Clinical Case 1

8-year-old boy who has pain in his right leg after falling while putting his foot in.
in a hole. The diagnosis of spiral fracture of the middle third of the tibia is established.
right.
The mechanism of injury was:
Flexion
Rotation
Extension
Compression

The treatment is:

External fixer
Immobilization with a splint
Short plaster boot immobilization
Long leg cast immobilization

The weeks in which the consolidation is expected are:

6 to 8
9 to 10
11 to 12
13 to 14
Tadchjians says that there is consolidation in surgical treatment from 8-20 weeks.

In children, the deformity that does NOT remodel is:

Varo
Flexion
Rotation
Extension

The initial position for immobilization is:

Knee flexed at 90 degrees and ankle in neutral
Knee extended to 180 degrees and ankle in neutral
Knee flexed at 15 degrees and ankle in dorsiflexion.
Knee flexion of 30 to 45 degrees and ankle of 10 to 20 degrees of plantar flexion
Clinical case 2

9-week-old girl, who presented with a rhinosinusitis condition ten days ago without
treatment; three days ago started with easy crying, irritability and limitation of mobility of
left pelvic member. EF: 37.8°C, left hip in flexion and abduction, with
increase in volume and pain with movement. Leukocytes 16,300. polymorphonuclear 83% and
VSG 35 mm/h.

The complementary study you are requesting is:

Lactate
Electrolytes
C Reactive Protein
Bleeding time

In this pathology, the initial radiographic sign:

Dislocation
Kidnapping
Periosteal reaction
 Increase in joint space

In the cytochemical analysis of the obtained exudate, you expect to find altered:
Basophils
Monocytes
Eosinophils
Neutrophils

In the exudate, Gram-positive cocci are reported; the probable etiological agent is:
Streptococcus group A
Neisseria gonorrhoeae
Staphylococcus aureus
Streptococcus pneumoniae

The first-choice antibiotic is:

Cefuroxime
Ciprofloxacin
Imipenem + vancomycin
Dicloxacillin + amikacin

Clinical case 3

18-month-old child, with an immunization schedule appropriate for age. 15 days ago presented
upper respiratory tract infection; and 7 days ago received direct trauma to the forearm
right due to presented edema, pain, functional incapacity, and fever of 38°C.
EF:temperatura 38.8°C, facies de dolor, muñeca derecha con limitación de movilidad activa;
on the back of the forearm, fluctuating hyperemic, hyperthermic, and painful mass. Hb 12 g/dL,
Hto 35%, leucocitos 16.500/mm3,polimorfonucleares 67%, linfocitos 46%, VSG 26 mm/hy
PCR 10 mg/dL.

The probable diagnosis is:

 Septic arthritis
Acute leukemia
Acute osteomyelitis
Eosinophilic granuloma

The radiological sign of this pathology is:

Lytic lesion
Periosteal reaction
Patch resorption
Image on shirt button

The management is:

Plaster cast
Surgical treatment
Bone marrow aspiration
Lesion biopsy by puncture

The initial pharmacological management is:

Chemotherapy
Surgical Treatment
immunotherapy
Recombinant enzyme

The complication that may arise

Hand in claw
Fissure injury
Functional hand
Venous Thrombosis
Clinical case 4

10-year-old boy who fell from a horse 2 days ago: presented painful deformity of
right doll; was managed empirically, presents edema, serohematic vesicles and
sharp pain.

The diagnosis is:

Arterial injury
Compartment syndrome
Grade IIIB open fracture
Grade IIIC open fracture

The most relevant clinical sign for diagnosis is

hypoesthesias
Decrease in pulses
Absence of capillary filling
Pain during passive exploration of the fingers

The time in hours after which nerve injury becomes irreversible is from:
6
8
10
12

The management in emergencies is:

Dermofasciotomy
Jones bandage
Vascular exploration
Deferred osteosynthesis
An acute complication is:
Infection
Rhabdomyolysis
Venous thrombosis
Malignant hyperthermia

Clinical case 5

32-year-old man who fell from his support plane, presents painful ptosis of
left shoulder.

