Fracture

Question 1

1. The 42-year-old female patient is asking why her clavicular fracture has a deformity which on Xray shows a displacement of the outer and middle thirds of the bone. You explain to her that there is a muscle in the area which can pull the clavicle and cause displacement of the fracture. What is this muscle?

a. Sternocleidomastoid
b. Deltoids
c. Upper trapezius
d. Scalenus anticus

Answer 1

a. Sternocleidomastoid

Question 2

2. Bones of the upper limb unite earlier than that of the lower limb due to their size. The average time of healing for the bones of the upper limb is weeks.

a. 1-6
b. 9-24
c. 12-18
d. 3-12

Answer 2

d. 3-12

Question 3

3. A 30-year-old sustained a tri-malleolar fracture of the ankle. The forces involved in this type of fracture include abduction/lateral rotation force and _____.

a. Flexion
b. Extension
c. Adduction
d. plantarflexion

Answer 3

c. Adduction

Question 4

4. The 14-year-old male patient came into the clinic with a referral from the orthopedic service. His diagnosis is a Monteggia fracture. What does this comprise?

a. Fracture of the ulna with ulnar subluxation
b. Fracture of the ulnar with radial head subluxation
c. Fracture of the radius with radial head subluxation
d. Fracture of the radius with subluxation of the ulna

Answer 4

b. Fracture of the ulnar with radial head subluxation

Question 5

5. These fractures are more stable than most fractures. This is called fractures.

a. Compound
b. Greenstick
c. Impacted
d. Avulsion

Answer 5

c. Impacted

Question 6

6.What are the principles of fixation in fracture healing? These are the following EXCEPT

a. A small amount of movement at a fracture site may actually encourage fracture healing
b. Rigid fixation may lessen the stimulus for callus formation
c. Adequate fixation prevents impairment of the blood supply necessary for fracture healing
d. Any amount of movement is not allowed to maintain fracture fixation
e. Scapular fracture

Answer 6

d. Any amount of movement is not allowed to maintain fracture fixation

Question 7

7. The 15-year-old male patient who sustained a calcaneal fracture of both feet, after jumping off a 10-foot-high fence, underwent surgery by open reduction and internal fixation. He is then referred for Rehabilitation. What is the most important movement (s) of the foot which should be regained?

a. Inversion and eversion
b. Abduction and adduction
c. Dorsiflexion and plantarflexion
d. Pronation and supination

Answer 7

a. Inversion and eversion

Question 8

8. The 67-year-old male patient came in with a diagnosis of avulsion fracture of the anterior iliac spine of the pelvis. What muscle might have caused this fracture?

a. Iliopsoas
b. Vastus medialis
c. Tensor fascia lata
d. Rectus femoris

Answer 8

d. Rectus Femoris

Question 9

9. Fracture of the ulna with radial head subluxation is called fracture.

a. Bankart
b. Galeazzi
c. Monteggia
d. Hutchinson

Answer 9

c. Monteggia

Question 10

10. The Colles fracture of your 66-year-old female patient is noted by the orthopedic surgeon to have overlapping of the fragments which has led to a shortening. This is called:

a. None of the answers
b. Malunion
c. Non-union
d. delayed union

Answer 10

b. Malunion

Remember: Mali- union

Question 11

11. The 26-year-old with distal radial and ulnar fractures, is referred for ROM exercises. What movement/s should be focused on during therapy, to prevent permanent forearm tightness and contracture which is common in this type of fracture:

a. Wrist dorsi and palmar flexion
b. Flexion and extension
c. Pronation and supination
d. Wrist radial and ulnar deviation

Answer 11

c. Pronation and supination

Question 12

12. TRUE of Stress Fracture of the Metatarsal bone:
    a. Usually involves the fourth and fifth metatarsal bones
    b. Temporary exhaustion of the musculotendinous support of the foot
    c. Result from repeated stresses associated with walking
    d. Onset of pain and tenderness precedes the xray changes by 1-2 weeks

Answer 12

c. Result from repeated stresses associated with walking

Question 13

13. The main causes of delayed union in a fracture are the following EXCEPT:

a. Poor blood supply in the area
b. Presence of infection
c. Use of internal fixation
d. Bone gap is too wide
e. All of the answers are correct

