Traumatology

Question 1

An open fracture can be treated in the same way as a closed fracture if
A) it is a type 1 open fracture
B) has only minimal lateral dislocation
C) it is a type 2 open fracture
D) in any type of open fracture, after proper treatment of the wound

Answer 1

A) it is a type 1 open fracture

Question 2

The following is true concerning compartment syndrome:
A) early absence of peripheral pulse
B) early absence of capillary refill
C) no pain
D) it does not occur if the injury is open

Answer 2

B) early absence of capillary refill

Question 3

What type of x-ray is needed to differentiate between the types of acromioclavicular joint dislocations?
A) clavicle x-ray
B) lateral scapula shoulder Y view
C) comparative weight bearing stress x-ray
D) shoulder x-ray

Answer 3

C) comparative weight bearing stress x-ray

Question 4

Which is the most common nerve injury resulting from shoulder dislocations?
A) Axillary nerve
B) Brachial plexus
C) Radial nerve
D) Ulnar nerve

Answer 4

A) Axillary nerve

Question 5

Which classification system is best for prognosis of proximal humerus fractures?
A) The Neer classification based on the number of fractured fragments
B) Garden classification
C) Böhler classification
D) Pauwels classification

Answer 5

A) The Neer classification based on the number of fractured fragments

Question 6

Which is the most frequently missed shoulder dislocation?
A) Luxatio erecta – inferior dislocation
B) Posterior dislocation
C) Axillary dislocation
D) Anterior dislocation

Answer 6

B) Posterior dislocation

Question 7

In a Monteggia fracture, where is the location of the radius head dislocation?
A) In the proximal radioulnar joint
B) In the distal radioulnar joint
C) There is no dislocation, it follows the fracture line
D) The elbow joint is dislocated

Answer 7

A) In the proximal radioulnar joint

Question 8

Locking of the knee joint and recurrent knee joint swelling with longer symptom-free periods are characteristics of which injury?
A) Meniscal tear
B) Cruciate ligament tear
C) Arthritis
D) Baker-cyst

Answer 8

A) Meniscal tear

Question 9

Surgical fixation is necessary in a dislocated (distracted) patella fracture where there is incongruence of the articular surface.
A) It always requires surgical treatment
B) It does not always require surgical treatment, only when there is discontinuity of the extensor apparatus
C) Just as good results can be achieved with conservative treatment
D) Surgical treatment is only necessary if there is an osteochondral fracture

Answer 9

A) It always requires surgical treatment

Question 10

What is the goal in the treatment of distal radius fractures?
1) To retain the original length of the bone
2) To restore the Böhler joint angles
3) To restore congruency of the joint
4) To inhibit redislocation

A) all of the answers are correct
B) only the 1st and 2nd answers are correct
C) only the 1st, 3rd and 4th answers are correct
D) only the 1st and 4th answers are correct

Answer 10

A) all of the answers are correct

Question 11

Which of the following have a high risk in a traumatic hip joint dislocation?
1) Femoral head necrosis
2) Extensive cartilage damage/early arthritis
3) Sciatic (ischiadic) nerve injury
4) Infection

A) only the 1st and 2nd answers are correct
B) only the 1st, 2nd and 3rd answers are correct
C) all of the answers are correct
D) only the 4th answer is correct

Answer 11

B) only the 1st, 2nd and 3rd answers are correct

Question 12

In a medial femoral neck fracture, the affected lower limb is shortened, in external rotation, and the patient cannot actively elevate his leg.
1) This is true for all types of femoral neck fractures
2) This is not true for laterobasal femoral neck fractures
3) This is not true for valgus type impacted femoral neck fractures
4) This is not true for non-dislocated Garden type II femoral neck fractures

A) only the 1st answer is correct
B) only the 2nd answer is correct
C) only the 3rd answer is correct
D) only the 3rd and 4th answers are correct

Answer 12

D) only the 3rd and 4th answers are correct

Question 13

Which of the following are correct regarding a degloving injury?
1) The skin and its underlying tissues are torn off the fascia
2) It can be an open or closed injury
3) It can be associated with significant blood loss
4) Skin necrosis is common

