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Self-Assessment Questions

Orthopaedic Surgery

Orthopaedic Trauma: Review Questions

George M. Babikian, MD

Dr. Babikian is Chief of Orthopaedic Division, Maine Medical Center, Portland, ME, and Assistant Clinical Professor, Department of Orthopaedics,
University of Vermont, Burlington, VT.

Choose the single best answer for each question.

1. Which of the following is the most significant risk factor for the development of adult respiratory distress syndrome (ARDS) in the multiply injured patient with a femur fracture?
  1. Head injury
  2. Chest injury
  3. Use of a reamed intramedullary rod for femoral fixation
  4. Delay of 18 hours in stabilizing the fracture
  5. Abdominal injury requiring laparotomy
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2. Which of the following tibial fractures is most likely to have residual angulation (> 5 degrees) after treatment with a statically locked intramedullary rod?

  1. A comminuted midshaft fracture
  2. A distal third oblique fracture
  3. A transverse midshaft fracture
  4. A proximal third metaphyseal fracture
  5. An open transverse fracture with a large butterfly fragment
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3. The tibial plateau fracture most often associated with vascular injury is:

  1. Schatzker type I (pure split of lateral plateau)
  2. Schatzker type II (split depressed lateral plateau)
  3. Schatzker type III (pure depressed lateral plateau)
  4. Schatzker type IV (medial plateau fracture)
  5. Schatzker type V (bicondylar fracture)
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4. Relative and absolute contraindications to the placement of an external fixator to control bleeding in patients with pelvic fractures include all of the following EXCEPT:
  1. A stable fracture pattern
  2. A posterior element fracture with an associated "floating" iliac wing
  3. A posterior element fracture with an associated ipsilateral acetabular fracture
  4. Proven arterial bleeding
  5. Head injury
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5. All of the following are indications for surgical management of humeral shaft fractures EXCEPT:

  1. Fractures caused by low-velocity gunshot wounds
  2. Floating elbow (ipsilateral humeral and forearm fractures)
  3. Bilateral humeral fractures
  4. Neurologic loss following closed fracture manipulation
  5. Polytrauma
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6. The incidence of complications and poor outcomes is high in fractures with vascular injury. Treatment for fractures with vascular injury should begin with which of the following?

  1. Fracture alignment and stability
  2. Early (within 6 hours of injury) restoration of blood flow
  3. Wound management
  4. Early mobilization
  5. Recognition of compartment syndrome
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