ABOS Part I Comprehensive Review - Batch 6

Question 1

A 28-year-old male rugby player sustains a direct blow to the superior aspect of his right shoulder with his arm adducted during a tackle. He presents with significant pain and a visible deformity. Radiographs show superior displacement of the distal

Accepted Answer

Type III

Question 2

A surgeon is performing an open reduction and internal fixation of a chronic acromioclavicular joint separation. During the procedure, they note significant horizontal instability of the clavicle on the acromion, even after initial reduction. Based o

Accepted Answer

Superior acromioclavicular ligament

Question 3

A 35-year-old construction worker presents with a Rockwood Type III acromioclavicular joint injury after a fall from scaffolding. He reports significant pain and difficulty performing overhead tasks required for his job. On physical exam, he has dyna

Accepted Answer

Surgical stabilization with an acute suspensory cortical button fixation.

Question 4

A 40-year-old male presents to the emergency department after a cycling accident, complaining of severe right shoulder pain. Physical examination reveals a prominent distal clavicle. To accurately assess the acromioclavicular joint and rule out a Roc

Accepted Answer

True AP shoulder, Scapular Y, and Axillary Lateral; Zanca view with 10-15 degrees cephalad tilt and 50% reduced penetrance.

Question 5

A 22-year-old collegiate football player undergoes arthroscopically assisted suspensory cortical button fixation for an acute Rockwood Type V acromioclavicular joint separation. During the procedure, the surgeon is preparing to drill the coracoid tun

Accepted Answer

Placing the guide pin centrally at the base of the coracoid.

Question 6

A 48-year-old patient presents with a chronic, symptomatic Rockwood Type V acromioclavicular joint separation sustained 8 months prior. He has failed conservative management. The surgeon plans an anatomic coracoclavicular ligament reconstruction. Whi

Accepted Answer

Biologic augmentation with a free tendon graft (e.g., semitendinosus autograft) is essential and must be protected with concurrent mechanical fixation.

Question 7

A 30-year-old patient undergoes surgical stabilization for a Rockwood Type V AC joint injury. Six months postoperatively, he presents with persistent pain localized to the distal clavicle, particularly with overhead activities. Radiographs show lucen

Accepted Answer

Distal clavicle osteolysis; managed by arthroscopic or open distal clavicle excision once CC ligaments have healed.

Question 8

A patient is 3 weeks post-operative following an acute AC joint reconstruction. During their physical therapy session, the therapist instructs them on pendulum exercises. Which of the following activities, if performed by the patient at this stage, w

Accepted Answer

Initiating active shoulder elevation.

Question 9

A surgeon is performing an open coracoclavicular ligament reconstruction. During the exposure of the coracoid process, the clavipectoral fascia is incised lateral to the conjoint tendon. Referring to the provided image and the neurovascular anatomy d

Accepted Answer

Musculocutaneous nerve

Question 10

The ISAKOS Upper Extremity Committee has provided consensus guidelines for the management of Rockwood Type III acromioclavicular joint injuries. According to these guidelines, which of the following patient presentations would most likely benefit fro

Accepted Answer

A 40-year-old manual laborer with a Type IIIB injury, demonstrating dynamic overriding of the clavicle on the acromion during cross-body adduction.

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Key Takeaway