ABOS Part I Comprehensive Review - Batch 35

Question 1

A 38-year-old male presents to the emergency department after a high-energy motor vehicle collision, sustaining a severe injury to his right ankle. Initial radiographs show a comminuted intra-articular fracture of the distal tibia with significant di

Accepted Answer

Type C, Subtype 3, Grade S3

Question 2

A 55-year-old construction worker sustains a G-A Type B, Subtype 2, Grade S2 pilon fracture after falling from a height. He presents with significant ankle swelling and tense skin, but no open wounds. Initial management involves closed reduction and

Accepted Answer

Proceed with definitive open reduction internal fixation (ORIF).

Question 3

A 42-year-old male presents with a G-A Type C, Subtype 3, Grade S2 pilon fracture following a fall from a ladder. After initial external fixation, a definitive surgical plan is being formulated. Which of the following imaging modalities is considered

Accepted Answer

Computed Tomography (CT) scan with 3D reconstructions

Question 4

A surgeon is planning definitive ORIF for a G-A Type B, Subtype 2 pilon fracture with significant anterolateral articular involvement. The chosen approach is the anterolateral approach. Which of the following describes the correct internervous plane

Accepted Answer

Between the tibialis anterior and the extensor digitorum longus, protecting the anterior tibial artery and deep peroneal nerve.

Question 5

During definitive ORIF of a G-A Type C pilon fracture, the surgeon has successfully reduced and fixed the associated fibula fracture. The next critical step, as emphasized by the literature and surgical technique, is to address the articular surface.

Accepted Answer

Directly visualize and anatomically reduce articular fragments, filling subchondral defects with bone graft.

Question 6

A 28-year-old male presents with a G-A Type B, Subtype 2, Grade S1 pilon fracture with an associated displaced fibula fracture. During definitive ORIF, after exposing the fracture, the surgeon's initial step is to address the fibula. What is the prim

Accepted Answer

It provides a stable external frame and template for restoring tibial length and rotation.

Question 7

A 68-year-old female with severe osteoporosis sustains a G-A Type C, Subtype 3, Grade S2 pilon fracture. After initial external fixation and soft tissue recovery, definitive ORIF is planned. Given the severe metaphyseal comminution and osteoporosis,

Accepted Answer

Indirect reduction techniques and minimally invasive plate osteosynthesis (MIPO) with locking plates.

Question 8

A 35-year-old male undergoes definitive ORIF for a G-A Type C, Subtype 2, Grade S2 pilon fracture. Post-operatively, at 3 weeks, he develops increasing pain, redness, swelling, and purulent discharge from one of the surgical incisions. Radiographs sh

Accepted Answer

Deep surgical site infection; urgent surgical debridement, irrigation, and IV antibiotics.

Question 9

A 48-year-old female undergoes ORIF for a G-A Type B, Subtype 1, Grade S1 pilon fracture. The fixation is deemed stable intraoperatively. According to the general principles of post-operative rehabilitation, when would the surgeon most likely conside

Accepted Answer

At 6-12 weeks post-operatively, guided by clinical and radiographic healing.

Question 10

A 50-year-old male, 2 years after sustaining a G-A Type C, Subtype 3 pilon fracture and undergoing ORIF, presents with persistent, debilitating ankle pain, stiffness, and radiographic evidence of severe post-traumatic osteoarthritis. He has failed co

Accepted Answer

Ankle arthrodesis or total ankle arthroplasty.

ABOS Part I Orthopaedic Deformity Correction, Limb Reconstruction & Gait Analysis Review | Part 21914

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Key Takeaway