ABOS Part I Comprehensive Review - Batch 5

Question 1

A 72-year-old female presents to the emergency department after a low-energy fall onto her outstretched arm, sustaining a closed, non-comminuted midshaft humerus fracture. She has no neurovascular deficits. Radiographs show a transverse fracture patt

Accepted Answer

Application of a functional humerus brace with close clinical and radiographic follow-up.

Question 2

A 35-year-old male sustains a comminuted midshaft humerus fracture after a motor vehicle accident. He presents with a complete radial nerve palsy (wrist drop, finger drop, thumb abduction weakness, and dorsoradial hand sensory loss). Given the fractu

Accepted Answer

The radial nerve spirals obliquely from posterior to lateral across the midshaft humerus within the spiral groove, deep to the lateral head of the triceps.

Question 3

A 40-year-old male sustains a highly comminuted midshaft humerus fracture (AO/OTA 12-C3) after a fall from a height. He has no neurovascular deficits. The surgeon opts for operative fixation. Considering the biomechanical principles discussed in the

Accepted Answer

Minimally invasive plate osteosynthesis (MIPO) with a locking compression plate (LCP) applying the principle of relative stability.

Question 4

A 60-year-old male with a history of morbid obesity and poorly controlled diabetes sustains a closed, segmental midshaft humerus fracture. He is non-compliant with medical advice and has a poor social support system. Initial attempts at functional br

Accepted Answer

All of the above are compelling indications for operative management.

Question 5

A 28-year-old male presents with a closed midshaft humerus fracture after a direct blow. On initial examination, he has a complete radial nerve palsy. Radiographs show a simple transverse fracture with minimal displacement. The orthopedic surgeon dec

Accepted Answer

Immediate surgical exploration of the radial nerve.

Question 6

A 55-year-old male presents with a midshaft humerus fracture following a high-energy trauma. On initial assessment, he has diminished radial pulses and an expanding hematoma in the arm. He also has a complete radial nerve palsy. Which of the followin

Accepted Answer

Angiography of the affected limb.

Question 7

A surgeon is planning an open reduction and internal fixation of a midshaft humerus fracture via a posterior approach (Henry triceps split). The patient is being positioned for surgery. Which of the following patient positions is MOST commonly used f

Accepted Answer

Lateral decubitus position on the unaffected side with the affected arm draped free over an overhead bar; advantage is excellent access to the entire posterior and posterolateral aspects of the humerus, allowing for easy identification and protection of the radial nerve.

Question 8

During a posterior approach (Henry triceps split) for open reduction and internal fixation of a midshaft humerus fracture, the surgeon has incised the skin and subcutaneous tissue and is proceeding with deep dissection. What is the MOST critical step

Accepted Answer

Identify the interval between the lateral and long heads of the triceps and then meticulously identify and protect the radial nerve.

Question 9

A 48-year-old male underwent open reduction and internal fixation with a locking compression plate for a comminuted midshaft humerus fracture 8 months ago. He continues to experience pain at the fracture site, and recent radiographs show no evidence

Accepted Answer

Revision surgery involving exchange nailing with autogenous bone grafting and addressing modifiable risk factors.

Question 10

A 30-year-old male undergoes successful open reduction and internal fixation of a midshaft humerus fracture with a locking compression plate. The fixation is deemed stable intraoperatively. According to the post-operative rehabilitation protocols out

Accepted Answer

A sling for comfort and protection, with early gentle active-assisted and passive ROM for the shoulder and elbow, avoiding heavy lifting.

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Key Takeaway