Answer 13

e. All of the answers are correct

Question 14

14. The 76-year-old female patient sustained a hip fracture after a fall from her bed. Xray’s show a femoral neck fracture and is advised surgery to avoid a complication common to this area. What is this complication?

a. Avascular necrosis
b. Malunion
c. Osteomyelitis
d. Delayed union

Answer 14

a. Avascular necrosis

Question 15

15. The 16-year-old patient sustained a supracondylar fracture of the humerus. In the Rehabilitation and care of this patient over the next few weeks, you will need to watch out for several complications of this fracture mainly the following EXCEPT:

a. All of the answers are correct
b. Volkmann’s contracture
c. Myositis ossificans
d. Cubitus valgus

Answer 15

a. All of the answers are correct

Question 16

16. A shell, frequently made from plaster or fiberglass, that encases a limb or, in some cases, large portions of the body) to stabilize and hold anatomical structures—most often a broken bone (or bones), in place until healing is confirmed is an example of an

a. Internal fixator
b. External fixator
c. Either
d. Neither

Answer 16

b. External fixator

Question 17

17. All of the following are clinical presentation in patients with osteoporosis, except

a. Presence of fracture
b. Dowager’s hump posteriorly
c. Codfish vertebra in radiographs
d. Rib hump anteriorly

Answer 17

d. Rib hump anteriorly

Question 18

18. Metaphyseal chondrodysplasia has similarity to what condition?

a. Scurvy
b. Beri-Beri
c. Ricket’s disease
d. B and C

Answer 18

c. Ricket’s disease

Question 19

19. Specific classification for femoral neck fracture

a. Gustillo Anderson
b. Salter Haris
c. Garden
d. Le Fort

Answer 19

c. Garden

Question 20

20. Another name of this condition would be spotted bones

a. Osteopoikilosis
b. Osteogenesis imperfecta
c. Osteopetrosis
d. None of these

Answer 20

a. Osteopoikilosis

Question 21

21. It happens when healing occurs beyond the expected time

a. Delayed union
b. Nonunion
c. Malunion
d. none of these

Answer 21

a. Delayed union

Question 22

22. These are transverse or oblique channels that transmit blood to the haversian system

a. lamellae
b. lacunae
c. Volkman’s canal
d. All of these

Answer 22

c. Volkman’s canal

Question 23

23. Salter-Harris Grade II

a. Results from crushing of part of the growth plate
b. Involves the plate and a small portion of the metaphysis
c. Stage where there is growth arrest
d. Traverses the bony epiphysis and involves the cartilage plate
e. None of these

Answer 23

b. Involves the plate and a small portion of the metaphysis

Question 24

24. This structure is involved in Jefferson’s fracture

a. Vertebral body of C1
b. Vertebral body of C2
c. Neural arch of C2
d. All of these
e. None of these

Answer 24

e. None of these

Question 25

25. Which among the following fractures heals the fastest a. Oblique b. transverse c. Comminuted d. Spiral

Answer 25

d. Spiral

Question 26

26. When an injured site is immobilized in a cast, the following statements are true in the care of a casted LE, except: a. Flexing and extending the toes is an exercise to test nerve function b. To check for circulation, briefly press on the large toenail until it turns white. Let go, and observe for the normal pink color to return c. Occasionally, when the skin under the cast feel itchy, an object may be inserted to relieve the itch d. If toes are cold cover them, notify the doctor if it doesn’t feel warm

Answer 26

c. Occasionally, when the skin under the cast feel itchy, an object may be inserted to relieve the itch

Question 27

27. 35-55% of a transradial amputation is categorized as a. Short above elbow b. Short below elbow c. Very short above elbow d. Very short below elbow

Answer 27

b. Short below elbow

Question 28

28. This phase begins after osteoblasts are being recruited a. Activation b. Formation c. Resorption d. Reformation

Answer 28

b. Formation

Question 29

29. Garden fracture III a. Incomplete b. Complete, fully displaced c. Complete, partially displaced d. Complete, undisplaced e. None of these

Answer 29

c. Complete, partially displaced

Question 30

30. Most common birth fracture a. Femoral b. Radial c. Humeral d. Clavicular

Answer 30

d. Clavicular

Question 31

31. True about comminuted fracture a. Bones are separated into several fragments b. This is due to strong pull muscles c. Bone is crushed and broken down into powder like substance d. Forms an angle and its due to torsional forces

