a critical syndesmotic stabilizer.

Question 4

A 42-year-old construction worker presents with a complex ankle fracture after a fall. A CT scan, conceptually shown below, reveals a posterolateral pilon fracture with significant comminution and a large metaphyseal defect after reduction of the art

Accepted Answer

Place bone graft beneath the reduced articular fragments.

Question 5

A 60-year-old diabetic patient undergoes ORIF of a displaced posterior malleolus fracture via a posterolateral approach. Two weeks post-operatively, the patient presents with increasing pain, erythema, and purulent discharge from the surgical incisio

Accepted Answer

Surgical debridement, intravenous antibiotics, and potentially negative pressure wound therapy.

Question 6

A 32-year-old male presents with a displaced posterior malleolus fracture involving 18% of the articular surface, along with a stable lateral malleolus fracture. A CT scan, conceptually shown below, confirms a 3mm articular step-off. The patient is o

Accepted Answer

Open reduction and internal fixation (ORIF) via a posterolateral approach.

Question 7

A 48-year-old male presents with a complex ankle fracture. Pre-operative planning includes a CT scan, conceptually shown below, which confirms a posterolateral pilon fracture with significant articular involvement. The patient is scheduled for ORIF v

Accepted Answer

Prone position.

Question 8

During a posterolateral approach for a displaced posterior malleolus fracture, the surgeon identifies the internervous plane. Which of the following structures defines the anterolateral boundary of this surgical interval?

Accepted Answer

Peroneal tendons (longus and brevis)

Question 9

A 70-year-old patient undergoes ORIF of a complex trimalleolar ankle fracture, including a large, displaced posterior malleolus fragment, via a posterolateral approach. Post-operatively, the patient is placed in a well-padded posterior splint. At the

Accepted Answer

Transition to a removable walking boot (CAM walker) with gradual progression to partial weight-bearing.

Question 10

A 35-year-old male undergoes ORIF of a posterolateral pilon fracture. During the procedure, after reduction of the articular fragments, the surgeon notes a significant metaphyseal defect. Bone graft is placed to support the articular surface. For def

Accepted Answer

Posterior or posterolateral locking plate fixation providing buttress support.

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Key Takeaway