ARTHREX DEX IOT EXAM 2025–2026
OFFICIAL PRACTICE QUESTIONS &
VERIFIED ANSWERS (COMPLETE
RATIONALE SOLUTION MANUAL)
This comprehensive exam preparation package
provides the exact verified practice questions,
complete solutions, and detailed rationales for the
March 2025 Arthrex Digital Education Experience
(DEX) IOT Assessment. It covers critical orthopedic
modules including foot and ankle fixation, hand and
wrist extremities, advanced orthobiologics, and
Synergy system hardware integrations. Master this
material to guarantee a Graded A+ score and ensure
first-time certification success.
Q1. A patient presents with an acute midfoot injury. The surgeon
suspects a Lisfranc injury. Which of the following describes the most
common mechanism of injury for a Lisfranc joint disruption?
A) Direct crush injury to the dorsum of the foot
B) High-energy motor vehicle accidents and falls from heights
,C) Athletic twisting injuries with a plantarflexed foot
D) All of the above
Correct Answer: D) All of the above
Rationale: Lisfranc injuries span a wide spectrum of trauma types. High-
energy mechanisms like motor vehicle accidents and falls from heights
cause significant osseous and ligamentous disruption, while low-energy
athletic injuries typically occur due to an axial load placed on a hyper-
plantarflexed forefoot.
Q2. During a surgical planning session, a resident is asked to identify
the anatomical classification of the Lisfranc joint. What is the correct
anatomical name?
A) Talonavicular joint
B) Calcaneocuboid joint
C) Tarsometatarsal joint
D) Metatarsophalangeal joint
Correct Answer: C) Tarsometatarsal joint
Rationale: The Lisfranc joint complex is anatomically designated as the
tarsometatarsal (TMT) joint. It serves as the articulation between the
cuneiforms and cuboid (tarsals) and the bases of the five metatarsals
(metatarsals).
Q3. Reconstructing the midfoot requires precise knowledge of the
primary stabilizing structures. Where does the classic Lisfranc
ligament originate and insert?
A) Originates on the medial cuneiform and inserts onto the base of the 1st
metatarsal
B) Originates on the medial cuneiform and inserts onto the base of the 2nd
metatarsal
C) Originates on the intermediate cuneiform and inserts onto the base of
the 2nd metatarsal
D) Originates on the lateral cuneiform and inserts onto the base of the 3rd
metatarsal
,Correct Answer: B) Originates on the medial cuneiform and inserts onto
the base of the 2nd metatarsal
Rationale: The true Lisfranc ligament is a dense, oblique interosseous
ligament that runs from the lateral aspect of the medial cuneiform to the
medial aspect of the base of the second metatarsal. There is no
interosseous ligament connecting the first and second metatarsal bases,
making this ligament vital for midfoot stability.
Q4. A surgeon is addressing a severe, intra-articular pilon fracture.
Which surgical approach and plate placement are most commonly
utilized for standard pilon fracture fixation?
A) Posteromedial approach and plate
B) Anterolateral surgical approach and plate
C) Direct posterior approach and plate
D) Straight medial approach and plate
Correct Answer: B) Anterolateral surgical approach and plate
Rationale: The anterolateral approach provides excellent visualization of
the distal tibial articular surface, allowing the surgeon to reduce the weight-
bearing joint surface under direct vision. The corresponding plate is
anatomically contoured to fit the lateral pillar of the distal tibia.
Q5. When evaluating an ankle fracture on plain radiographs, the
surgeon assesses the integrity of the ankle mortise. Which of the
following bones comprises the ankle mortise?
A) Tibia, fibula, and talus
B) Tibia, fibula, and calcaneus
C) Tibia, talus, and calcaneus
D) Fibula, talus, and cuboid
Correct Answer: A) Tibia, fibula, and talus
Rationale: The ankle mortise is a classic "mortise and tenon" joint formed
by the distal tibia and distal fibula (which create the socket or mortise)
articulating with the trochlea of the talus (the tenon). The calcaneus does
not form part of this upper ankle joint complex.
, Q6. A sales representative needs to pull the correct hardware
inventory for an Anterolateral Distal Tibia Plating case. Which of the
following statements is TRUE regarding the sizing configurations of
these specific plates?
A) They are universal (left/right identical) and range from 2 to 10 holes
B) They are site-specific (left and right), ranging from 4-hole to 18-hole
configurations, increasing by 2 holes at a time
C) They only come in 4, 8, and 12-hole variations
D) They are site-specific and increase by 1 hole at a time from 5 to 15
holes
Correct Answer: B) They are site-specific (left and right), ranging from 4-
hole to 18-hole configurations, increasing by 2 holes at a time
Rationale: Arthrex Anterolateral Distal Tibia plates are anatomically pre-
contoured, requiring distinct left and right options. To accommodate varied
patient heights and fracture patterns, they scale up from 4 to 18 holes in
even-numbered increments.
Q7. Literature demonstrates that malreduction of the syndesmosis
significantly correlates with poor clinical outcomes. What do current
peer-reviewed studies conclude regarding a surgeon's ability to
achieve perfect syndesmotic reduction?
A) Standard manual reduction using a reduction clamp ensures perfect
alignment 100% of the time
B) Highly skilled surgeons have documented difficulty reducing the ankle
syndesmosis using fluoroscopic imaging and clamps
C) Fluoroscopy is highly sensitive and completely eliminates the risk of
rotational malreduction
D) Open reduction is discouraged because tactile feel is always superior to
imaging
Correct Answer: B) Highly skilled surgeons have documented difficulty
reducing the ankle syndesmosis using fluoroscopic imaging and clamps
Rationale: Clinical and biomechanical studies show that traditional two-
dimensional fluoroscopy and standard pelvic reduction clamps frequently
OFFICIAL PRACTICE QUESTIONS &
VERIFIED ANSWERS (COMPLETE
RATIONALE SOLUTION MANUAL)
This comprehensive exam preparation package
provides the exact verified practice questions,
complete solutions, and detailed rationales for the
March 2025 Arthrex Digital Education Experience
(DEX) IOT Assessment. It covers critical orthopedic
modules including foot and ankle fixation, hand and
wrist extremities, advanced orthobiologics, and
Synergy system hardware integrations. Master this
material to guarantee a Graded A+ score and ensure
first-time certification success.
