ABOS Part I Comprehensive Review - Batch 21

Question 1

A 38-year-old male presents with the right lower extremity injury shown in the radiograph below, following a high-velocity motorcycle collision. His past medical history includes Type 2 Diabetes Mellitus (HbA1c 6.8%) and a 15 pack-year smoking histor

Accepted Answer

Delayed union or nonunion

Question 2

During the initial clinical assessment, the patient's lower leg compartments were tense and swollen but remained compressible. Pain with passive stretch of the ischemic muscles was elicited but not deemed disproportionate to the severe underlying fra

Accepted Answer

DBP - ICP < 30 mmHg

Question 3

The radiograph below shows a severely displaced, comminuted fracture of the proximal third of the tibial diaphysis. This specific deformity pattern, characterized by apex anterior (procurvatum) and apex lateral (valgus) angulation, is classic for pro

Accepted Answer

Unopposed pull of the extensor mechanism (quadriceps via patellar tendon)

Question 4

Following initial radiographs, a dedicated computed tomography (CT) scan of the right knee and proximal tibia with fine axial cuts and multiplanar reconstructions was ordered. What is the MOST critical reason for obtaining this CT scan in a high-ener

Accepted Answer

To rule out occult intra-articular extension into the tibial plateau.

Question 5

The surgical plan for this patient involves a Suprapatellar Intramedullary Nailing technique. What is the primary biomechanical advantage of utilizing the suprapatellar approach with the knee in a semi-extended position (15-20 degrees of flexion) for

Accepted Answer

It neutralizes the primary deforming force (extensor mechanism pull) that causes procurvatum.

Question 6

To achieve and maintain reduction and prevent the classic valgus and procurvatum deformity during intramedullary nailing of this proximal tibial fracture, blocking (Poller) screws were employed. Based on the typical deforming forces and the biomechan

Accepted Answer

One screw in the posterior half and one in the lateral half of the proximal fragment.

Question 7

The patient's fracture was classified according to the AO/OTA alphanumeric system. Based on the description of a 'severely displaced, comminuted fracture of the proximal third of the tibial diaphysis' with a 'dominant oblique configuration with a lar

Accepted Answer

42-B3

Question 8

The CT scan definitively ruled out intra-articular extension into the tibial plateau, confirming an extra-articular diaphyseal injury. If, however, the CT scan had revealed a bicondylar tibial plateau fracture (Schatzker VI) with metaphyseal-diaphyse

Accepted Answer

The treatment paradigm would shift entirely towards anatomical reduction of the articular surface and stable internal fixation, often utilizing dual plating constructs.

Question 9

The patient's neurovascular examination revealed palpable and symmetric dorsalis pedis and posterior tibial pulses (2+ bilaterally), brisk capillary refill, and intact motor and sensory function for the deep peroneal, superficial peroneal, and tibial

Accepted Answer

Anterior tibial artery

Question 10

During the intramedullary nailing procedure, sequential flexible reaming was performed. What is a significant benefit of reaming the medullary canal, particularly in the context of promoting fracture healing?

Accepted Answer

It generates autologous bone graft (osteogenic reamings) that promotes secondary bone healing.

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Key Takeaway