A) only the 1st answer is correct
B) only the 1st and 2nd answers are correct
C) only the 1st, 2nd and 3rd answers are correct
D) only the 1st, 2nd, 3rd and 4th answers are correct

Answer 13

D) only the 1st, 2nd, 3rd and 4th answers are correct

Question 14

What can be the cause of delayed bone healing and nonunion?
1) Disturbed blood supply of the fractured bone
2) Soft tissue damage
3) Soft tissue interposition
4) Too much distance between the fractured bony ends

A) only the 1st answer is correct
B) only the 1st and 2nd answers are correct
C) only the 1st, 2nd and 3rd answers are correct
D) all of the answers are correct

Answer 14

D) all of the answers are correct

Question 15

Which of the following are associated injuries of shoulder dislocations, which lead to recurrent shoulder dislocation?
1) Bankart-lesion
2) Hill–Sachs-lesion
3) Rotator cuff injury
4) Axillary nerve paresis

A) only the 1st answer is correct
B) only the 2nd answer is correct
C) only the 1st, 2nd, 3rd and 4th answers are correct
D) only the 1st and 2nd answers are correct

Answer 15

D) only the 1st and 2nd answers are correct

Question 16

Which of the following pose the greatest risk in pediatric supracondylar humerus fractures?
1) Misdiagnosis of brachial artery injury
2) Volkmann‘s ischemic contracture
3) Nonunion
4) Median nerve injury

A) all of the answers are correct
B) only the 1st and 2nd answers are correct
C) only the 1st, 2nd and 3rd answers are correct
D) only the 4th answer is correct

Answer 16

B) only the 1st and 2nd answers are correct

Question 17

What do we need to take into consideration in tibia pilon (plafond) fractures?
1) The mosaic type fracture of the cartilage of the tibiotalar joint
2) Severe soft tissue damage
3) Delayed bone union
4) Posttraumatic arthritis

A) only the 1st, 2nd, 3rd and 4th answers are correct
B) only the 2nd and 3rd answers are correct
C) only the 3rd answer is correct
D) only the 3rd and 4th answers are correct

Answer 17

A) only the 1st, 2nd, 3rd and 4th answers are correct

Question 18

After reduction of an elbow dislocation, if the joint is stable, we should not immobilize the joint for over 1 week because the risk of extension deficit increases linearly with the time period of immobilization.
A) The first statement is true
B) The first statement is false
C) Both statements are true and there is a logical correlation between the two
D) Both statements are false

Answer 18

C) Both statements are true and there is a logical correlation between the two

Question 19

Isolated radius head subluxation (nursemaid’s elbow) in children is caused by the sudden pulling of the arm, therefor the child is unable to pronate the forearm.
A) The first statement is true
B) The first statement is false
C) Both statements are true and there is a logical correlation between the two
D) Both statements are false

Answer 19

C) Both statements are true and there is a logical correlation between the two

Question 20

The most frequent complication of femoral neck fractures - femoral head necrosis – only occurs in Garden type 3 and 4 fractures because the arterial blood vessels are injured only in these types of fractures.
A) The first statement is true
B) The first statement is false
C) Both statements are true and there is a logical correlation between the two
D) Both statements are false

Answer 20

D) Both statements are false

Question 21

The prognosis of femoral neck fractures is the same in the elderly and young patients because the mechanism of injury is the same in both groups.
A) The first statement is true
B) The first statement is false
C) Both statements are true and there is a logical correlation between the two
D) Both statements are false

Answer 21

D) Both statements are false

Question 22

The ideal time of treatment of femoral neck fractures is within 6-12 hours of the injury because the incidence of all complications are statistically the lowest within this timeframe.
A) The first statement is true
B) The first statement is false
C) Both statements are true and there is a logical correlation between the two
D) Both statements are false

