This document contains 20 multiple choice questions testing knowledge of elbow anatomy, injuries, and treatments. The questions cover topics like testing the integrity of the medial collateral ligament, fractures of the coronoid and lateral condyle, treatments for elbow dislocations and instability, and diagnosing cubital tunnel syndrome. Surgical approaches, procedures, and rehabilitation protocols are also addressed.

2. • 1. The best method for testing the integrity of the anterior oblique band of the medial collateral ligament is:
• E. Valgus stress in 30° of flexion and full pronation
• 2. At the elbow, the anterior bundle of the medial collateral ligament inserts at which site?
• C. Anteromedial process of the coronoid
• 3. The ideal candidate for interpositional arthroplasty of the elbow joint is:
• A. Incapacitating pain in a 27-year-old non manual worker with rheumatoid arthritis
• 4. Substance(s) used in interpositional arthroplasty of the elbow:
• D. All the above
• 5. With regards elbow joint stability and the medial collateral ligament, which of the following statements is
false:
• D. The posterior oblique fibres are the primary stabiliser of the elbow in valgus stress

3. • 6. A 35-year-old woman presents with an elbow injury which includes a coronoid fracture involving more
than 50%, a comminuted radial head fracture, and an elbow dislocation. What is the most appropriate
treatment?
• E. Radial head arthroplasty, coronoid open reduction internal fixation, and lateral collateral ligament
repair
• 7. The following statement is true regarding the Milch type I fracture of the lateral condyle of the elbow:
• C. The elbow joint is considered stable
• 8. An injury to the nutrient vessel supplying the lateral condyle of elbow during operative treatment leads to
avascular necrosis. The location of this vessel is
• B. Posterolateral
• 9. The following displacement based on Wilkin’s classification for an olecranon fracture is associated with
posterior interosseous nerve injury
• C. Type B – varus

4. • 10. Which of the following is the best diagnostic test to establish the diagnosis of cubital tunnel syndrome:
• C. Motor nerve conduction velocity across the elbow
• 11. A 35-year-old man is involved in a motorcycle collision and reports left elbow pain. Examination of the
left arm reveals diffuse swelling and ecchymosis. His distal neurovascular status is intact. A radiograph of the
injury is shown in Figure 21. The most appropriate surgical approach should include
• D. Posterior extensile elbow approach with olecranon chevron osteotomy.
• 12. What is considered a contraindication to elbow arthroscopy?
• D. Ulnar neuropathy with prior submuscular ulnar nerve transposition
• 13. A 37-year-old man with a nondisplaced radial neck fracture has failed to respond to 8 months of
nonsurgical management. He has undergone extensive physical therapy and bracing without improvement.
Examination reveals that active and passive range of motion is limited to 50° to 85°, with full
pronosupination. He has mildly diminished sensation in the little and ring fingers. Radiographs reveal healing
of the fracture, no deformity, and no arthrosis or heterotopic bone formation. What is the most appropriate
management?
• B. Anterior and posterior capsule release, with ulnar nerve transposition

5. • 14. A 67-year-old woman with rheumatoid arthritis has had a 3-year history of gradually progressive right elbow pain
and limited function despite intra-articular injections and medical management. She previously underwent a
rheumatoid hand reconstruction, and has no pain or dysfunction of the ipsilateral shoulder. Radiographs are shown in
Figure 22, A and B. What is the most appropriate treatment?
• D. Total elbow arthroplasty
• 15. A 45-year-old right-hand dominant woman falls onto an outstretched left hand. Imaging shows a complex elbow
dislocation. The postreduction CT scan demonstrates a reduced joint, comminuted radial head fracture, and type I
coronoid fracture. Surgical intervention is recommended to address the involved structures. Which component of the
intervention adds the most rotational stability?
• C. Repair or reconstruction of the lateral collateral ligament (LCL) complex
• 16. A 38-year-old man sustains a terrible triad injury consisting of an elbow dislocation, comminuted and displaced
radial head fracture, and a type I coronoid fracture. Intraoperative findings after radial head replacement and lateral
collateral ligament complex repair reveal persistent instability consisting of medial opening on valgus stress and
posteromedial subluxation of the ulnohumeral and radiocapitellar joints. What is the best next step?
• a. Medial collateral ligament repair or reconstruction

6. • 17. During the Kocher approach to repair a radial head fracture, care must be taken not to release what
posterior structure lying under the anconeus that may be inadvertently injured during this common lateral
approach to the elbow?
• D. Lateral ulnar collateral ligament
• 18. A 26-year-old male wrestler suffers the elbow injury shown in Figure A. On physical exam he is
neurologically intact and has a palpable radial pulse. He is treated with closed reduction in the emergency
room. In order to optimize his clinical outcomes, which of the following treatment and rehabilitation
protocols should be avoided?
• B. Initial splinting and immobilization for 4 weeks followed by physical therapy
• 19. A fracture of what portion of the coronoid is most often associated with a terrible triad injury?
• A. Tip
• 20. In elbow arthroscopy:
• D. Proximal postero-lateral portal has highest risk of damage to neurovascular structures

