Orthopedic 2026 MCQs (Set 1): Humeral Fractures, Compartment Syndrome & Stress Fractures | ABOS, AAOS Board Review

In children with moderate to severe osteogenesis imperfecta (OI), intravenous pamidronate therapy has been shown to increase the thickness of cortical bone. This occurs primarily as a consequence of

Which of the following changes of calcium metabolism accompany the loss of bone during menopause?

A 14-year-old boy has an asymptomatic mass on the right arm. MRI scans and biopsy specimens are shown in Figures 51a through 51d. Immunostaining is positive for desmin. Additional staging studies should include

Sudden cardiac death in the young athlete is most frequently caused by

At the level of tibial bone resection in total knee arthroplasty, where does the common peroneal nerve lie?

The fracture shown in Figure 50 is most reliably treated with what form of fixation?

A 40-year-old patient who has a type II odontoid fracture is placed in a halo vest for 12 weeks; however, current radiographs show no evidence of healing. The next most appropriate step in management should consist of

Figures 3a and 3b show the inversion stress radiographs of a patient's ankle. What is the most likely ligament injury pattern?

What is the most common complication of using structural bulk allograft to reconstruct segmental defects of the acetabulum?

A 40-year-old woman who is an avid tennis player reports the insidious onset of progressive left shoulder pain for the past 2 months. Examination reveals full range of motion with a positive impingement sign. Strength in the supraspinatus and infraspinatus muscles is normal, although stress testing is painful. An earlier subacromial cortisone injection provided good, but only temporary relief. An AP radiograph of the left shoulder is shown in Figure 10. Management should now consist of

A 40-year-old man has a painful mass on his anterior ankle joint with limited range of motion. A radiograph, MRI scan, a gross specimen, and a hematoxylin/eosin biopsy specimen are shown in Figures 5a through 5d. What is the most likely diagnosis?

In the treatment of thoracic disk herniations, what approach is associated with the highest risk of iatrogenic paraplegia?

The condition shown in Figures 9a and 9b is most likely the result of

A 13-year-old patient has foot drop and lateral knee pain. AP and lateral radiographs and an MRI scan are shown in Figures 49a through 49c. A biopsy specimen is shown in Figure 49d. What is the preferred method of treatment?

A 34-year-old woman reports constant midlateral arm pain after sustaining minimal trauma to the shoulder. Radiographs and a biopsy specimen are shown in Figures 29a and 29b. What is the most likely diagnosis?

What is the most common location for localized pigmented villonodular synovitis (PVNS) to occur?

A 16-year-old girl has had pain in the left groin for the past 4 months. She notes that the pain is worse at night; however, she denies any history of trauma and has no constitutional symptoms. There is no history of steroid or alcohol use. Examination reveals pain in the left groin with rotation of the hip. There is no associated soft-tissue mass. A radiograph and MRI scan are shown in Figures 32a and 32b, and biopsy specimens are shown in Figures 32c and 32d. What is the most likely diagnosis?

A 77-year-old woman who underwent a cemented total hip arthroplasty 10 years ago now reports groin pain. Examination reveals a loosened acetabular component and a well-fixed femoral component. Treatment should consist of revision of

A patient reports progessive bilateral hand clumsiness and ataxia. Examination reveals a positive Hoffmann's sign and intrinsic atrophy. MRI reveals multilevel cervical spondylosis, and lateral flexion and extension radiographs show cervical kyphosis in the neutral position, with restoration of lordosis on extension. Which of the following procedures is most likely to result in poor long-term results?

Venous thrombolembolism is a common complication following total hip and total knee arthroplasty; therefore, prophylaxis is deemed efficacious. Several studies on low-molecular-weight heparin (LMWH) have shown which of the following findings?

Figures 32a and 32b show the AP and lateral radiographs of an 11-year-old boy who has a severe limp, a fever, and swelling and tenderness of the thigh. Aspiration of the bone reveals purulent material. The patient has most likely been symptomatic for

Accurate evaluation of the upper portion of the subscapularis muscle is best accomplished with active internal rotation

A knock-out mouse for the Vitamin D receptor has which of the following phenotypes?

