Post Tutorial 3 - LL # Datin Vasanthie

A 33-year-old man fell while jogging and twisted his ankle. He has a painful, swollen ankle with obvious deformity. X-ray shows a dislocated ankle with bimalleolar fracture. What is the best immediate management?

• Closed reduction under sedation

• Apply a walking boot and refer

• ORIF within 24 hours

• Ankle brace and outpatient review

A 60-year-old woman slips in her bathroom and lands on her left side. She is unable to stand. Pelvic X-ray shows a displaced intracapsular neck of femur fracture. She was previously fit and independent. What is the most appropriate treatment?

• Hemiarthroplasty

• Total hip replacement

• ORIF with dynamic hip screw

• Conservative management

A 24-year-old man is brought to the ED after a motorcycle collision. His right leg is shortened, internally rotated, flexed and adducted. What is the most likely diagnosis?

• Neck of femur fracture

• Posterior hip dislocation

• Intertrochanteric fracture

• Anterior hip dislocation

A 35-year-old man sustains an open tibial fracture after a road traffic accident. The wound is 12 cm long with periosteal stripping and moderate contamination. According to the Gustilo-Anderson classification, what is the type?

• II

• IIIA

• IIIB

• IIIC

A 45-year-old woman twisted her foot while stepping down from a curb. She has pain and swelling over the middle of the foot. X-ray shows widening between the first and second metatarsal bases. What is the most likely diagnosis?

• Lisfranc injury

• Navicular fracture

• Metatarsal stress fracture

• Ankle sprain

A 29-year-old construction worker falls and sustains a comminuted intra-articular fracture of the distal tibia with axial compression. X-ray confirms involvement of the plafond. What is the fracture?

• Jones

• Pilon

• Tibial shaft

• Tibial plateau

A 26-year-old army trainee presents with a gradual onset of pain over the top of the foot after long marches. There is point tenderness over the shaft of the third metatarsal. X-ray shows a subtle, nondisplaced hairline fracture. What is the fracture?

• Jones

• March

• Greenstick

• Avulsion

A 35-year-old man trips and falls directly onto his left knee. He reports an audible crack followed by swelling and intense pain. He is unable to bear weight but can perform a straight leg raise. X-ray shows a non-displaced transverse fracture of the patella with a moderate knee effusion. What is the most appropriate initial management?

• Conservative management with knee immobilisation

• Arthroscopy with surgical repair

• Open reduction and internal fixation (ORIF)

• Physiotherapy only

A 22-year-old athlete sustains a twisting injury to his right knee. Examination reveals instability and anterior tibial displacement with a positive Lachman test. What is the most likely diagnosis?

• ACL tear

• PCL tear

• Tibial plateau fracture

• Knee dislocation

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