Answer 22

C) Both statements are true and there is a logical correlation between the two

Question 23

The best implant choice for fixation of intertrochanteric fractures is the trochanteric nail because it give the most stability, allowing early mobilization of the elderly patient.
A) The first statement is true
B) The first statement is false
C) Both statements are true and there is a logical correlation between the two
D) Both statements are false

Answer 23

C) Both statements are true and there is a logical correlation between the two

Question 24

The prognosis of intertrochanteric femoral fractures is worse than that of subtrochanteric fractures because intertrochanteric fractures are more likely to have nonunion.
A) The first statement is true
B) The first statement is false
C) Both statements are true and there is a logical correlation between the two
D) Both statements are false

Answer 24

D) Both statements are false

Question 25

Peroneal nerve injuries and lateral collateral ligament injuries are associated injuries of fibula head fractures therefor they cannot be treated conservatively.
A) Both statements are true, but there is no logical correlation between the two
B) Both statements are true and there is a logical correlation between the two
C) Only the first statement is true
D) Only the second statement is true

Answer 25

C) Only the first statement is true

Question 26

Isolated tibia fractures regularly displace in varus and in recurvation therefor they usually require surgical fixation.
A) Both statements are true and there is a logical correlation between the two
B) Both statements are true, but there is no logical correlation between the two
C) Only the first statement is true
D) Only the second statement is true

Answer 26

A) Both statements are true and there is a logical correlation between the two

Question 27

Surgical fixation of crural (tibia) fractures is advantageous because they heal slower with conservative treatment and mobilization of the patient takes place much later.
A) Both statements are true
B) Both statements are false
C) Only the first statement is true
D) Only the second statement is true

Answer 27

A) Both statements are true

Question 28

The goal of surgical fixation of lateral malleolar fractures is to correct the shortening of the fibula because a shortened fibula cause subluxation of the talus
A) Both statements are true and there is a logical correlation between the two
B) Both statements are true, but there is no logical correlation between the two
C) Only the first statement is true
D) Only the second statement is true

Answer 28

A) Both statements are true and there is a logical correlation between the two

Question 29

In metatarsal fractures, the arch of the foot is impaired, therefor the restoration of the 1st and 5th metatarsals are necessary to achieve painless weight bearing gait.
A) Both statements are true and there is a logical correlation between the two
B) Both statements are true, but there is no logical correlation between the two
C) Only the first statement is true
D) Only the second statement is true

Answer 29

A) Both statements are true and there is a logical correlation between the two

Question 30

In lateral compression trauma of the pelvis, displacement of the anterior pelvic ring occurs, therefor associated urinary bladder injury is frequent.
A) Both statements are true and there is a logical correlation between the two
B) Both statements are true, but there is no logical correlation between the two
C) Only the first statement is true
D) Only the second statement is true

Answer 30

A) Both statements are true and there is a logical correlation between the two

Question 31

There are two principles of treatment in severely injured (polytraumatized) patients: primary definitive care or damage control treatment; the treatment of choice is independent of the patient’s condition.
A) Both statements are true and there is a logical correlation between the two
B) Both statements are true, but there is no logical correlation between the two
C) Only the first statement is true
D) Only the second statement is true

Answer 31

C) Only the first statement is true

Question 32

In acetabulum fractures and in fracture luxations of the hip joint, cartilage damage and hip joint arthritis in correlation with joint incongruence as well as femoral head avascular necrosis can occur.
A) True
B) False

Answer 32

A) True

Question 33

It is good to know the mechanism of injury in severely injured (polytraumatized) patients because we can then suspect characteristic injury-combinations, which can help us in properly diagnosing an unconscious patient.
A) True
B) False

Answer 33

A) True

Question 34

Only non-dislocated, anatomically reduced, stable and retainable ankle fractures can be treated conservatively.
A) True
B) False

Answer 34

A) True

Question 35

There is no risk of aseptic necrosis in talus fractures.
A) True
B) False

Answer 35

B) False

Question 36

The aftercare of operated talus fractures involves immediate full weight bearing.
A) True
B) False