The displacement of the proximal end is conditioned by the action of the muscle:
Sternohyoid
Pectoralis major
Scapular elevator
Sternocleidomastoid

The deformity in shoulder ptosis is characterized by

Abduction, internal rotation, and extension of the shoulder
Shortening, inclination, adduction and internal rotation of the shoulder
Lengthening, inclination, abduction, and external rotation of the shoulder
elongation, anteversion, abduction, and internal rotation of the shoulder

The biomechanical principle used was:

Support
Protection
Intraosseous tutor
Double compression

The implant of choice for the surgical technique is plate placement:

Half tube
DCP 45 mm
3.5 mm hook
 ● Reconstruction 3.5 mm

The most common complication of this treatment is:

No union
Complex regional pain
Brachial plexus injury
Subclavian vessel injury

Clinical case 6
40-year-old man who presented with seizure crises that resulted in a fall and subsequently
presents painful deformity of the right shoulder.

According to AO, it classifies it as:

● 11:00
11B
11C
12B
The fractures of the proximal third of the humerus in 2 parts of the greater tuberosity are
they associate with:

Scapular fracture
Acromioclavicular dislocation
Anterior Glenohumeral Dislocation
Fracture of the middle third of the clavicle

The greater tuberosity of the humerus is displaced by the action of:

Deltoid
Rotating mango
Pectoralis major
Scapula elevator

The biomechanical principle that is required is:

Support
Protection
Compression
Intraosseous tutor

After internal fixation, it is important to review;

Rotating mango
Long head of the biceps tendon
Middle glenohumeral ligament
Anterior glenohumeral ligament

Clinical case 7
18-year-old man who experiences intense pain in the left shoulder when throwing a ball,
Three months ago, he presented the same symptoms, clinically with shoulder ptosis.
affected

According to studies by McLaughin, the age group most affected by this injury is:
● Entre 20 a 30 años
● Entre 30 a 40 años
Under 20 years old
Over 50 years old

The primary management of this injury is reduction:

Open and osteoarthritis
Closed and arthroscopic plasty
Open and ligament transfer
Closed and external immobilization

The type of injury that occurs most frequently is

unidirectional inferior
Bidirectional posterior
Unidirectional anterior
Unidirectional posterior

Hypoesthesia in the lateral upper third of the arm is suggestive of injury to:
Axillary artery
Circumflex nerve
Musculocutaneous nerve
 Superficial humeral artery

The Bankart lesion describes:

Combined tendon injury
Long biceps tendon injury
Anterior glenoid labrum tear
Posterolateral defect of the humeral head

Clinical case 8
25-year-old man who suffered a rollover car accident upon his arrival
There is a deformity in the left arm. No management has been given since admission.

The surface tension of the humerus is:

Anterior
Posterior
Anteromedial
Internal lateral

Conservative treatment is indicated in the presence of a fracture with:

Angulation and overlapping
Diaphysis of the contralateral humerus
• Angulation of less than 15 degrees in the anterior direction and less than 25 degrees in
I say
Angle of less than 20 degrees in the anterior direction and less than 25 degrees in
I am going

The area where the radial nerve is less mobile and becomes more vulnerable is:
Twist canal
Elbow fold
Border of the pectoralis minor
distal third of the humeral shaft

The access for placement of the anterograde nail is:

Anterior
Intradeltoid
Transdeltoid
Deltopectoral groove

After 8 months of the selected treatment with intramedullary nail, there are no data on
consolidation, the treatment is:
● Scarification + medullary nail
 Placement of 'U' splint and subsequent
Placement of autologous bone graft
Revision of osteosynthesis + bone graft

Clinical Case 9

78-year-old woman, who fell and has a bruise on her elbow, is experiencing intense pain.
functional limitation and deformity.