A 30-year-old patient has wrist pain. A radiograph and biopsy specimen are shown in Figures 34a and 34b. What is the most likely diagnosis?

What region of the thoracic curve is most dangerous for pedicle screw insertion while performing a posterior fusion for adolescent idiopathic scoliosis?

A radiograph, MRI scans, and a biopsy specimen of a 9-year-old boy with thigh pain are shown in Figures 37a through 37d. Management should consist of

A 65-year-old woman with a history of diabetes mellitus and plantar ulcers has an erythematous and swollen right foot and ankle. Despite IV antibiotics, the erythema spreads to her lower calf within 24 hours. She has a systolic blood pressure of 80/55 mm Hg and a pulse rate of 120. Laboratory studies show a creatinine level of 1.5 mg. Initial management should consist of

A 28-year-old man has had a 2-year history of progressive lateral ankle pain. History reveals that he underwent a triple arthrodesis at age 13 for a tarsal coalition. The pain has been refractory to braces, custom inserts, and nonsteroidal anti-inflammatory drugs. Weight-bearing radiographs of the ankle and foot are shown in Figures 3a through 3d. Surgical management should include which of the following?

A patient has a displaced complex intra-articular distal humeral fracture. What factor is considered most important when deciding on what surgical approach to use?

A 10-year-old boy has had a prominent scapula for the past year. He reports crepitus and aching over the area, but only when he is active. A radiograph and CT scans are shown in Figures 37a through 37c. What is the most likely diagnosis?

A 39-year-old woman fell onto her flexed elbow and sustained a comminuted displaced radial head and neck fracture. Radiographs confirm concentric reduction of the ulnohumeral joint. Examination reveals pain with compression of the radius and ulna at the wrist. What is the best treatment for the radial head fracture?

Figures 39a and 39b show the radiographs of an otherwise healthy 10-year-old boy who has had thigh pain and a limp for the past 9 months. Examination reveals that the left lower extremity is 1 cm shorter, with reduced flexion, abduction, and internal rotation on the left side. The patient is at the 50th percentile for height and the 90th percentile for weight. Serum studies will most likely show

A 29-year-old woman who underwent an anterior cruciate ligament (ACL) reconstruction 6 months ago now reports difficulty achieving full knee extension, and physical therapy fails to provide relief. The knee is stable on ligament testing. Figure 3 shows the findings at a repeat arthroscopy. Treatment should now include

Figure 15a shows the radiograph of a patient who has a chondrosarcoma of the acetabulum. Bone scans are shown in Figures 15b and 15c. Numerous soft subcutaneous masses are present. A clinical photograph of the hand is shown in Figure 15d. What is the most likely diagnosis?

Figures 32a and 32b show the radiographs of an active 13-year-old boy who has persistent left thigh pain and a limp despite a trial of protected weight bearing. Management should consist of

A 34-year-old man has had a 13-month history of an equinovarus deformity of the foot and ankle after a motorcycle accident. His foot and ankle are flexible, but bracing has become uncomfortable. Active dorsiflexion and eversion are absent. What is the most appropriate treatment?

Figure 7 shows the MRI scan of a 23-year-old competitive rugby player who has anterior ankle pain and swelling. He states that he has been playing for many years and has sprained his ankle several times. Examination will reveal what specific hallmark feature?

A 53-year-old man has a 4- x 5-cm high-grade soft-tissue sarcoma in the midthigh. As part of the staging evaluation, regional nodes should be assessed by

Figure 43 shows the lateral radiograph of a patient who underwent anterior cruciate ligament reconstruction. Based on the tunnel placement shown in the radiograph, evaluation of postoperative knee range of motion will most likely show

Storage of musculoskeletal allografts by cryopreservation is achieved by

A previously healthy 13-year-old girl has had thigh pain for the past 3 weeks. The radiograph shown in Figure 47a reveals a lesion in the right femur. A bone scan and CT scan of the chest show no evidence of other lesions. A biopsy specimen is shown in Figure 47b. What is the most likely diagnosis?

