Trauma — MCQs
On this page
Most common nerve injured in fracture of medial epicondyle of humerus is:
Most common site of myositis ossificans ?
Whiplash injury is a tear of which ligament?
Which of the following best describes a hinge fracture?
What is the characteristic feature of Barton's fracture?
What is a Hangman's fracture?
What is a late complication of elbow dislocation?
What is the most common type of shoulder dislocation?
Saturday night palsy is which type of nerve injury?
Which type of supracondylar fracture of the femur is classified as extra-articular?
Trauma Indian Medical PG Practice Questions and MCQs
Question 1061: Most common nerve injured in fracture of medial epicondyle of humerus is:
- A. Radial nerve
- B. Ulnar nerve (Correct Answer)
- C. Median nerve
- D. Musculocutaneous nerve
Explanation: ***Ulnar nerve*** - The **ulnar nerve** runs directly behind the **medial epicondyle** of the humerus in a groove called the **cubital tunnel**, making it highly vulnerable to injury during fractures of this bony prominence. - Injury to the ulnar nerve at this location can cause symptoms like **numbness and tingling** in the **little finger and half of the ring finger**, **weakness in certain hand muscles**, and eventually a **"claw hand" deformity**. *Radial nerve* - The **radial nerve** courses along the posterior aspect of the humerus in the **spiral groove** and is more commonly injured with **mid-shaft humeral fractures**. - Injury typically results in **wrist drop** and **sensory loss over the dorsum of the hand**. *Median nerve* - The **median nerve** travels more anteriorly in the arm and forearm and is most commonly injured with **supracondylar fractures of the humerus** or **carpal tunnel syndrome** at the wrist. - Damage leads to **ape hand deformity** and sensory deficits over the **thumb, index, middle, and radial half of the ring finger**. *Musculocutaneous nerve* - The **musculocutaneous nerve** innervates the biceps brachii and brachialis muscles and provides sensation to the lateral forearm; it is **less commonly injured in elbow fractures**. - Injury would primarily affect **elbow flexion** and **sensation over the lateral forearm**, which is not the typical presentation for medial epicondyle fractures.
Question 1062: Most common site of myositis ossificans ?
- A. Shoulder
- B. Wrist
- C. Quadriceps/Thigh (Correct Answer)
- D. Elbow
Explanation: ***Quadriceps/Thigh*** - The **quadriceps and thigh** muscles are frequently affected due to their common involvement in sports injuries and trauma. - This region is prone to **hematoma formation** after contusions, which can predispose to ectopic bone formation. *Shoulder* - While the shoulder can be affected by myositis ossificans, it is **less common** than the quadriceps. - Traumatic myositis ossificans in the shoulder typically involves the **deltoid muscle**. *Wrist* - Myositis ossificans of the **wrist is rare** and usually occurs after severe trauma or crush injuries. - The small muscle mass and limited direct trauma to the wrist muscles make it an **unlikely primary site**. *Elbow* - Myositis ossificans can occur around the elbow, particularly in the **brachialis muscle**, often following dislocations or fractures. - However, the elbow is still **less commonly affected overall** compared to the large muscle groups of the thigh.
Question 1063: Whiplash injury is a tear of which ligament?
- A. Ligamenta flava
- B. Supraspinal ligament
- C. Post. longitudinal ligament (Correct Answer)
- D. Anterior longitudinal ligament
Explanation: ***Post. longitudinal ligament*** - Whiplash injury, often caused by **hyperextension-hyperflexion** of the cervical spine, commonly results in a tear of the **posterior longitudinal ligament**. - This ligament is crucial for stabilizing the spine and preventing **hyperflexion**, making it vulnerable during sudden, forceful movements. *Ligamenta flava* - The **ligamenta flava** are located on the posterior aspect of the vertebral canal and are primarily composed of elastic tissue, providing flexibility. - While they can be injured in severe trauma, they are less commonly implicated in typical whiplash compared to the **posterior longitudinal ligament**. *Anterior longitudinal ligament* - The **anterior longitudinal ligament** is primarily involved in preventing **hyperextension** of the spine. - While it can be injured in whiplash, the hyperextension phase typically stresses this ligament, but the hyperflexion rebound phase is more damaging to posterior structures. *Supraspinal ligament* - The **supraspinal ligament** connects the tips of the spinous processes and primarily limits **flexion** of the spine. - While it can be strained during whiplash, it is not the primary ligament commonly torn in typical whiplash injuries, which often involve deeper spinal ligaments.
Question 1064: Which of the following best describes a hinge fracture?
