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Chapter 28. Orthopedics

Which of the following is most closely associated with calcaneal fractures?

A. Spiral fracture of the tibia

B. Compression fractures of the lumbar spine

C. Lateral compression fractures of the pelvis

D. Calvarial fractures

E. Clavicular fractures

Answer: B. A calcaneal fracture is classically caused by a fall from height onto outstretched legs, such as a parachute jump or a fall from a ladder. Thus, someone who sustains this type of fracture is likely to have other fractures that are caused by an axial load. The choice that is most likely to be caused by an axial load is a compression fracture of the lumbar spine.

What is described by the term Monteggia fracture?

A. Fracture of the proximal one-third of the ulna with associated dislocation of the radial head

B. Fracture of the mid-radius with associated dislocation of the distal radial-ulnar joint

C. A distraction-type injury of the spine where the anterior ligament fails under tension

D. Burst fracture of C1

E. Disruption of the ligament binding the first metatarsal to the second

Answer: A. The other choices describe a Galeazzi fracture, Chance fracture, Jefferson fracture, and a Lisfranc injury, respectively.

What must be done in all posterior knee dislocations if there is no other sign of trauma?

A. Application of a long leg splint

B. Application of a long leg cast

C. Determination of compartment pressures above and below the knee

D. Ankle-brachial index

E. Amputation

Answer: D. An evaluation of the popliteal artery is essential for all patients who suffer from a posterior knee dislocation to rule out occult injury to the artery. The other modalities may be helpful in selected instances, but not necessarily in every circumstance.

Which of the following fracture types is indicative of child abuse?

A. Spiral tibia fracture in a 3-year-old

B. Forearm fracture in a 10-year-old

C. Femur fracture in an infant

D. Physeal fracture in a ...

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