Answer 36

B) False

Question 37

In which type of hand infection is antibiotic treatment necessary?
A) Pulp space infection (felon)
B) Pyogenic (suppurative) arthritis
C) Pyogenic (suppurative) tenosynovitis
D) Deep hand phlegmon
E) In any type of hand infection, if there is associated lymphangitis

Answer 37

E) In any type of hand infection, if there is associated lymphangitis

Question 38

Which of the following is NOT true regarding perilunate dislocations?
A) Perilunate dislocations result from high energy trauma.
B) On the AP view, the displaced lunate has a triangular profile, rather than its normal quadrilateral image.
C) The head of the capitate does not sit within the distal articular cup of the lunate.
D) Osteoporosis plays a major role in the cause of the injury
E) It can be associated with a scaphoid fracture.

Answer 38

D) Osteoporosis plays a major role in the cause of the injury

Question 39

What do we have to be most aware of when treating metacarpal fractures?
A) Prevention of shortening.
B) Any palmar displacement requires reduction.
C) It is important to perfectly reduce the small wedge fragment.
D) To decrease lateral displacement.
E) To completely eliminate any rotational malalignment

Answer 39

E) To completely eliminate any rotational malalignment

Question 40

Patients should perform Kleinert postoperative controlled mobilization exercises following primary tendon suture repair surgery in the “no man’s land’ area, because this will reduce the risk of the sutured deep and superficial tendon adhesions to the tendon sheath.
A) Both statements are true and there is a logical correlation between the two
B) Both statements are true, but there is no logical correlation between the two
C) The first statement is true, the second statement is false
D) The first statement is false, the second statement is true
E) Both statements are false

Answer 40

A) Both statements are true and there is a logical correlation between the two

Question 41

In humerus shaft fractures, which nerve can be injured and how do you examine it?
A) Radial nerve: examine wrist flexion
B) Median nerve: examine wrist extension and 2nd-5th fingers’ extension
C) Radial nerve: examine wrist extension and 2nd-5th fingers’ extension
D) Ulnar nerve: examine wrist extension, 2nd-5th fingers’ extension, as well as extension and abduction of the thumb
E) Radial nerve: examine wrist extension, 2nd-5th fingers’ extension, as well as extension and abduction of the thumb

Answer 41

E) Radial nerve: examine wrist extension, 2nd-5th fingers’ extension, as well as extension and abduction of the thumb

Question 42

Which of the following is NOT TRUE regarding the clinical symptoms and surgical treatment of Bennett fractures?
A) The thumb is dislocated from the trapezium in a radials and proximal direction.
B) A small fragment is fractured from the base of the 1st metacarpal.
C) The dislocation is caused by the pulling of the abductor pollicis tendon.
D) The dislocation can only be reduced by open surgical.
E) After reduction, temporary arthrodesis gives the best results usually.

Answer 42

D) The dislocation can only be reduced by open surgical.

Question 43

Which of the following characteristics are NOT a clinical symptom of proximal median nerve injuries?
A) “Hand of Benediction” deformity
B) Loss of sensation of the 1-7 digital nerves
C) Loss of opposition of the thumb
D) Loss of extension of the thumb
E) The skin of the hand is dry where innervated by the median nerve, due to loss of sudomotor function

Answer 43

D) Loss of extension of the thumb

Question 44

Brachial plexus injuries can be surgically treated with nerve transfer or neurotization. This is followed by physiotherapy, which leads to rapid healing.
A) Both statements are true and there is a logical correlation between the two
B) Both statements are true, but there is no logical correlation between the two
C) The first statement is true, the second statement is false
D) The first statement is false, the second statement is true
E) Both statements are false

Answer 44

C) The first statement is true, the second statement is false

Question 45

Regeneration after microsurgical nerve repair…
A) Immediately takes place
B) Takes place within 3 months
C) Takes place within 3 weeks
D) Regeneration is approximately 1 mm/day in a distal direction
E) Regeneration is approximately 1 cm/day in a distal direction

Answer 45

D) Regeneration is approximately 1 mm/day in a distal direction

Question 46

Which of the following statements is NOT TRUE concerning pyogenic (suppurative) tenosynovitis?
A) The entire length of the tendon sheath is swollen and tender.
B) The involved finger is in a flexed posture.
C) The tendon sheath must be opened in at least 2 places, irrigated and drained.
D) Delayed treatment of pyogenic tenosynovitis leads to damage and/or necrosis of the flexor tendon.
E) V-shaped phlegmon is not a tenosynovitis.

