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Technique guide are not considered high yield topics for orthopaedic standardized exams including the ABOS, EBOT and RC.
An 82-year-old nursing home resident falls onto his elbow while rising from a seated position. He has pain and swelling at the elbow without evidence of instability. His radiographs show a comminuted displaced olecranon fracture involving 25% of the articular surface with global osteopenia. Which of the following treatment options has a low risk of complications and a high likelihood of a functional elbow outcome?
Cast immobilization in 45 degrees of flexion for 8 weeks
Closed reduction and percutaneous pinning
ORIF with a tension band construct
ORIF with a locking plate
Cast immobilization in 90 degrees flexion
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A 24-year-old male sustains the isolated, closed injury seen in Figure A as the result of a fall. What surgical treatment is recommended for this fracture?
Tension band with intramedullary screw
Plate and screw fixation
Total elbow arthroplasty
A 35-year-old patient sustains an upper extremity injury after a motor vehicle collision. Radiographs are shown in Figures A and B. Which treatment modality will optimize internal stability of the elbow?
Open reduction and internal fixation with k-wires
Open reduction and internal fixation with tension band wiring
Open reduction and internal fixation with plate fixation
Open reduction and internal fixation with an intramedullary screw
There is a risk of impaired forearm rotation after tension band fixation of an olecranon fracture with which of the following?
Ipsilateral proximal humerus fracture
Protrusion of Kirschner wire fixation through the volar cortex of the proximal ulna
Use of ulnar intramedullary Kirschner wire fixation
Olecranon fracture comminution
Lack of triceps tendon repair
A 45-year-old male undergoes open reduction internal fixation for a displaced olecranon fracture as shown in Figure A. What is the most common complication for this type of fixation?
anterior interosseous nerve palsy
A 62-year-old man falls on his porch and sustains an elbow injury. A radiograph is provided in Figure A. Which of the following is the best treatment?
Closed reduction and long arm casting
Early motion with a hinged elbow brace
Open reduction internal fixation with a tension band construct
Open reduction internal fixation with a plate
Fragment excision and advancement of the triceps tendon
During surgical treatment of an olecranon fracture with a tension band construct as seen in Figure A, what nerve is at risk with over penetration of the proximal anterior cortex of the ulna with the Kirchner wire?
Anterior interosseous nerve
Posterior interosseous nerve
Bridge plating of the olecranon is MOST appropriate in which of the following clinical scenarios?
Fixation of an olecranon osteotomy used for distal humerus surgery in a 24-year-old male
Simple transverse olecranon fracture in 33-year-old female
Comminuted olecranon fracture in 45-year-old male
Severely comminuted proximal olecranon fracture in an osteoporotic 91-year-old female
Aphophyseal elbow fracture in 6-year-old male
A 79-year-old woman with osteoporosis presents with a displaced, severely comminuted olecranon fracture involving the proximal 40%. Which of the following represents the most appropriate surgical treatment?
Kirschner wire tension band
Fragment excision and triceps advancement
Dorsal bridge plating
A 19-year-old male sustains the isolated, closed injury seen in Figure A. He is subsequently treated as shown in Figure B. When utilizing this technique, what forces are generated at the articular surface?