- A. A fracture involving the petrous bone
- B. A type of basilar fracture (Correct Answer)
- C. A fracture involving the foramen magnum
- D. A fracture involving the occipital condyles
Explanation: ***A type of basilar fracture*** - A **hinge fracture** is a specific type of **basilar skull fracture** that typically runs transversely across the floor of the middle cranial fossa. - This fracture often extends through structures like the **sella turcica** and **petrous ridge**, causing significant cerebrospinal fluid (CSF) leakage and cranial nerve palsies due to the tearing of the dura mater. *A fracture involving the petrous bone* - While a hinge fracture can involve the **petrous bone**, this description is too broad, as many types of trauma can affect the petrous bone without constituting a hinge fracture. - The key characteristic of a hinge fracture is its transverse course across the cranial base, not just involvement of a single bone. *A fracture involving the foramen magnum* - Fractures involving the **foramen magnum** are typically considered **occipital condyle fractures** or fractures of the clivus, distinct from the transverse course of a hinge fracture. - These fractures often have different clinical presentations, such as lower cranial nerve deficits or atlanto-occipital dislocation. *A fracture involving the occipital condyles* - **Occipital condyle fractures** are isolated injuries affecting the articulation between the skull and the cervical spine. - They are localized to the posterior cranial fossa and do not describe the characteristic transverse, widespread pattern across the middle cranial fossa seen in a hinge fracture.
Question 1065: What is the characteristic feature of Barton's fracture?
- A. Extra-articular fracture of the distal end radius
- B. Intra-articular fracture of the distal end radius without carpal bone subluxation
- C. Intra-articular fracture of the distal end radius with carpal bone subluxation
- D. Intra-articular fracture of the distal end radius with carpal bone subluxation and joint involvement (Correct Answer)
Explanation: ***Intra-articular fracture of the distal end radius with carpal bone subluxation and joint involvement*** - A **Barton's fracture** is defined as an **intra-articular fracture** of the distal radius involving the dorsal or volar rim, accompanied by **subluxation of the carpus**. - The displacement of the **carpal bones** relative to the fractured radius is a hallmark of this injury, necessitating careful reduction for optimal outcome. *Extra-articular fracture of the distal end radius* - An **extra-articular fracture** means the fracture line does not extend into the joint space, which is not characteristic of a Barton's fracture. - Examples of extra-articular distal radius fractures include some types of **Colles' fractures** or **Smith's fractures** without joint involvement. *Intra-articular fracture of the distal end radius without carpal bone subluxation* - While a Barton's fracture is intra-articular, the crucial distinguishing feature is the accompanying **carpal subluxation**. - An **intra-articular fracture** without carpal subluxation would be classified differently, such as a **Chauffeur's fracture** or certain types of **die-punch fractures**. *Intra-articular fracture of the distal end radius with carpal bone subluxation* - This option is partially correct but less complete than the best answer, as it implies joint involvement by definition but doesn't explicitly state it. - The combination of **intra-articular involvement** and **carpal subluxation** explicitly defines a Barton's fracture, whether dorsal or volar.
Question 1066: What is a Hangman's fracture?
- A. Fracture dislocation of C2 (Correct Answer)
- B. Fracture dislocation of ankle joint
- C. Fracture of odontoid
- D. Subluxation of C5 over C6
Explanation: ***Fracture dislocation of C2*** - A Hangman's fracture classically refers to a **bilateral fracture of the pars interarticularis of the axis (C2)**, often with an associated anterior subluxation of C2 on C3. - This injury is typically caused by **hyperextension-distraction forces**, such as those experienced in judicial hangings or motor vehicle accidents. *Subluxation of C5 over C6* - While cervical subluxations are serious, a **C5-C6 subluxation** does not specifically describe a Hangman's fracture. - This type of injury involves different vertebral levels and typically results from different mechanisms. *Fracture dislocation of ankle joint* - This option refers to an injury in the **lower limb**, completely unrelated to the cervical spine. - A Hangman's fracture is a specific type of **cervical vertebral fracture**. *Fracture of odontoid* - A fracture of the odontoid process involves the **dens (odontoid process)** of C2. - This is a distinct type of C2 fracture from a Hangman's fracture, which involves the **pars interarticularis**.
Question 1067: What is a late complication of elbow dislocation?
