4.2 of 99 Ratings
Technique guides are not considered high yield topics for orthopaedic standardized exams including ABOS, EBOT and RC.
During a trauma conference, a hand surgeon presents a case of a 25-year-old male who injured his elbow while roller skating. While describing the patient's radiographs, he reports that this injury is associated with valgus posterolateral rotatory instability. Which of the following images is most likely the patient's radiograph?
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A young gymnast fell awkwardly onto an outstretched hand during a competition. At the time of impact, his forearm was positioned in supination. Axial and posterolateral forces were loaded along the forearm into the elbow and the elbow underwent a significant valgus thrust. What injury pattern is most likely to result from the combination of these forces at the elbow?
Extension-type supracondylar fracture
Flexion-type supracondylar fracture
Anterior olecranon fracture dislocation
Coronoid fracture, olecranon fracture and elbow dislocation
Coronoid fracture, radial head fracture and elbow dislocation
A 26-year-old male sustains a fall from a ladder onto his outstretched right hand. He is evaluated in the emergency room and is found to have a closed injury to his elbow without evidence of neurovascular compromise. Plain radiographs are obtained and are shown in Figures A and B. During surgery a sequential approach is used to treat each element of this injury. Which part of the procedure is felt to add the most to rotatory stability?
Radial head replacement
Radial head ORIF
Lateral collateral ligament complex repair or reconstruction
Medial collateral ligament complex reconstruction
At the elbow, the anterior bundle of the medial collateral ligament inserts at which site?
3mm distal to the tip of the coronoid
Anteromedial process of the coronoid
Medial border of the olecranon fossa
Radial side of ulna at origin of annular ligament
A 25-year-old Norwegian amateur curler slips on the ice, falling onto an outstretched right elbow. He is taken to the local teaching hospital and radiographs demonstrate a significantly comminuted radial head fracture and coronoid base fracture. His elbow is reduced and splinted. To restore stability and allow early range of motion, which of the following will most likely need to be performed in most cases?
Radial head fixation or replacement
Radial head fixation or replacement and coronoid fixation
Radial head fixation or replacement, coronoid fixation, and lateral ulnar collateral ligament (LUCL) repair
Radial head fixation or replacement, coronoid fixation, LUCL and medial ulnar collateral ligament (MUCL) repair
Radial head fixation or replacement, coronoid fixation, LUCL and MUCL repair, and application of a hinged fixator
A 58-year-old right-hand-dominant computer programmer trips and falls onto his right arm. He reports right arm pain and that his elbow felt "sloppy". His initial lateral radiograph is shown in Figure A. The orthopedic junior resident counsels him that he will likely need a radial head arthroplasty, ligament repair, and possible fixation of the ulna. What factor would most significantly affect the decision to surgically address the ulna fracture?
Degree of radial head comminution
The deforming force acting on the avulsed fracture fragment
Size of fragment and elbow stability after radial head replacement
The degree of fracture displacement
Patient age and bone quality
A 35-year-old woman presents with an elbow injury which includes a coronoid fracture involving more than 50%, a comminuted radial head fracture, and an elbow dislocation. What is the most appropriate treatment?
closed reduction and early range of motion
radial head resection and lateral collateral ligament reconstruction
radial head resection and coronoid open reduction internal fixation
radial head arthroplasty and coronoid open reduction internal fixation
radial head arthroplasty, coronoid open reduction internal fixation, and lateral collateral ligament repair
You are planning operative treatment of the injury shown in figure A. If the MCL is intact, in what position should the elbow and forearm be splinted at the end of the case?
extension and pronation
extension and supination
extension and neutral rotation
flexion and pronation
flexion and supination
A 62-year-old man slips on ice and sustains an elbow dislocation. Post-reduction imaging reveals a highly comminuted radial head fracture and coronoid fracture through its base. What is the most appropriate treatment?
Early passive range-of-motion in a hinged elbow brace
Application of a static spanning external fixator for 6 weeks
Radial head excision, coronoid excision, and repair of the lateral ulnar collateral ligament and medial collateral as needed
Radial head excision, open reduction internal fixation of the coronoid, and repair of the lateral ulnar collateral ligament and medial collateral as needed
Radial head replacement, open reduction internal fixation of the coronoid, and repair of the lateral ulnar collateral ligament and medial collateral as needed