7. • Figure 6 is the pelvic radiograph from a 33 year old man involved in a high speed automobile crash.
Examination reveals a blood pressure of 90/50 mm hg and a pulse rate of 120/min. radiographs of the
chest and lateral cervical spine are normal. A CT scan of the abdomen does not reveal any intra
abdominal bleeding. What is the most appropriate management fo the pelvic fracture?
• Application of a pelvic binder
• Fiqure 22 is the CT scan of a 43 year old woman who was involved in a motor vehicle collision and
sustained multiple injury including a pelvic fracture. The injury shown in
• Lateral compression mechanism type 3 resulting in a partially unstable left hemipelvis internal
rotation and a partially unstable right hemipelvis external rotation (open book)
• Which nerve is at risk during the ilio inguinal approach to the pelvis, and often needs to be divided?
• Lateral cutaneous nerve of thigh
• In judet views of the pelvis, the right obturator oblique view shows?
• Posterior wall and anterior column of the right acetabulum
• Which type pelvic injury is most likely to result in urethral/balder injury?
• In wardly displaced parasymphyseal fracture >1cm
• injury to which artery is most likely to cause uncontrollable bleeding during the posterior approach to
the hip
• inferior gluteal

8. • The incision of Boyd’s approach:
• Lateral border of triceps
• The incision of Kocher’s approach:
• Between ECU and anconeus
• The incision of Kaplan’s approach:
• Between ECRB and EDC
• The risk of nerve injury using lateral approaches can be reduced by following procedure :
• Forearm pronation
• The danger of lateral approaches is injury to :
• Posterior interosseus nerve
• The recommended approach of total elbow arthroplasty is campbell technique, which is the
triceps muscle is :
• Split
• The following statements are true about Henry approaches of the elbow, except:
• The surgeon makes an incision that is handbreath proximal to antecubital flexion crease
and a fingerbreadth medial to biceps

9. • Modification approach of Boyd approach that preserve the vascularity
of proximal ulnar fragment in Monteggia fracture-dislocation is:
• Gordon
• The following statements are correct about Chevron osteotomy,
except:
• Triceps muscle need to split
• The following statements are correct about anteromedial approach of
elbow, except:
• Triceps muscle need to split
• The following statements are correct about anteromedial approach of
elbow, except:
• Division of medial collateral ligament will result in varus instability
of the elbow

10. • Statement about spreading TB in vertebrae, except:
• Atypical type common in anterior column of the spine
• Common clinical feature that find in active phase of Spinal tuberculous:
• Febrile condition with malaise all day along
• Neurological problems are common in TB spine, mechanical one of usual cause
that made complication. What are a can be done based on mechanical problems
for prevent complication?
• TB debris can be rid by removal and decompression
• What is Magnetic resonance imaging finding in tuberculous spondylitis patient?
• Well defined post contrast paraspinal abnormal signal margin
• In TB treatment there are medical therapy or radical surgery, what is Indication
for medical treatment in TB?:
• Instability

11. • Mc Afee classification consist compression, stable burst, unstable burst, flexion
distraction, chance and translation Type, what is instability criteria in Mc Afee
classification?
• Facet joint subluxation
• Patient with sensory but no motor function preserved below the neurological
level and includes sacral segment S4-S5 are in ASIA impairment scale of?
• Incomplete B
• Statement of Thoracolumbal Injury Classification is true, except:
• Patients in morphology compression, intact of PLC with neurological deficit of
root level are considered for surgery
• What is goal for non operative treatment in Thoracolumbar fracture?
• Restore spinal stability
• Radiological evaluation of patients with thoracolumbar trauma is true, except:
• Marrow edema in adjacent bones can see in CT

12. • The musculocutaneous nerve arises from the:
• lateral cord of the brachial plexus
• The ulnar nerve:
• all of the above
• Entrapment of the median nerve:
• a and c
1. The acromioclavicular joint is formed by the:
a. distal end of the clavicle and the anterior and media aspect of the acromion
• The biceps muscle:
• all of the above
• The elbow joint is composed of the following bones:
• all of the above
• The radial nerve at the elbow lies between the:
a. lateral epicondyle of the humerus and the musculospiral groove

13. • The cubital tunnel:
a. is made up of the olecranon process and medial epicondyle
• of the humerus
• The triangular fibroelastic cartilage:
• all of the above
• The carpometacarpal joint:
• a and c
• 11. The best method for testing the integrity of the anterior oblique band of the medial collateral ligament is:
• E. Valgus stress in 30° of flexion and full pronation
• 12. At the elbow, the anterior bundle of the medial collateral ligament inserts at which site?
• C. Anteromedial process of the coronoid
• 13. The ideal candidate for interpositional arthroplasty of the elbow joint is:
• A. Incapacitating pain in a 27-year-old non manual worker with rheumatoid arthritis
• 14. Substance(s) used in interpositional arthroplasty of the elbow:
• D. All the above

14. • 15. With regards elbow joint stability and the medial collateral ligament, which of the following
statements is false:
• D. The posterior oblique fibres are the primary stabiliser of the elbow in valgus stress
• 16. A 35-year-old woman presents with an elbow injury which includes a coronoid fracture involving
more than 50%, a comminuted radial head fracture, and an elbow dislocation. What is the most
appropriate treatment?
• E. Radial head arthroplasty, coronoid open reduction internal fixation, and lateral collateral ligament
repair
• 17. The following statement is true regarding the Milch type I fracture of the lateral condyle of the
elbow:
• C. The elbow joint is considered stable
• 18. An injury to the nutrient vessel supplying the lateral condyle of elbow during operative treatment
leads to avascular necrosis. The location of this vessel is
• B. Posterolateral
• 19. The following displacement based on Wilkin’s classification for an olecranon fracture is associated
with posterior interosseous nerve injury
• C. Type B – varus
• 20. Which of the following is the best diagnostic test to establish the diagnosis of cubital tunnel
syndrome:
• C. Motor nerve conduction velocity across the elbow