A 53-year-old man with a history of severe left hip pain has a significant limp that is the result of a 5-cm limb-length discrepancy. An AP radiograph is shown in Figure 48. The underlying etiology is most likely related to a history of

An 18-month-old child with obstetrical palsy has a maximum external rotation as shown in Figure 34. The parents should be advised that without surgical treatment the likelihood that glenoid dysplasia will develop is approximately what percent?

A 28-year-old woman who is training for the New York Marathon reports pain in the posteromedial aspect of her right ankle. Examination reveals tenderness just posterior to the medial malleolus. Radiographs are normal. An MRI scan is shown in Figure 3. What is the most likely diagnosis?

A 19-year-old football player who sustained three traumatic anterior shoulder dislocations underwent surgery to repair a Bankart lesion. Nine months after surgery, examination reveals stability, elevation to 150 degrees, external rotation to 0 degrees with the elbow at his side and to 50 degrees at 90 degrees of abduction, and internal rotation to T12. If his range of motion does not improve, he is at most risk for

What type of nerve palsy is most common following elbow arthroscopy?

A 50-year-old electrician who is right-hand dominant has had right shoulder pain and stiffness after sustaining an electric shock 2 months ago. An AP radiograph obtained at the time of injury was considered negative, and the patient was diagnosed with a shoulder sprain. The patient now reports continued shoulder pain and restricted motion. AP and axillary radiographs and a CT scan are shown in Figures 41a through 41c. Management should consist of

A 60-year-old patient had the procedure shown in Figure 7 performed 5 years ago. When converting this patient to a total knee arthroplasty (TKA), what patellar problem is commonly encountered intraoperatively?

For halo traction, what is the preferred site for anterior pin placement?

The arrow in Figure 11 points toward a finding consistent with which of the following?

Turf toe typically involves injury to which of the following structures of the great toe?

An otherwise healthy 13-year-old boy sustains the fracture shown in Figure 40 while throwing a fastball. Management should consist of

Figure 8 shows the CT scan of an 11-year-old boy who has had a 1-year history of worsening painful flatfeet. He reports pain associated with physical education at school, especially with running and jumping. Management consisting of activity restriction, anti-inflammatory drugs, and casting has failed to provide relief. Treatment should now consist of

A 14-year-old boy undergoes application of a circular frame with tibial and fibular osteotomy for gradual limb lengthening. He initiates lengthening 7 days after surgery. During the first week of lengthening, he reports that turning of the distraction devices is becoming increasingly difficult. On the 9th day of lengthening, he is seen in the emergency department after feeling a pop in his leg and noting the acute onset of severe pain. What complication has most likely occurred?

In patient selection for meniscal allograft transplantation, which of the following variables has the greatest influence on outcome?

Figures 48a and 48b show the elbow radiographs of a 5-year-old boy who fell from a tree after dinner. Examination reveals that he is unable to extend his wrist. Management should consist of immediate

Figures 8a through 8d show the radiographs and CT scans of a 14-year-old girl who has a painful, rigid planovalgus foot. Management consisting of arch supports and anti-inflammatory drugs failed to provide relief. A below-knee walking cast resulted in pain resolution, but she now reports that the pain has recurred. Management should now consist of

The failure of the acetabular component shown in Figure 15 is most likely the result of the use of a 32-mm head and

A 10-year-old girl with a history of an obstetrical brachial plexus palsy has been referred for evaluation. Examination reveals a severe adduction internal rotation contracture of the shoulder and a mild flexion contracture of the elbow. Hand function is normal. Radiographs show mild glenohumeral joint incongruity. To achieve the best functional outcome, management should consist of

A 40-year-old man has a palpable mass over the dorsum of the ankle. He reports no history of direct trauma but notes that he sustained a laceration to the middle of his leg 6 weeks ago. Examination reveals a 4-cm x 1-cm mass. T1- and T2-weighted MRI scans are shown in Figures 12a and 12b. An intraoperative photograph and biopsy specimen are shown in Figures 12c and 12d. What is the most likely diagnosis?

