Lower Limb Injuries

Question 1

What is the anatomical location of a femoral neck fracture?

Answer 1

Between the femoral head and the intertrochanteric line.

Question 2

What is the anatomical location of an intertrochanteric fracture?

Answer 2

Between the greater and lesser trochanters.

Question 3

Which type of proximal femur fracture has a higher risk of avascular necrosis?

Answer 3

Femoral neck fracture.

Question 4

What is the typical treatment for a displaced femoral neck fracture in the elderly?

Answer 4

Hemiarthroplasty or total hip replacement.

Question 5

What is the typical treatment for a stable intertrochanteric fracture?

Answer 5

Dynamic Hip Screw (DHS).

Question 6

What imaging is essential for evaluating proximal femur fractures?

Answer 6

AP pelvis and cross-table lateral radiographs.

Question 7

What are the signs of a posterior hip dislocation?

Answer 7

Shortened limb, hip flexed, adducted, and internally rotated.

Question 8

What are the signs of an anterior hip dislocation?

Answer 8

Hip flexed and externally rotated.

Question 9

What is Shenton’s line used for?

Answer 9

To assess femoral neck alignment in hip radiographs.

Question 10

What is the most common hip dislocation?

Answer 10

Posterior dislocation.

Question 11

What is the gold standard treatment for femoral shaft fractures?

Answer 11

Intramedullary (IM) nail with locking screws.

Question 12

What is a Type 4 femoral shaft fracture according to Winquist-Hansen classification?

Answer 12

Segmental comminution.

Question 13

What view is used to detect intra-articular extension in distal femur fractures?

Answer 13

AP and lateral knee radiographs; CT for details.

Question 14

What is the main treatment for distal femur fractures?

Answer 14

Retrograde IM nail or distal femur plate.

Question 15

What clinical test indicates extensor mechanism integrity in patellar fractures?

Answer 15

Straight leg raise test.

Question 16

When is ORIF indicated in patellar fractures?

Answer 16

When extensor mechanism is incompetent.

Question 17

What classification is used for tibial plateau fractures?

Answer 17

Schatzker classification.

Question 18

Which tibial plateau fractures are considered high energy?

Answer 18

Schatzker types IV, V, and VI.

Question 19

What are complications of tibial plateau fractures?

Answer 19

Compartment syndrome, vascular injury, ligament tears.

Question 20

What imaging is important for surgical planning of tibial plateau fractures?

Answer 20

CT scan.

Question 21

Why are tibial shaft fractures often open?

Answer 21

Lack of soft tissue over the anterior tibia.

Question 22

What is Grade 3B in Gustilo-Anderson classification?

Answer 22

Open fracture >10cm with periosteal stripping requiring flap coverage.

Question 23

What is the gold standard treatment for tibial shaft fractures?

Answer 23

IM nail.

Question 24

What is a pilon fracture?

Answer 24

Fracture involving the distal tibia metaphysis and ankle joint.

Question 25

What is a key principle in managing pilon fractures?

Answer 25

Soft tissue management before definitive fixation.

Question 26

What is a syndesmotic injury indicator on AP ankle view?

Answer 26

Tibiofibular overlap <10mm or clear space >5mm.

Question 27

What classification is used for fibula fractures relative to the mortise?

Answer 27

Weber-Danis classification.

Question 28

What is a Maisonneuve injury?

Answer 28

Proximal fibula fracture with syndesmotic ankle injury.

Question 29

When is ORIF indicated in ankle fractures?

Answer 29

Bimalleolar, trimalleolar fractures, syndesmotic injuries.

Question 30

What sign on X-ray indicates intact vascularity in talus fractures?

Answer 30

Hawkins sign (subchondral lucency).

Question 31

Which type of talus fracture has the highest AVN risk?

Answer 31

Hawkins type IV.

Question 32

What imaging is mandatory for talus fractures?

Answer 32

CT scan.

Question 33

What are common complications of talus fractures?

Answer 33

AVN, post-traumatic arthritis, varus malunion.

Question 34

What mechanism commonly causes calcaneal fractures?

Answer 34

Fall from height or MVA.

Question 35

What is a common associated injury with calcaneal fractures?

Answer 35

Vertebral spine injuries.

Question 36

What views are used for imaging calcaneal fractures?

Answer 36

AP, lateral, and Harris view.

Question 37

What is a Jones fracture?

Answer 37

Fracture at the metaphyseal-diaphyseal junction within 1.5cm of the 5th MT base.

Question 38

How is an avulsion fracture of the 5th MT treated?

Answer 38

Like an ankle sprain with bulky dressing and follow-up X-ray.

Question 39

What is valgus deformity?

Answer 39

Limb angulation toward the midline (e.g., knock knee).

Question 40

What is varus deformity?

Answer 40

Limb angulation away from the midline (e.g., bowleg).

Question 41

What is the most common cause of hip dislocation?

Answer 41

High-energy trauma (dashboard injury).

Question 42

Why is early mobilization important in hip dislocations?

Answer 42

To reduce the risk of avascular necrosis.

Question 43

What is the purpose of Judet views in hip trauma?

Answer 43

To evaluate acetabular fractures.

Question 44

What does a dynamic hip screw (DHS) do?

Answer 44

Allows controlled collapse and healing of intertrochanteric fractures.

Question 45

What is the preferred surgical option for unstable intertrochanteric fractures?

Answer 45

Intramedullary reconstruction nail.

Question 46

What is the primary concern in open tibial fractures?

Answer 46

Infection and soft tissue management.

Question 47

What is a complication of missed compartment syndrome?

Answer 47

Ischemic necrosis of muscles and nerves.

Question 48

What should be checked before and after reduction of dislocations?

Answer 48

Neurovascular status.