Q1. A patient presents with an acute midfoot injury. The surgeon
suspects a Lisfranc injury. Which of the following describes the most
common mechanism of injury for a Lisfranc joint disruption?
A) Direct crush injury to the dorsum of the foot
B) High-energy motor vehicle accidents and falls from heights
,C) Athletic twisting injuries with a plantarflexed foot
D) All of the above
Correct Answer: D) All of the above
Rationale: Lisfranc injuries span a wide spectrum of trauma types. High-
energy mechanisms like motor vehicle accidents and falls from heights
cause significant osseous and ligamentous disruption, while low-energy
athletic injuries typically occur due to an axial load placed on a hyper-
plantarflexed forefoot.
Q2. During a surgical planning session, a resident is asked to identify
the anatomical classification of the Lisfranc joint. What is the correct
anatomical name?
A) Talonavicular joint
B) Calcaneocuboid joint
C) Tarsometatarsal joint
D) Metatarsophalangeal joint
Correct Answer: C) Tarsometatarsal joint
Rationale: The Lisfranc joint complex is anatomically designated as the
tarsometatarsal (TMT) joint. It serves as the articulation between the
cuneiforms and cuboid (tarsals) and the bases of the five metatarsals
(metatarsals).
Q3. Reconstructing the midfoot requires precise knowledge of the
primary stabilizing structures. Where does the classic Lisfranc
ligament originate and insert?
A) Originates on the medial cuneiform and inserts onto the base of the 1st
metatarsal
B) Originates on the medial cuneiform and inserts onto the base of the 2nd
metatarsal
C) Originates on the intermediate cuneiform and inserts onto the base of
the 2nd metatarsal
D) Originates on the lateral cuneiform and inserts onto the base of the 3rd
metatarsal
,Correct Answer: B) Originates on the medial cuneiform and inserts onto
the base of the 2nd metatarsal
Rationale: The true Lisfranc ligament is a dense, oblique interosseous
ligament that runs from the lateral aspect of the medial cuneiform to the
medial aspect of the base of the second metatarsal. There is no
interosseous ligament connecting the first and second metatarsal bases,
making this ligament vital for midfoot stability.
Q4. A surgeon is addressing a severe, intra-articular pilon fracture.
Which surgical approach and plate placement are most commonly
utilized for standard pilon fracture fixation?
A) Posteromedial approach and plate
B) Anterolateral surgical approach and plate
C) Direct posterior approach and plate
D) Straight medial approach and plate
Correct Answer: B) Anterolateral surgical approach and plate
Rationale: The anterolateral approach provides excellent visualization of
the distal tibial articular surface, allowing the surgeon to reduce the weight-
bearing joint surface under direct vision. The corresponding plate is
anatomically contoured to fit the lateral pillar of the distal tibia.
Q5. When evaluating an ankle fracture on plain radiographs, the
surgeon assesses the integrity of the ankle mortise. Which of the
following bones comprises the ankle mortise?
A) Tibia, fibula, and talus
B) Tibia, fibula, and calcaneus
C) Tibia, talus, and calcaneus
D) Fibula, talus, and cuboid
Correct Answer: A) Tibia, fibula, and talus
Rationale: The ankle mortise is a classic "mortise and tenon" joint formed
by the distal tibia and distal fibula (which create the socket or mortise)
articulating with the trochlea of the talus (the tenon). The calcaneus does
not form part of this upper ankle joint complex.
, Q6. A sales representative needs to pull the correct hardware
inventory for an Anterolateral Distal Tibia Plating case. Which of the
following statements is TRUE regarding the sizing configurations of
these specific plates?
A) They are universal (left/right identical) and range from 2 to 10 holes
B) They are site-specific (left and right), ranging from 4-hole to 18-hole
configurations, increasing by 2 holes at a time
C) They only come in 4, 8, and 12-hole variations
D) They are site-specific and increase by 1 hole at a time from 5 to 15
holes
Correct Answer: B) They are site-specific (left and right), ranging from 4-
hole to 18-hole configurations, increasing by 2 holes at a time
Rationale: Arthrex Anterolateral Distal Tibia plates are anatomically pre-
contoured, requiring distinct left and right options. To accommodate varied
patient heights and fracture patterns, they scale up from 4 to 18 holes in
even-numbered increments.
Q7. Literature demonstrates that malreduction of the syndesmosis
significantly correlates with poor clinical outcomes. What do current
peer-reviewed studies conclude regarding a surgeon's ability to
achieve perfect syndesmotic reduction?
A) Standard manual reduction using a reduction clamp ensures perfect
alignment 100% of the time
B) Highly skilled surgeons have documented difficulty reducing the ankle
syndesmosis using fluoroscopic imaging and clamps
C) Fluoroscopy is highly sensitive and completely eliminates the risk of
rotational malreduction
D) Open reduction is discouraged because tactile feel is always superior to
imaging
Correct Answer: B) Highly skilled surgeons have documented difficulty
reducing the ankle syndesmosis using fluoroscopic imaging and clamps
Rationale: Clinical and biomechanical studies show that traditional two-
dimensional fluoroscopy and standard pelvic reduction clamps frequently