The number of columns that make up the distal humerus are:

● 2
3
● 4
5

The Tangential Line to the articular surface of the distal humerus, which corresponds to the axis
trochlear, in the coronal plane (AP), forms an angle with the diaphyseal axis; the normal value is:
8 degrees or more of Valgus
From 0 to 4 degrees of Varo
From 0 to 4 degrees of valgus
 Between 4 and 8 degrees of valgus

In the lateral approach to the distal third of the humerus, the distal sensory branches of the nerve
which muscles does the radial run between:
Anconeus and brachioradialis
Triceps and brachial biceps
Brachioradialis and triceps brachii
Long supinator and brachial biceps

The treatment of choice is:

Skeletal traction and plaster
Open reduction and internal fixation
Closed reduction and skeletal traction
Closed reduction and immobilization

The structure that is at risk of injury during the treatment is:

Ulnar nerve
Median nerve
Anterior interosseous nerve
Posterior interosseous nerve

Clinical case 10
29-year-old man, who presents a twisting injury mechanism against resistance.
right arm, began with sudden intense pain, functional limitation, and deformity in the third
middle of the arm.

They can produce osteopenia and increase the risk of fractures by low mechanisms.
energy
NSAIDs
Anxiolytics
Ifusa Balm
Corticosteroids

The biomechanical principle that was used was:

Tirante
Simple intraosseous tutor
Intraosseous tutor protection
Support

The type of consolidation sought in the treatment is

● Primary
For the first time

Secondary
For soft callus

The anterolateral approach of the arm, the anatomical structure located between the brachial
and brachioradialis:

Axillary artery
Radial nerve
Basilic vein
Cephalic vein

In the injury of the proximal third of the humerus, the structure that is at great risk of injury
es:
Axillary artery
Basilic vein
Cephalic Vein
Brachial artery
Clinical Case 11

23-year-old man who fell from a motorcycle.

According to AO, an absolute criterion for surgical treatment of fractures
diaphyses of the humerus is:
Obesity
Polytrauma
Osteoporosis
Long spiral fractures

According to AO, it classifies it as:

11B
● 12:00
12B
● 12 C

The treatment for damage control is:

External fixer
Thoracobrachial immobilizer
Brachial-palmar splint
 Thoracobrachial immobilizer

The biomechanical principle required for damage control is

Support
Protection
Compression
Intraosseous Tutor

With the chosen treatment, the stability achieved is

Precocious
Absolute
Relative
Due to fracture hematoma

Clinical case 12

7-year-old girl, who fell from the support plane, presents painful deformity of the
right elbow, functional limitation and ecchymosis on its medial side.

The ossification center of this bony apophysis appears at the age in years of:
● 2
3
7
5

The epitrochlear muscles are:

● Cubital posterior, anconeus and long supinator
Palmaris longus, pronator teres, and anterior ulnar
Radial prime, short supinator, and long thumb extensor
 Palmaris brevis, pronator quadratus, and flexor digitorum superficialis

This injury can be associated in up to half of the cases with:

Elbow dislocation
Ulnar artery injury
Deep humeral artery injury
Monteggia fracture-dislocation

The structure that may show injury is:

Radial artery
Ulnar artery
Ulnar nerve
Internal cutaneous nerve

In this case, the treatment of choice is reduction:

Closed and long plastered
Closed and percutaneous fixation
Open and internal fixation with Kirschner nails
Open and reconstruction plate with screws

Clinical case 13

4-year-old child who fell from the height of a chair, presents deformity, pain and
disabling elbow and bruising on the medial side of the left elbow,

The mechanism of injury that produces this fracture consists of falling with the elbow in;
Flexion
Torsion
Extension
Supination
The posterolateral displacement of the distal fragment can injure:
Radial artery
Radial nerve
Ulnar artery
Median nerve

The treatment that provides the greatest stability to the fracture site is reduction:
Closed and crossed nails
Open and cannulated screws
Closed and long plaster in extent
Closed and transolecranean traction

The presence of pain during passive extension of the fingers is suggestive of:
Radial nerve injury
Compartment syndrome
Anterior interosseous nerve injury
Deep brachial artery injury

The main long-term consequence is the presence of:

Cubitus varus
Cubital valgus
Ossifying myositis
Flexion deformity

Clinical case 14
40-year-old man who fell from his height onto his hand and elbow in extension presents
intense pain, regional deformity, and functional disability.