Answer 46

E) V-shaped phlegmon is not a tenosynovitis.

Question 47

What can be the cause of pain on the radial side of the wrist?
1) De Quervain stenosing tendovaginitis
2) Irritation or rupture of the extensor pollicis longus muscle after a radius fracture
3) A previously asymptomatic scaphoid non-union
4) Degeneration or injury to the triangular fibrocartilage complex (TFCC)
5) Trapezium injury or posttraumatic arthritis

A) only the 1st, 3rd and 5th answers are correct
B) only the 1st, 2nd, 3rd and 5th answers are correct
C) only the 1st, 3rd, 4th and 5th answers are correct
D) only the 1st, 2nd, 4th and 5th answers are correct
E) only the 2nd, 3rd and 5th answers are correct

Answer 47

B) only the 1st, 2nd, 3rd and 5th answers are correct

Question 48

What should be done with the amputated body part and stump for replantation?
1) The amputated part should be wrapped in sterile gauze and be placed in ice during transport.
2) The amputated part should be placed inside a closed, sterile plastic bag, which is then placed inside another bag containing ice water.
3) Ligature or temporary clamping of the bleeding vessels of the stump with a Hemostat.
4) Slowing the bleeding of the stump by applying a compression bandage.
5) Writing down a short status of the level of injury, type of injury, and arranging fast transport.

A) only the 1st, 3rd and 5th answers are correct
B) only the 1st, 2nd and 5th answers are correct
C) only the 2nd, 3rd and 4th answers are correct
D) only the 2nd, 4th and th5 answers are correct
E) only the 1st, 4th and 5th answers are correct

Answer 48

D) only the 2nd, 4th and th5 answers are correct

Question 49

A ball has injured the middle finger of a young athlete. The PIP joint is swollen, deformed and painful. What injury do you think of?
1) fracture of the head of the middle phalanx
2) palmar plate injury
3) Boutonniere deformity
4) PIP joint dislocation
5) intraarticular proximal phalanx head fracture

A) only the 1st, 2nd and 3rd answers are correct
B) only the 1st, 3rd and 4th answers are correct
C) only the 2nd, 3rd, 4th and 5th answers are correct
D) only the 1st, 2nd, 3rd and 4th answers are correct
E) all of the answers are correct

Answer 49

C) only the 2nd, 3rd, 4th and 5th answers are correct

Question 50

Which of the following are characteristic of scaphoid fractures?
1) tenderness of the snuff box
2) there are no characteristic clinical symptoms
3) hematoma and deformity on the radial side of the wrist
4) painful wrist extension
5) due to the mild symptoms, patients often do not go to a doctor

A) only the 1st, 2nd and 3rd answers are correct
B) only the 1st, 2nd and 5th answers are correct
C) only the 1st, 3rd, 4th and 5th answers are correct
D) only the 1st, 2nd, 4th and 5th answers are correct
E) only the 2nd, 3rd, 4th and 5th answers are correct

Answer 50

D) only the 1st, 2nd, 4th and 5th answers are correct

Question 51

Which are symptoms of carpal tunnel syndrome?
1) hypotrophic hypothenar
2) hypoesthesia from the thumb to the middle of the ring finger of the hand
3) weakened opposition of the thumb, sometimes even atrophy
4) the pain and paresthesia is more intense at night
5) hypoesthesia spreads to the entire arm (brachialgia paresthetica nocturna)

A) only the 1st, 2nd and 4th answers are correct
B) only the 1st, 3rd, 4th and 5th answers are correct
C) only the 1st, 2nd, 4th and 5th answers are correct
D) only the 1st, 4th and 5th answers are correct
E) only the 2nd, 3rd, 4th and 5th answers are correct