- A. Median nerve injury
- B. Brachial artery injury
- C. Myositis ossificans (Correct Answer)
- D. None of the options
Explanation: **Myositis ossificans** - **Myositis ossificans** is the abnormal formation of **heterotopic bone** within muscle or other soft tissues, often developing weeks to months after joint trauma such as an elbow dislocation. - It typically presents as a painful, firm mass with restricted joint movement, especially **flexion** and **extension** at the elbow. *Median nerve injury* - **Median nerve injury** can occur at the time of the initial elbow dislocation (an **acute complication**), but it is not typically considered a late complication that develops over weeks or months. - Symptoms include numbness in the thumb, index, and middle fingers, as well as weakness in **thumb opposition** and **flexion** of the index finger. *Brachial artery injury* - **Brachial artery injury** is an **acute complication** of severe elbow dislocation, leading to compromise of distal blood flow. - Signs include absence of pulses, pallor, paresthesia, and pain in the forearm and hand, requiring immediate surgical intervention. *None of the options* - This option is incorrect because **myositis ossificans** is a well-recognized late complication of elbow dislocation.
Question 1068: What is the most common type of shoulder dislocation?
- A. Subcoracoid
- B. Subclavicular
- C. Posterior
- D. Anterior (Correct Answer)
Explanation: ***Anterior*** - **Anterior shoulder dislocations** account for more than 95% of all shoulder dislocations due to the anatomical vulnerability created by the lack of structural support anteriorly. - The **humeral head** displaces anteriorly and inferiorly relative to the glenoid, often resulting from **abduction and external rotation** forces. *Subcoracoid* - **Subcoracoid dislocation** is a specific type of **anterior dislocation** where the humeral head specifically lies inferior to the coracoid process. - While it is a common presentation of anterior dislocation, "anterior" refers to the broader category and hence is the more encompassing and correct answer. *Subclavicular* - **Subclavicular dislocation** is an even rarer type of **anterior dislocation** where the humeral head is displaced medially, lying inferior to the clavicle. - This is a much less common variant compared to general anterior dislocations. *Posterior* - **Posterior shoulder dislocations** are rare, accounting for only 2-4% of all shoulder dislocations. - They are typically associated with specific mechanisms like **seizures**, **electric shock**, or a fall on an adducted, internally rotated arm.
Question 1069: Saturday night palsy is which type of nerve injury?
- A. Neuropraxia (Correct Answer)
- B. Axonotemesis
- C. Complete section
- D. Neurotmesis
Explanation: ***Neuropraxia*** - This is the mildest form of nerve injury, involving a **temporary conduction block** without axonal disruption, often due to **compression** or mild stretching. - **Saturday night palsy**, caused by prolonged compression of the radial nerve, is a classic example, characterized by rapid and complete recovery, typically within days to weeks. *Axonotemesis* - This involves **axon damage** and Wallerian degeneration distal to the injury, but the **endoneurium and connective tissue sheaths remain intact**. - Recovery is slower and often incomplete, as it requires axonal regeneration through the preserved connective tissue tubes, taking months. *Neurotmesis* - This is the most severe type of nerve injury, involving **complete transection of the nerve fiber**, including the axon, myelin, and all connective tissue sheaths. - Recovery is often poor and requires surgical intervention to attempt re-approximation of the nerve ends. *Complete section* - This term is largely synonymous with **neurotmesis**, indicating a full anatomical disruption of the nerve. - It involves the severance of all nerve components, leading to complete loss of function distal to the injury and the poorest prognosis for spontaneous recovery.
Question 1070: Which type of supracondylar fracture of the femur is classified as extra-articular?
- A. Type B
- B. Type C
- C. Type A (Correct Answer)
- D. Type D
Explanation: ***Type A*** - **Type A supracondylar fractures** are defined as those that do not involve the joint surface, making them **extra-articular**. - These fractures typically occur proximal to the condyles without extending into the knee articulation. *Type B* - **Type B supracondylar fractures** are considered **partial articular**, meaning they involve only a portion of the articular surface. - While they affect the joint, they are not completely intra-articular in nature. *Type C* - **Type C supracondylar fractures** are classified as **complete articular** fractures. - This type implies that the fracture line extends through the entire joint surface and separates the articular segment from the metaphysis. *Type D* - The classification of supracondylar femoral fractures generally uses A, B, and C types to denote extra-articular, partial articular, and complete articular involvement, respectively. - **Type D** is not a standard classification used to define an extra-articular supracondylar femoral fracture in common orthopedic systems like the Orthopaedic Trauma Association (OTA) classification.
Practice by Chapter
Principles of Fracture Management
Practice Questions
Upper Limb Fractures
Practice Questions
Lower Limb Fractures
Practice Questions
Spinal Trauma
Practice Questions
Pelvic and Acetabular Fractures
Practice Questions
Open Fractures
Practice Questions
Fractures in Children
Practice Questions
Fracture Complications
Practice Questions
Nonunion and Malunion
Practice Questions
Polytrauma Management
Practice Questions
Joint Dislocations
Practice Questions
Soft Tissue Injuries
Practice Questions
Want unlimited practice?
Get full access to all questions, explanations, and performance tracking.
Start For Free