The degrees of the loading or carrying angle should be between:

5 to 10
20 to 30
90 to 100
120 to 135

The ligaments that support the proximal radioulnar pivot joint are:
Circular and square
Internal and annular lateral
Internal lateral and Cooper
Extremity and square lateral

In the region of the antecubital fossa run:

Humeral artery, radial and median nerves
● Pronator teres, humeral artery, and radial nerve
Humeral artery, median and musculocutaneous nerves
● Long supinator tendon of the biceps and humeral artery

The static stabilizers of the elbow joint are:

Biceps and triceps muscles
Ligaments and triceps muscle
Articulation, capsule, and ligaments
Articular capsule and biceps tendon

Clinical case 15

13-year-old man who fell off a bicycle 60 minutes ago is experiencing intense pain.
functional incapacity and deformity of the region. PE: right forearm with deformity,
cubital angulation, skin with superficial dermabrasion in the middle third of the posterior region,
normal coloration, normal peripheral pulses, and capillary refill time of 3 seconds.

The most likely diagnosis is fracture:

Galeazzi
Monteggia
22-A3 OTA
Exposed degree Gustilo I

The most likely mechanism of injury was:

Forced valgus
High-energy direct trauma
Low energy flexion and trauma
Direct trauma to the extended hand

The treatment of choice is:

RAFI with needles and plaster cast
Surgical washing and synthesis with 2 plates 3.5
Synthesis with 3.5 plates on bone tension surface
Synthesis with 3.5 plates on the compression surface of the bone

The nerve that is most commonly injured in this fracture is:

Cubital
Deep radial
Radial superficial
Posterior interosseous

The biomechanical principle required is:

Protection and support
Radial and axial compression
Tension and axial compression
Intraosseous tutor and protection
Clinical case 16

Woman, 32 years old, who in a car accident of the collision type received a direct contusion in the
right arm and forearm. EF: right arm forearm with deformity, bone crepitation
and significant pain is observed with the hand in a pendulum.

The diagnosis is:

Right floating elbow
Fracture of the right radius
Fracture of the left radius
Left humerus fracture

In damage control, the initial immobilization:

Desault
Verpeaux
Brachypalmus
External fixer

The pendulum hand is due to:

Radial nerve injury
Compartment syndrome CCI
Median nerve injury
Proximal Radioulnar Dislocation

The fracture line of the humerus is:

 Spiroid
Transverse
Long oblique
Short oblique

The most serious complication of this injury is:

Radial nerve injury
Compartment syndrome
Median nerve injury
Proximal radioulnar dislocation

Clinical case 17
11-year-old girl who fell from a bunk bed with the pelvic limbs in abduction.
She presents pain in the right hip with inability to walk.

The diagnosis is:

Transcervical fracture
Post-traumatic synovitis
Intertrochanteric fracture
Proximal femoral epiphysiolysis

The main artery that supplies the femoral head is:

Superficial femoral
Anterior circumflex
Posterior circumflex
Of the round ligament

The treatment is:

Callot
Internal fixation
Walking with crutches
Traction and rest for 3 to 4 weeks

The main complication is:

Condrolysis
 Coxa valga
MP shortening
Avascular necrosis

The trabecular group affected by the fracture line is:

Calcar
Trochanteric
Adams Arch
Secondary compression

Clinical case 18

74-year-old woman with chronic left hip pain; she fell from her own height with
direct contusion Presents pain, inability to stand upright and the arches of
mobility.

According to AO, it is classified as

31A1
31A2
31A3
31C3

The vascular supply of the femoral head is provided by:

Obturator
 Retinacular
Profunda femoris
Superficial femoral

In the posterior approach to the hip, the structure that is protected when separating the twins and
the shutters:
Sacral plexus
Sciatic nerve
Middle gluteal nerve
Superior gluteal artery

The indicated treatment is

Support
Tie
Compression
Joint replacement

The type of prosthesis indicated is

Cemented
Partial
Cemented hybrid
Unpaved

Clinical case 19
33-year-old man who, while traveling as a co-pilot, suffers a car accident; presents
pain in the right pelvic limb and inability to walk,

The position of the pelvic member that is expected to be observed is:

Knee flexion and pendulum foot
Shortening of extension and external rotation
Abduction, shortening, and neutral position
Shortening, flexion, adduction, and internal rotation