A 15-year-old athlete collapses suddenly during practice and dies. What is the most likely cause of death?

During a transperitoneal approach to the L5-S1 interspace, care must be taken to protect the superior hypogastric plexus from injury. Which of the following techniques reduces the risk of neurologic injury?

Figure 28 shows an arthroscopic view of a right shoulder in the lateral position through a posterior portal. What is the area between structure B (biceps) and SS (subscapularis tendon)?

A 60-year-old woman reports anterior knee pain 2 years after undergoing primary total knee arthroplasty for rheumatoid arthritis. A Merchant view of the patella is shown in Figure 16. What is the most likely cause of her pain?

Which of the following procedures is considered most appropriate in patients with rheumatoid arthritis?

An otherwise healthy 57-year-old woman has limited range of motion and moderate effusion after undergoing total knee arthroplasty 6 months ago. One of two cultures of joint aspirate reveals methicillin-resistant Staphylococcus epidermidis. Management should now consist of

What percent of patients initially diagnosed with classic, high-grade osteosarcoma of the extremity have visible evidence of pulmonary metastasis on CT of the chest?

A 52-year-old woman who is right hand-dominant sustains an injury to her elbow in a fall. A radiograph is shown in Figure 60. The preferred treatment of this injury pattern should include

A 42-year-old man has a symptomatic flatfoot deformity and walks with a slight limp after falling off a scaffold 9 months ago. He also reports that he has had difficulty returning to work. Orthotics have failed to provide relief. Current radiographs are shown in Figures 19a and 19b. To relieve his pain and return the patient to work, treatment should consist of

Which of the following ligaments is most commonly involved in posterolateral rotatory instability of the elbow?

Figure 40 shows the radiograph of a 16-year-old wrestler who injured his elbow when he was thrown to the mat by his opponent. Closed reduction is readily accomplished, and the elbow seems stable. Management should now consist of application of a splint for

The use of a screw between the clavicle and the coracoid process to maintain the clavicle and acromioclavicular (AC) joint in a reduced position is a treatment option for AC joint separations. Screw removal is generally recommended after soft-tissue healing. What effect does this rigid coracoclavicular fixation have on shoulder kinematics?

What is the recommended treatment of a skeletally immature 12-year-old boy who has an anterior cruciate ligament-deficient knee?

The most favorable outcomes from release of the tarsal tunnel are in patients who have which of the following findings?

A 6-year-old girl has a painless spinal deformity. Examination reveals 2+ and equal knee jerks and ankle jerks, negative clonus, and a negative Babinski. The straight leg raising test is negative. Abdominal reflexes are asymmetrical. PA and lateral radiographs are shown in Figures 15a and 15b. What is the next most appropriate step in management?

Figure 11 shows the radiograph of an otherwise healthy 22-year-old man who sustained a midfoot injury in a motor vehicle accident 9 days ago. Treatment should consist of

Which of the following is the most relevant clinical factor in the maturation assessment of an adolescent female athlete contemplating anterior cruciate ligament (ACL) reconstruction?

In a patient who has rheumatoid arthritis with acetabular protrusion, what is the best biomechanical position for the cup with respect to the preoperative center of rotation?

A patient with an acromioclavicular dislocation has a very prominent distal clavicle. Examination reveals that the deformity increases rather than reduces with an isometric shoulder shrug. Which of the following structures is most likely intact?

A 23-year-old man sustained an injury to his left foot when a forklift rolled over it at work. Examination reveals marked swelling of the midfoot and forefoot, with tenderness to palpation over the medial hindfoot and dorsomedial forefoot. The distal dorsalis pedis pulse is audible on Doppler examination, and his sensation is intact to touch. Radiographs are shown in Figures 33a and 33b. Management should consist of

In the anterior cruciate ligament (ACL)-deficient knee, which of the following variables has the highest correlation with the development of arthritis?