Answer 31

a. Bones are separated into several fragments

Question 32

32. Main en trident is a deformity seen in patients with achondroplasia that is characterized by a gap in between a. 1st and 2nd digit b. 2nd and 3rd digit c. 3rd and 4th digit d. 4th and 5th digit

Answer 32

c. 3rd and 4th digit

Question 33

33. This type of achondroplasia presents with a proximally set hitchhiker’s thumb a. Diastrophic dwarfism b. Pseudochondroplasia c. Hypochondroplasia d. Chondroectodermal dysplasia

Answer 33

a. Diastrophic dwarfism

Question 34

34. Recommended stump shape for below knee amputation a. Cylindrical b. Conical c. Spherical d. Cuboidal

Answer 34

a. Cylindrical Remember: Busy Ako (B-Cy A-Co)

Question 35

35. This is the type of amputation that creates a crude pinching mechanism by separation of the distal ends of the forearm a. Krukenberg amputation b. Cineplastic amputation c. Guilotine amputation d. A and C e. B and C

Answer 35

a. Krukenberg amputation Remember: CRUDEkenberg

Question 36

36. A crack or avulsion seen along the cortex of the bone can be classified as a.Simple b.Compound c. Complete d. Incomplete

Answer 36

d. Incomplete

Question 37

37. Common fracture in children a. Nightstick b. Greenstick c. Roland d. Jones

Answer 37

b. Greenstick

Question 38

38. All of the following are common findings in patient with osteogenesis imperfecta, except: a. Wedge-wood blue sclera b. Deafness c. Brittle bones d. Auditory hypersensitivity

Answer 38

d. Auditory hypersensitivity

Question 39

39. The sequence in bone remodeling are as follows a. Quiescence, Activation, Resorption, Remodeling, Formation b. Quiescence Reversal, Activation, Formation c. Quiescence Activation, Reversal, Resorption, Formation d. Quiescence, Activation, Resorption, Reversal, Formation

Answer 39

d. Quiescence, Activation, Resorption, Reversal, Formation

Question 40

40. Fracture of the ala of the pelvis a. Duverney b. Kienboch c. Smith d. Malgaine

Answer 40

a. Duverney

Question 41

41. Salter Harris grading where growth arrest starts a. Grade 1 b. Grade 2 c. Grade 3 d. Grade 4

Answer 41

d. Grade 4

Question 42

42. Percentage for standard above elbow amputation a. 0-20 b. 20-50 c. 35-55 d. 50-90

Answer 42

d. 50-90

Question 43

43. Benneth Fracture a. Avulsion of the 1st MCP b. Comminution of the 1st MCP c. Avulsion of the 5th MCP d. Comminution of the 5th MCP

Answer 43

a. Avulsion of the 1st MCP

Question 44

44. Mode of transmission in patient with achondroplasia a. Droplet b. Contact c. Autosomal dominant d. X-linked recessive

Answer 44

c. Autosomal dominant

Question 45

45. The adhesive rubber tips of skin traction can handle weight a. 5-6 kg b. 10-12kgs c. 6-8 kg d. none of these

Answer 45

d. none of these

Question 46

46. This is the classification of fractures that describes extent of wound coverage a. Salter-Harris classification b. Le Fort c. Gustillo Anderson d. Garden Classification

Answer 46

c. Gustillo Anderson Remember: NaGUSgusan --> wound

Question 47

47. Refers to the shaft of the bone a. Diaphysis b. epiphysis c. Metaphysis d. metaphyseal plate

Answer 47

a. Diaphysis Remember: BoDi (body)

Question 48

48. It is the only X-linked Disorder among the mucopolysaccharides a. MPS I Hunter’s b. MPS II Hurler’s c. MPS I Hurler’s d. MPS II Hunter’s

Answer 48

d. MPS II Hunter’s

Question 49

49. Osteoporosis is a silent disease. It is assessed and diagnosed once fractures are already evident. a. Both statements are correct b. Both statements are incorrect c. Only the first statement is correct d. Only the second statement is correct

Answer 49

a. Both statements are correct

Question 50

50. According to Wolff’s Law, every change in form & function is followed by definite change in its internal architecture. This allows the bone to adapt to certain stresses that is being applied to it. a. Both statements are correct b. Both statements are incorrect c. Only the first statement is correct d. Only the second statement is correct

Answer 50

a. Both statements are correct