The traumatic mechanism is:

Directly on the greater trochanter
● On the inner surface of the thigh
● On the posterior surface of the hip
● On knee, hip in flexion, adduction and internal rotation

The diagnosis is:

Posterior dislocation
Anterior dislocation and fracture of the anterior wall of the acetabulum
Posterior dislocation and fracture of the anterior wall of the acetabulum
Posterior dislocation and fracture of the posterior wall of the acetabulum

The most common associated injury is

Vascular
 Neurological
Femoral fracture
Pelvic fracture

To prevent heterotopic ossification indicate:

Pregabalin
Enoxaparin
Indomethacin
Carbamazepine

Clinical case 20

48-year-old woman who, in a head-on collision accident, suffers a knee contusion.

on the car dashboard, presents pain and deformity in the right thigh, presents in shape
sudden hypotension, tachycardia, sweating, increased size of the right thigh and
distal hypoperfusion.

According to AO, the diaphyseal fracture is classified as:

32A1
32A3
32B1
32B3

According to AO of the proximal fracture, it classifies it as:

31A1
31B1
31B2
31C1
The most feared complication of proximal fracture is:
Coxarthrosis
Ossifying myositis
 Avascular necrosis
Osteochondritis dissecans

In this patient, the following must be ruled out:

Rhabdomyolysis
Vascular injury
Reperfusion syndrome
Compartment syndrome

The diagnosis must be confirmed by:

Myoglobinuria in urine
Arteriography and Doppler
Pulse oximetry on the thumb
Measurement of the thigh compartments

Clinical case 21

25-year-old woman who sustained direct trauma to the right thigh after being run over;
presents deformity and shortening

In this case, the muscle that flexes and externally rotates the proximal fragment.
Fascia Lata
Iliac psoas
Middle gluteus
Minor adductor

The characteristic clinical data in shaft fractures is:

Deformity
 Vascular injury
Important Edema
Hip flexion at 90 degrees
An unnoticed injury due to the mechanism of injury is:
Patellar tendon ruptures
Quadriceps muscle tear
Avulsion fracture of the greater trochanter
Capsular Ligament Injury of the knee

The most recommended definitive treatment is:

Mixed osteosynthesis
Skeletal traction
Blocked central medullary enclave
Pelvimuslopodalic plaster device

The biomechanical principle that is required is:

Support
Protection
Intraosseous tutor
Axial Compression

Clinical case 22

70-year-old man who fell from his height presents pain and deformity of the left thigh.

According to AO, it classifies it as:

32B3
32C1
32C2
 32B2

En esta fractura, cuando se utilizan placas el principia biomecánico que utiliza es:
Support
Axial compression
Radial compression
Protection

The general principle of the plates for this case is

Support
Tensed
Molding
Precast

The standard anterograde intramedullary nail insertion site for the femur is:
intercondylar
Pear-shaped fossa
Greater trochanter
Focus of fracture

The medial displacement of the distal fragment is due to the action of:
Abductors
Adductors
Iliac Psoas
Gastrocnemius

Clinical case 23'

32-year-old man who suffered a car accident 7 hours ago. No injuries.

distal neurovascular.

According to the classification of Gustilo and Anderson, it corresponds to type:

II
IIB
● IIIA
● III C

The initial management is:

Surgical washing and debridement
Intramedullary nailing of the femur
Surgical debridement and stabilization
Open reduction and internal fixation with DCP plate
The most common complication that can occur at 72 hours is:
Fat embolism
Septic shock
 Hypovolemic shock
Compartment syndrome

This complication manifests with:

Fever and hypotension
Fever, leukocytosis, and tachycardia
Hypotension, Tachycardia, and drowsiness
Tachypnea, conjunctival and axillary petechiae

The most common complication due to the placement of nails for external fixation.
es:
Osteomyelitis
Pseudoarthrosis
Loss of soft tissue
Infection in the path of the nails

Clinical case 24

3-month-old girl who suddenly presents irritability, swelling, pain and

color change in the left thigh. Physical examination: swelling, crepitus, and pain.

