Trauma Practice Questions

Q: Bankart's lesion is associated with which anatomical structure?

Anterior surface of the glenoid labrum. ***Anterior surface of the glenoid labrum*** - A **Bankart lesion** is an injury to the **anterior-inferior glenoid labrum** of the shoulder. - It frequently occurs after an **anterior shoulder dislocation** when the humeral head avulses the labrum from the glenoid rim. *Posterior surface of the glenoid labrum* - An injury to the posterior labrum is known as a **posterior Bankart lesion** or a **reverse Bankart lesion**, which is less common. - This type of injury is typically associated with **posterior shoulder dislocations**. *Posterior part of the head of the humerus* - A **Hill-Sachs lesion** involves an impression fracture on the **posterolateral aspect of the humeral head**. - This lesion occurs as the humeral head impacts the anterior glenoid rim during an **anterior shoulder dislocation**. *Anterior part of the head of the humerus* - Injury to the anterior part of the humeral head is less common in typical shoulder dislocations. - While it could theoretically be involved in very specific trauma, it's not the primary anatomical location for a Bankart lesion.

Q: Which of the following statements is true about crescent fracture?

Fracture of the iliac bone with sacroiliac disruption. ***Fracture of the iliac bone with sacroiliac disruption*** - A **crescent fracture** is characterized by an **oblique fracture of the iliac bone** extending into the posterior superior iliac spine, often associated with a **sacroiliac joint disruption**. - This specific injury pattern suggests **vertical instability of the posterior pelvic ring**, as the sacroiliac ligamentous complex is compromised. *Diastasis of the pubis with associated pubic rami fractures* - This description typically refers to **anterior pelvic ring injuries**, often seen in **open-book fractures** or vertical shear injuries, which are distinct from crescent fractures. - While pubic rami fractures can coexist with crescent fractures as part of a more complex pelvic injury, crescent fracture primarily defines the **posterior injury pattern**. *Anteroposterior instability with rotational stability in the pelvis* - **Anteroposterior instability** often results from disruption of the **anterior pelvic ring**, such as pubic symphysis diastasis, and is less about the rotational stability. - A crescent fracture specifically conveys **vertical instability** of the posterior pelvis due to the compromised sacroiliac joint and iliac fracture. *Associated with stable pelvic ring injuries* - **Crescent fractures** involve disruption of the **posterior pelvic ring**, specifically the sacroiliac joint, and are inherently **unstable**. - This type of injury requires surgical intervention due to the significant risk of hemorrhage and displacement.

Q: A 70-year-old man presents with a hip fracture after a fall. What type of fracture is most common in this scenario?

Femoral neck fracture. ***Femoral neck fracture*** - **Femoral neck fractures** are exceedingly common in elderly patients, particularly women, after low-energy trauma such as a fall. - This fracture type is due to the **osteoporotic weakening** of the bone in this region, which bears significant weight. *Intertrochanteric fracture* - **Intertrochanteric fractures** occur between the greater and lesser trochanters and are also common in the elderly, but they tend to be extracapsular and have a better vascular supply. - While common, they typically involve higher energy trauma or significant twisting forces compared to the low-energy falls associated with femoral neck fractures in the elderly. *Subtrochanteric fracture* - **Subtrochanteric fractures** are located below the lesser trochanter. While they can occur in older patients, they are less common than femoral neck or intertrochanteric fractures after a simple fall. - These fractures often result from **high-energy trauma** in younger individuals or can be associated with certain medications like bisphosphonates. *Femoral head fracture* - **Femoral head fractures** are rare and typically occur in younger patients from high-energy mechanisms, such as a **dashboard injury** in a car accident, often associated with a hip dislocation. - The patient's presentation of an elderly person with a fall makes a femoral head fracture highly unlikely as the primary injury.

Question 1

Bankart's lesion is associated with which anatomical structure?

Accepted Answer

Anterior surface of the glenoid labrum

Answer

Posterior surface of the glenoid labrum

Answer

Posterior part of the head of the humerus

Answer

Anterior part of the head of the humerus

Question 2

Which of the following statements about intracapsular fractures of the femoral neck is true?

Accepted Answer

Malunion is rare, with avascular necrosis and nonunion being more common complications.

Answer

The contour of the greater trochanter remains unaffected in most cases.

Answer

Displacement occurs less frequently compared to extracapsular fractures.

Answer

Tenderness is mainly present over the anterior joint line

Question 3

Which of the following statements is true about crescent fracture?

Accepted Answer

Fracture of the iliac bone with sacroiliac disruption

Answer

Diastasis of the pubis with associated pubic rami fractures.

Answer

Anteroposterior instability with rotational stability in the pelvis.

Answer

Associated with stable pelvic ring injuries.

Question 4

A 70-year-old man presents with a hip fracture after a fall. What type of fracture is most common in this scenario?

Accepted Answer

Femoral neck fracture

Answer

Intertrochanteric fracture

Answer

Femoral head fracture

Answer

Subtrochanteric fracture

Trauma — MCQs

Trauma — MCQs

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