Answer 51

E) only the 2nd, 3rd, 4th and 5th answers are correct

Question 52

Which are symptoms of cubital tunnel syndrome (sulcus ulnaris syndrome)?
1) hypoesthesia on the ulnar half of the ring finger and on the pinky
2) positive Froment’s sign: the patient cannot grip a piece of paper between their thumb and index finger.
3) the ring finger and pinky are in a flexed pose, the patient cannot fully extend the PIP and DIP joints
4) the patient cannot close the pinky to the extended ring finger due to the impaired motor function of the intrinsic muscles
5) the patient cannot flex the thumb

A) only the 1st, 2nd, 3rd and 4th answers are correct
B) only the 1st, 3rd, 4th and 5th answers are correct
C) only the 2nd, 3rd, 4th and 5th answers are correct
D) only the 1st, 4th and 5th answers are correct
E) only the 2nd, 3rd and 5th answers are correct

Answer 52

A) only the 1st, 2nd, 3rd and 4th answers are correct

Question 53

Which of the following are characteristic of trigger finger?
1) The triggering or “popping” is caused by a thickened nodule in the tendon passing through the pulley
2) If the thickening of the tendon continues, the finger locks and gets stuck in a bent position and can only be extended passively.
3) Trigger finger cannot be treated surgically, the patient must use a finger splint.
4) Swelling and tenderness can be observed at the entrance to the tendon sheath.
5) Surgical release of the pulley in local anesthesia relieves the symptoms.

A) only the 1st, 2nd and 3rd answers are correct
B) only the 1st, 3rd, 4th and 5th answers are correct
C) only the 1st, 2nd and 4th answers are correct
D) only the 1st, 2nd, 4th and 5th answers are correct
E) only the 2nd, 3rd, 4th and 5th answers are correct

Answer 53

D) only the 1st, 2nd, 4th and 5th answers are correct

Question 54

Which of the following are correct regarding Dupuytren’s contracture?
1) Among many other risk factors, Dupuytren’s contracture is likely to be hereditary.
2) Most often occurs in middle-aged males.
3) The disease progresses and worsens over time and causes the flexion contractures of the fingers.
4) Dupuytren’s contracture can be treated with splinting, cast fixation and dynamic redressing bandaging
5) The surgical treatment involves complete removal of the thickened, degenerated tissue as well as the intact aponeurosis.

A) only the 1st, 2nd, 3rd and 4th answers are correct
B) only the 1st, 2nd, 3rd and 5th answers are correct
C) only the 1st, 2nd, 4th and 5th answers are correct
D) only the 2nd, 3rd, 4th and 5th answers are correct
E) all of the answers are correct

Answer 54

B) only the 1st, 2nd, 3rd and 5th answers are correct

Question 55

Which of the following are correct regarding functional (intrinsic plus position) immobilization of the hand?
1) The wrist is in 30° extension
2) The pollex is in abduction-opposition position
3) All MCP joints are in 70–80° flexion
4) The PIP and DIP joints are in extension
5) The MCP joints are in extension, while the PIP and DIP joints are in 20° flexion

A) only the 1st, 2nd and 4th answers are correct
B) only the 1st, 3rd and 4th answers are correct
C) only the 1st, 2nd, 3rd and 4th answers are correct
D) only the 2nd, 3rd and 5th answers are correct
E) only the 3rd, 4th and 5th answers are correct

Answer 55

C) only the 1st, 2nd, 3rd and 4th answers are correct

Question 56

Which of the following are indications for replantation?
1) More than one finger amputation
2) Thumb amputation
3) Amputation of the entire hand
4) Amputation in children
5) Extensive destruction of the amputated finger

A) only the 1st, 2nd, 3rd and 4th answers are correct
B) all of the answers are correct
C) only the 3rd, 4th and 5th answers are correct
D) only the 4th and 5th answers are correct
E) answer is correct only the 2nd

Answer 56

A) only the 1st, 2nd, 3rd and 4th answers are correct