Initially, you must discard:

Osteogenesis imperfecta
Injuries from child abuse
Fracture related to childbirth
Fracture in pathological bone tissue
In addition to looking for other bone injuries, the first action to take is:
Legal notification
Interconsultation with genetics
Interconsultation with neurology
Interconsultation with endocrinology

The treatment of choice for diaphyseal fracture is:

External fixation
Pavlik Harness
Flexible clamps
Pelvimuslopodal plaster device

The maximum allowed angulation in the reduction of this fracture is:

10
15
20
30

Due to the patient's age, the weeks in which this fracture is expected to heal is
● 4
6
● 8
10

Clinical case 25

Woman who suffered a motorcycle accident in which she received direct trauma.
on the left thigh.

The diaphyseal fracture of the femur is the one that occurs:

At the level of the lesser trochanter
9 cm from the lesser trochanter
A 5cm distal to the lesser trochanter
Equidistant from the knee joint interline and the tibiotarsal joint

A characteristic of a diaphyseal fracture due to torsion is:

Occupy a part of the diaphysis
 Present a segmental stroke
Present a triangular segment
Present a long and helical stroke

The milliliters of hemorrhage that can occur in this fracture bleeding are up to:
500
1200
1000
2000

The localization of stress fractures in the femur, frequently present in

soldiers or runners is;
Distal third
Transtrochanteric
Middle and distal third
Proximal and middle third

The diaphyseal fracture of the femur will be favored in its consolidation if

There is no infection
It has adequate skin coverage
Bone graft is placed in the fracture line
Blood flow is restored with the reduction

Clinical case 26
38-year-old woman who suffered a motorcycle accident, presents deformity at the mid-third level.
from the right thigh; without loss of alertness or distal neurovascular alterations
apparent.

According to AO/OTA, it classifies as:

32B3
32C1
32C2
● 32 C3

The stabilization must be carried out:

Before 24 hours
Between 48 and 72 hours
Between the 5th and 10th day
During the window period

The biomechanical principle required is intraosseous tutor plus:

Compression
Only intramedullary splint
Support
Protection

The prophylactic treatment of fat embolism is:

Dextran
Heparin
Low molecular weight heparins
Immediate stabilization of the fracture

Clinical case 27
22-year-old man, who was trapped in a collision car accident.
for 5 hours.

According to Gustillo, this injury is classified as:

● II
● IIIA
● IIIB
III C

According to the AO/OTA classification of fractures, it corresponds to:

42B2
42B3
42C2
42C3

At 8 hours, the patient shows signs of fever, weakness, general discomfort, and dark urine.
the diagnosis to be ruled out is:
Rhabdomyolysis
Multiple organ failure
Reperfusion syndrome
Compartment syndrome

The support for the diagnosis is:

● CPK Laboratory, Creatinine, EGO
Measurement of interleukin 6 and 10
Measure the intracompartimental pressure
Place the pulse oximeter without the injured toe.

The treatment to follow according to the diagnosis is

 Intravenous steroids
Intravenous antibiotics
Parenteral solutions and mannitol
Supracondylar amputation

Clinical case 28

40-year-old man who was riding a motorcycle on a fast track and with equipment
protection falls on its left side, without loss of alertness.

In supracondylar femoral fractures, the muscle that pulls backwards the

distal femoral fragments:
Popliteal
Quadriceps
Hamstrings
Calf sleeves

The posterior tibial nerve and the popliteal artery and vein are located in the:
Soleo ring
Popliteal fossa
Hunter's duct
Tibial compartment

The tibioperoneal trunk is a continuation of the artery:

Popliteal
Anterior tibialis
Posterior tibial
Deep femoral

The branches of the popliteal artery in the fossa are:

Genicular, peroneal, and tibial
Genicular media, anterior tibial and peroneals
Inferior geniculate, peroneal and anterior tibial
Superior, intermediate, and inferior geniculate bodies
The irrigation of the cruciate ligaments comes from:
Deep femoral
Genicular intermedia
Tibiofibular trunk
Recurrent anterior tibial

Clinical case 29

42-year-old man who fell from his height with a pronation and rotation mechanism
external right ankle; presents deformity, pain, and loss of function.