Figures 21a and 21b show the radiographs of a 22-year-old man who was shot through the abdomen the previous evening. An exploratory laparotomy performed at the time of admission revealed a colon injury. Current examination reveals no neurologic deficits. Management for the spinal injury should include

A 72-year-old man who underwent total shoulder arthroplasty 2 years ago slipped on ice and fell on his shoulder 3 weeks ago. Immediately after falling he was unable to elevate his arm. Motor examination reveals deltoid 5-/5, subscapularis 5-/5, external rotation 4-/5, and supraspinatus 2/5. Radiographs are shown in Figures 8a and 8b. What is the most likely diagnosis?

A 62-year-old man with a long history of ankylosing spondylitis has neck pain after lightly bumping his head on the wall. Examination reveals neck pain with any attempted motion; the neurologic examination is normal. Plain radiographs show extensive ankylosis of the cervical spine and kyphosis but no fracture. What is the next most appropriate step in management?

Figures 47a and 47b show the CT scans of a patient who reports persistent pain in the sinus tarsi following a fall. The avulsion fracture fragment remains attached to what ligament?

The peroneus tertius is a commonly used landmark for arthroscopic portal placement. What is the function of this tendon?

During anterior surgery on the cervical spine, at what level would the lateral dissection of the longus coli muscle most likely cause Horner's syndrome?

In the nonsurgical management of posterior tibial tendon dysfunction with flexible deformity, a common strategy is to prescribe an ankle-foot orthosis or a University of California Biomechanics Laboratory (UCBL) orthosis with medial posting. A high patient satisfaction rating and favorable outcome with this nonsurgical management is most likely in which of the following situations?

Figures 6a through 6d show the radiographs and biopsy specimens of an 8-year-old girl with leg pain. Management of the lesion should consist of

A 47-year-old patient has had persistent pain and weakness after undergoing a reamed intramedullary nailing for a midshaft humerus fracture 8 months ago. There is no evidence of infection. Radiographs are shown in Figures 19a and 19b. Management should consist of

A 29-year-old man reports a 2-week history of severe neck pain after being struck sharply on the back of the head and neck while moving a refrigerator down a flight of stairs. Initial evaluation in the emergency department revealed no obvious fracture and he was discharged in a soft collar. Neurologic examination is within normal limits, and radiographs taken in the office are shown in Figures 21a through 21c. Subsequent MRI scans show intra-substance rupture of the transverse atlantal ligament. What is the most appropriate treatment option at this time?

Figures 36a and 36b show the MRI scans of a 15-year-old girl who has had pain and recurrent hemarthrosis in the knee for the past year. Plain radiographs are normal. What is the most likely diagnosis?

Antibiotic-loaded bone cement prostheses, such as that shown in Figure 8, are best created by using which of the following methods?

Figure 37 shows the radiograph of a 23-year-old football player who sustained a blow to the anterior aspect of his shoulder. Examination reveals pain and limited rotation. He is unable to flex the arm above the shoulder. Management should include which of the following studies?

A 25-year-old man has chronic back pain that has been slowly worsening. He has no constitutional symptoms, and he denies any previous medical problems. Examination shows a tall lean build with no objective neurologic findings or skin lesions. Figure 32 shows a T2-weighted sagittal MRI scan. What is the most likely diagnosis?

A 6-year-old boy with spastic diplegic cerebral palsy has a crouched gait. Examination reveals hip flexion contractures of 15 degrees and popliteal angles of 70 degrees. Equinus contractures measure 10 degrees with the knees extended. Which of the following surgical procedures, if performed alone, will worsen the crouching?

A superior labrum anterior and posterior (SLAP) lesion doubles the strain in which of the following stabilizing structures?

In children with isolated zone II lacerations of the flexor tendon, poor digital motion is best correlated with

What nerve is most at risk during placement of the anterolateral portal in elbow arthroscopy?

What patient factor is predictive of better outcomes for surgical management of a displaced calcaneal fracture compared to nonsurgical management?