Pre Tutorial 3 - LL # Datin Vasanthie

A 25-year-old man was involved in a road traffic accident. He was in the driver's seat when a lorry in front lost control and became trapped when the dashboard and footwell were pushed forward on impact. He is currently stable but has significant pain, shortening, internal rotation, slight flexion and adduction of his right leg. What is the diagnosis?

• Femoral shaft fracture

• Neck of Femur fracture

• Posterior Hip Dislocation

• Anterior Hip Dislocation

Zainon is a 60-year-old woman who enjoys taking her grandson on long walks in the countryside and regularly tends to her garden. Last night she tripped over her cat and sustained an undisplaced intracapsular neck of femur fracture. What is the most appropriate management for Zainon's hip fracture?

• Hemiarthroplasty

• Total hip replacement

• Conservative management

• Internal fixation (cannulated hip screw)

A 30-year-old male is brought to the emergency department after a high-impact sports injury. He presents with severe pain and visibly deformed knee. Examination reveals a grossly unstable knee joint with limited range of motion. What would you immediately examine next?

• Quadriceps tear

• Nerve injury

• Peripheral pulses

• Collateral ligament

A 32-year-old patient sustained an injury while playing football. He has significant pain in his left ankle and is unable to weight bear. On examination, there is an obvious deformity, swelling and tenderness on the left ankle. There is also evidence of skin tenting around the ankle. Neurological sensation and vascular supply are intact. A radiograph of the left ankle shows a closed medial and lateral malleolus fracture that is displaced with associated dislocation of the tibiotalar joint. What is the most appropriate immediate management for this patient?

• Refer to vascular surgeon

• Closed reduction under sedation

• Controlled ankle motion (CAM) boot

• ORIF

A 22-year-old man sustains an open tibial fracture after an accident with farmyard machinery. He has an 10 cm gaping and ragged wound overlying a simple oblique fracture of his distal tibia. The limb is neurovascularly intact. Which is the most appropriate initial management?

• ORIF within 12 hours

• Wound debridement and external fixation within 12 hours

• Immediate wound debridement and ORIF

• Immediate wound debridement and external fixation

A 56-year-old motorcyclist sustains a comminuted proximal fibula fracture. The fracture is treated conservatively with an above knee POP cast. What is the most likely complication related to this fracture?

• Sciatic nerve injury

• Common peroneal nerve injury

• Popliteal artery injury

• Anterior tibial artery injury

A 35-year-old man tripped over a rug and landed on his left knee, stating that there was an audible crack followed by intense pain. He wasn't able to weight bear due to the pain and after a few minutes the knee began to swell and darken. Range of movement was limited due to pain but he was able to perform a straight leg raise successfully. Plain radiographs showed a non-displaced fracture of the patella with joint effusion. What is the most appropriate management with regards to this patient's knee injury?

• Conservative management with knee immobilisation

• Arthroscopy with surgical reconstruction

• Surgical management – ORIF

• Surgical management – partial patellectomy

A 30-year-old male soccer player sustained a severe shear injury to his midfoot during a game. He complains of severe pain and swelling on the top of his foot. On examination, there is tenderness over the tarsometatarsal joint with ecchymosis. What is the most likely diagnosis?

• Achilles tendon rupture

• Bimalleolar fracture

• Stress fracture

• Lisfranc injury

A 50-year-old male suffered a high-energy motor vehicle accident. He has severe pain and swelling in his ankle, and on examination, there is deformity and tenderness at the distal tibia. X-rays reveal a comminuted fracture involving the articular surface of the tibia. What is the most likely diagnosis?

• Ankle fracture

• Pilon fracture

• Maisonneuve fracture

• Tibial plateau fracture

A 25-year-old male military recruit presents with sharp pain on the top of his foot after a long march during training. He reports that the pain started gradually during the march and has worsened since then. On examination, there is localized tenderness over the third metatarsal bone with mild swelling. X-rays show a hairline fracture in the bone. What is the most likely diagnosis?

• Greenstick fracture

• Pilon fracture

• March fracture

• Jones fracture