According to AO, it classifies it as:

44B3
44C2
44B1
44A2

The AP radiological projection, the degrees of internal rotation in which it should be taken are:
5
10
30
20

The biomechanical principle for the fibula malleolus is:

Support
Protection
Axial compression
Radial compression
The biomechanical principle for the medial malleolus is:
Strap
Support
Protection
Axial compression

The indicated treatment for the fibular malleolus is with a plate:

DCP 3.5 mm
3.5 mm cane third
Cane third 4.5 mm
Reconstruction 3.5 mm

Clinical case 31

50-year-old woman who fell from a sidewalk while walking, presents disability in the
march, intense pain and swelling in the left ankle.

If you decide to place a shroud, the biomechanical principle that applies is:
Support
Strap
Radial compression
Interfragmentary compression

The joint is the tibiofibular-talar type:

Trochlear
Anfiartrosis
Syndesmosis
Reciprocal lace
The ligament responsible for the avulsion of the medial malleolus in this fracture is:
Deltoid
Subtalar
Peroneal-calcaneal
Anterior talofibular

The structure that causes the avulsion of the base of the 5th metatarsal is:
Anterior peroneal tendon
Long lateral peroneal tendon
Short lateral peroneal tendon
Anterior astragaline ligament of the penis

The number of structures that make up the lateral ligamentous complex of the ankle is
● 2
3
4
5

Clinical case 32

28-year-old man who suffered forced inversion of right ankle while playing soccer, presents
pain, swelling, bruising, limited mobility and inability to
march.

According to Weber, this fracture-dislocation is classified as:

● B
C
44B3.2
● 44A1.1

The percentage in which the syndesmosis is injured:

0
40
60
100

The radiographic projection in which the integrity of the syndesmosis is assessed is:
 With stress
Ankle sprain
AP real of the ankle
Ankle Oblique

In this case, the treatment of choice is:

Conservative with plaster
Wiring with 1.0 wire
Syndesmosis repair and positioning screw
Third plate of a 6-hole rod with cortical screws

In the case of fibula osteosynthesis, the nerve that may be injured is:
Sural
Lateral peroneal
Deep peroneal
Superficial peroneal

Clinical case 33

Woman 45 years old, who suffered forced inversion of the left ankle; presents pain, increase.
of volume in the anteroexternal region, partial limitation for the range of motion and the
ambulation. EF: moderate anterolateral instability. The AP projection shows
syndesmosis with a relation of 1/1, concluding that it presents an ankle sprain:

The test to assess anterolateral ankle instability is:

Kleiger
McMurray
Anterior drawer
Rear box

The radiological study that confirms a lateral collateral ligament injury is:
Dorsoplantar
 Of the shroud
Internal Oblique
AP with investment stress

The bundle that is most frequently injured is the:

Half
Anterior
Superior
Posterior

The insertions of the ligaments are classified into

Fibrous and cartilaginous
Direct and indirect
Vascular and avascular
Superficial and indirect

The protein present in small amounts in the ligaments associated with the properties
mechanics of the tissue is:
Fibronectin
Fibromodulin
Condronectin
Elastin

Clinical case 34
Mujer de 62 años quien hace 6 horas se cayó de su propia altura con eje de carga en tobillo
right; presents intense pain, deformity, and increase in volume.

The diagnosis is fracture-dislocation:

Lisfranc
Chopart
Trimaleolar
Bimalleolar
The mechanism responsible for the posterior dislocation is:
Varo
Rotation
Hyperflexion
Hyperextension

The components of the medial collateral ligament are:

Antero-lateral
Postero-medial
Anterior and posterior
Deep and shallow

The responsible factor for increasing capillary permeability in the inflammatory response is:
Histamine
Serotonin
Macrophage
Bradykinin

Partial ligamentary stability is achieved from the predominant collagen fibers.

type:
I
● II
● IV
● V

Clinical case 35
31-year-old man, who suffered a fall from a height of 5 meters, loss of alertness,
deformity of the right elbow and left leg
From how many ISS points is someone considered polytraumatized?
10
21
40
17

The initial priority behavior in this patient is:

Plate to the tibia
Nail in the tibia milling
External fixators to the pelvis
Definitive fixation of all fractures

