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Technique guides are not considered high yield topics for orthopaedic standardized exams including ABOS, EBOT and RC.
A 71-year-old female presents to the emergency department with the injury depicted in Figure A after a ground level fall. 5 days later the patient undergoes surgery for this injury. Her postoperative radiographs are depicted in Figure B. Which of the following is true of this treatment modality in this patient?
Increased risk of implant failure when compared to open reduction internal fixation (ORIF)
Earlier return to full weight bearing when compared to ORIF
Decreased risk of arthrofibrosis when compared to primary total knee arthroplasty (TKA) for osteoarthritis
Decreased risk of complications when compared to primary TKA for osteoarthritis
Higher complication rate compared to TKA performed following ORIF of tibial plateau fractures
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A patient presents with the injury shown in figures A and B. What has been associated with the definitive treatment of this injury with the technique depicted in figures C and D?
Longer operative times
Increased deep surgical infection rates
Unacceptably high malunion/nonunion rates
Slower early return to function
Longer hospital stays
A 34-year-old construction worker fell 10-feet from a ladder and landed on a flexed knee. He is now complaining of severe right knee pain and inability to bear weight. On physical examination, there are no open skin lesions and his DP and PT pulses are 2+ and symmetric to the contralateral side. Current imaging is shown in figures A-D. What would be the most appropriate definitive treatment option?
Open reduction with a direct medial approach and locked lateral plating
Closed reduction with hybrid external fixation
Open reduction with a lateral approach and locked lateral plating
Open reduction with a posteromedial approach and buttress plating
Open reduction with a anteromedial approach and anteromedial buttress plating
A 27-year-old sustains a high-speed moped injury and presents with the injury depicted in Figures A through E. Which of the following correctly describes the interval classically exploited for definitive reduction and fixation in the surgical approach for the medial-sided injury?
Between the superficial MCL and medial head of the gastrocnemius
Between the sartorius and soleus
Between the gracilis and semitendinosus
Between the posterior oblique ligament and soleus
Between the pes anserinus and medial head of the gastrocnemius
Which of the following is the most significant risk factor for lateral meniscal tears associated with lateral tibial plateau fractures?
Age greater than 50
Ipsilateral calcaneus fracture
Greater than 10mm of articular depression
Schatzker I fracture pattern
A 44-year-old female sustains the injury shown in Figures A and B as the result of a motor vehicle collision. She undergoes immediate four compartment leg fasciotomy and placement of a spanning external fixator. A post-fixator CT scan image is shown in Figure C. After allowing her soft tissues to improve, the optimal definitive stabilization of this fracture is which of the following?
Continued use of knee-spanning external fixator
Conversion of external fixator to a simple hinged knee fixator
Conversion to intramedullary nailing
Open reduction and internal fixation with a lateral locked plate
Open reduction and internal fixation with medial and lateral plates
Which of the following injuries is most likely associated with the fracture seen in Figure A?
Medial meniscal tear
Lateral meniscal tear
Lateral collateral ligament rupture
Medial collateral ligament rupture
Posterior cruciate ligament rupture
An ankle-brachial index is most commonly indicated after sustaining which of the following fracture patterns, seen in Figures A-E?
A 35-year-old female presents with the orthopaedic injuries shown in Figures A-D following a high-speed motor vehicle collision. She is also found to have a right-sided diaphragmatic hernia (Figure E) and a stable subarachnoid hemorrhage. The femoral and tibial plateau fractures are open with no gross contamination, and there is an ipsilateral Morel-Lavelle lesion of the left thigh. What is the most appropriate initial management of the patient’s injuries in addition to debridement and irrigation of the open injuries?
Application of a knee immobilizer, splinting of the ankle and forearm
External fixation of the femur and tibial plateau, splinting of the ankle and forearm
Retrograde intramedullary nailing of the femur, limited internal fixation of the tibial plateau, splinting of the ankle and forearm
External fixation of the femur, ORIF of the tibial plateau, splinting of the ankle and forearm
Retrograde intramedullary nailing of the femur, ORIF of the tibial plateau, ORIF of the ankle and forearm
Figure A shows an acute, isolated and closed, left knee injury in a 40-year-old male struck by a motor vehicle. What would be the most appropriate surgical fixation for this injury?
Definitive external fixation
Temporary external fixation then lateral percutaneous screws
Lateral nonlocking plate +/- bone graft substitutes
Medial and lateral locking plate +/- bone graft substitutes
Lateral percutaneous screws with assisted arthroscopy
A 32-year-old male sustains the injury shown in Figures A through D as the result of a high-speed motorcycle collision. He initially undergoes spanning external fixation and returns to the office for soft tissue evaluation prior to his definitive surgery. During this visit, you discuss that the most appropriate fixation is which of the following?
Lateral precontoured locked plating
Posterior buttress plating
Medial antiglide plating
Anterolateral and posteromedial plating
Posterolateral neutralization plating
A 45-year-old patient sustains the injury shown in figure A. What radiographic finding most highly suggests a lateral meniscal injury?
Joint depression of 3mm
Ipsilateral femoral shaft fracture
Joint widening of 6mm
Ipsilateral tibial shaft fracture
Displaced tibial spine fracture
A 23-year-old healthy male was involved in a motor vehicle collision and sustained the injury seen in Figure A. Physical examination after ORIF of the plateau fracture revealed a Grade 3 Lachman, varus laxity at both 0 and 30 degrees of knee flexion, and 15 degrees of external rotation asymmetry at 30 degrees of knee flexion. Which of the following structures (indicated with asterisk*) must be surgically repaired to restore stability to the knee?
A 32-year-old man sustains the knee injury seen in Figure A after falling from a ladder. Which of the following options is the most biomechanically stable and appropriate definitive surgical treatment?
Spanning knee external fixation
Lateral plateau locking plate
Posteromedial locking plate
Lateral plateau percutaneous lag screws and posteromedial plate
Lateral plateau and posteromedial plating
Which of the following tibial plateau fractures would be most appropriately treated by buttress plating alone?
A 38-year-old male suffers the injury shown in Figure A. During operative fixation, free osteoarticular fragments are encountered and reconstruction of these pieces is attempted. Postoperatively, which of the following will have the most beneficial effect on the healing potential of the surviving chondrocytes within these reconstructed articular segments?
Gentle compressive loading of the affected joint through early range of motion exercises
Strict joint immobilzation for three weeks
Shear loading of the affected joint
Joint distraction with a spanning external fixator for three weeks
Glucosamine chondroitin sulfate supplementation
A 58-year-old man injures his knee in a high-speed motor vehicle collision. Radiographs and CT are shown in Figures A through C. What is the most appropriate surgical plan based on the images provided?
ORIF with medial and lateral plating with grafting of metaphyseal defect
ORIF with lateral plating with grafting of metaphyseal defect
ORIF with medial plating
ORIF with lateral plating
Percutaneous articular fragment reduction and screw fixation
A 21-year-old male sustains the injury shown in Figures A through D. Which of the following is the most appropriate definitive treatment of this injury?
Spanning external fixation
Lateral locking plate
Lateral buttress plate
Posteromedial buttress plate
Medial bridging plate
Vascular complications are most commonly seen with which of the following fractures about the knee?
Lipohemarthrosis of the knee is most likely secondary to which of the following?
Seronegative monoarticular arthritis
Patellar tendon rupture
Medial meniscus tear
Medial patellofemoral ligament rupture
A 53-year-old man sustains the injury seen in figure A and later undergoes open reduction and internal fixation. What variable will most significantly increase his rate of degenerative arthritis in the long-term?
Postoperative joint stepoff
Alteration of limb mechanical axis