Thromboprophylaxis involves administering

Vitamin K
Methylprednisolone
Acetylsalicylic acid
Low molecular weight heparin

The window period refers to:

● immunosuppression period day 11 to 20
Timely moment for surgery 5 to 10
Waiting time to perform the surgery is 2 to 4 days.
Ideal moment for temporary stabilization day 1

The laboratory parameters that indicate that it is physiologically stabilized.

son
White blood cells above 3,000 and platelets above 100,000
Leukocytes above 12,000 and platelets around 100,000
Leukocytes above 3,000 and platelets below 100,000
Leukocytes above 12,000 and platelets below 100,000
Clinical Case 37

19-year-old man who 4 months ago suffered anterior shoulder dislocation, was treated
initially with immobilization for 3 weeks. Currently refers to 'insecurity of the
Shoulder. Complete range of motion, positive apprehension sign, and muscle strength.
complete.

The primary static stabilizer of the previous shoulder translation in 90 degrees abduction.
degrees is:
Biceps tendon
Subscapular tendon
Middle glenohumeral ligament
Inferior glenohumeral ligament

The most common type of anterior dislocation is

Intrathoracic
Subclavicular
Subglenoid
Subcoracoidea

The injury that can cause failure of the arthroscopic Bankart repair is:
Absence of cartilaginous labrum
Small Hill-Sachs that does not fit
Strain of the glenohumeral ligament complex
Defect of the glenoid edge in the anteroposterior direction of 25% or more

After stabilization surgery, the most important prognostic factor in development

the glenohumeral osteoarthritis in the medium term is
Residual instability
Limitation to bending
Poor rehabilitation
Return to contact sports
Without treatment, the expected recurrence rate is:
50
60
70
90

Clinical case 38

47-year-old man who has had 20 episodes of glenohumeral dislocation

For the closed reduction, the following is done:
Adduction and internal rotation
Thoracic-brachial immobilization
Sheet traction
Traction-countertraction, abduction, and rotation

Glenohumeral instability is:

A compensation of the shoulder stabilizing mechanisms
the brake and the loss of the bonding strength of the glenohumeral ligaments
Impossibility of the humeral head remaining in the center of the cavity
glenoid
Rupture of the short portion of the biceps tendon

EI SLAP corresponds to injury

Articular capsule
Posterior of the glenoid labrum
From the anterior part of the glenoid rim
From the upper part of the glenoid cavity

The characteristic lesions of recurrent anterior traumatic instability are:

 Articular capsule and middle and upper ligament
From the superior glenohumeral and subscapular ligaments
medial interior labral capsule and glenohumeral ligaments
Posterior labral capsule and middle and inferior glenohumeral ligaments

As for the surgical treatment of glenohumeral instability, the correct approach is:
The most complicated procedure is the best
The capsulo-muscular plication procedure is the best.
In all cases, bone graft placement is necessary.
The procedure must be chosen according to the type of stability.

Clinical case 39
29-year-old man who fell from his support plane 4 years ago with the
thoracic extremity in extension. Abduction and lateral rotation present deformity in
shoulder, forced position in abduction and medial rotation, shoulder sign and
functional incapacity was managed with reduction and immobilization. This event has been
repeated 15 times.

The diagnosis of the initial event was dislocation.

Glenohumeral
Acromioclavicular
Scapulothoracic
External costoclavicular

The diagnosis of the event recurrence is dislocation:

Reoffender
Recurrent
Acromioclavicular
External clavicular cost

Clinically presents apprehension sign, fulcrum and groove positive. In the MRI
magnetic resonance shows Bankart and Hill-Sachs lesion; the diagnosis is instability:
inferior
Postinor
Inferior Anterior
Multidirectional

In the case of surgical treatment, the most common complication would be:
Infection
 Recurrent dislocation
Neurovascular Injury
Implant loosening

In the anatomical surgical stabilization of the shoulder; the elements for stability
previous are
Middle and upper glenohumeral ligaments
Middle and inferior glenohumeral ligaments
Superior and anterior glenohumeral ligaments
Bicipital tendon and anterior glenohumeral ligament