©BRIGHSTARS 2024/2025 ALL RIGHTS RESERVED.
MCQs – Orthopaedics Exam Questions And
Answers 100% Pass.
A 24-year-old male patient presents with a left sided Monteggia fracture-dislocation after a fall
from a height. He complains of pain in his forearm ans elbow. Your examination shows that he
has a drop wrist (cannot dorsiflex his wrist). Which nerve is most likely to be injured in this
fracture pattern?
A. Ulnar nerve
B. Posterior interosseous nerve
C. Median nerve
D. Anterior interosseous nerve
E. Lateral antebrachial cutaneous nerve - Answer✔B. PIN
The radial nerve divides into two branches in the antecubital fossa (deep/motor and
superficial/sensory) with the deep motor branch passing through the heads of the supinator
muscles to become the posterior interosseous nerve (PIN) which winds around the radial neck
and innervates the muscles of the extensor (posterior) compartment of the forearm, which are
responsible for wrist extension.
What is the most critical urgent strategy in femur fractures?
A. Call an orthopaedic surgeon.
B. Apply a Thomas splint.
C. Manage fluids.
D. Administer morphine. - Answer✔(B) is correct, as a Thomas splint reduces blood loss, pain
and risk for FES.
A dislocated knee should be treated as an emergency, representing a threatened limb. The
immediate reduction should be undertaken without waiting for radiography. Popliteal artery
disruption is seen in 20% to 60% of cases.
True or false - Answer✔True
1|Page
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A dislocated knee may be part of multiple injuries in a patient and, therefore, ATLS principles
should form part of the initial assessment and management of the patient.
True or False - Answer✔True
Knee dislocations are disabling injuries, and they need appropriate early care to reduce
morbidity.
True or False - Answer✔True
A 58-year-old female with diabetes presents with a bimalleolar ankle fracture to the ER. The
fibula is fractured above the level of the syndesmosis. Management of the injury should include:
A.Below knee circular cast with crutches for 2 weeks followed by a moonboot for another 4
weeks.
B. Fixation of the lateral malleolus only and cast application.
C.Medial and lateral malleolus surgical fixation with immediate weight bearing.
D.This is a stable injury and can be treated in a cast for 8 weeks.
E. This is an unstable injury that needs medial and lateral fixation as well as fixation of the
syndesmosis followed by casting for 6 to 8 weeks. - Answer✔E. Medial and Lateral ORIF + 6-8
weeks of casting
Achilles' tendon ruptures and ligament and meniscal injuries to the knee should be referred to an
orthopaedic surgeon for further assessment and possible surgical intervention.
True or False - Answer✔True
A 24-year-old male rugby player is injured during a game when his foot is locked on the ground,
and his knee is twisted. The knee swells up immediately, and he is unable to bear weight. The
most likely structure injured is:
A. Posterior cruciate ligament
B. Medial meniscus
C. Anterior cruciate ligament
D. Lateral collateral ligament
E. Patella tendon - Answer✔(C) is correct, as this is the typical history described by the patient
with an acute ACL injury
A 54-year-old male is running at his daughter's school in the father-daughter race. Halfway down
the track, he hears a pop and is unable to continue running. Which of these is not a risk factor for
Achilles' tendon rupture:
2|Page
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A. Systemic steroid use
B. Course of ciprofloxacin for UTI a week ago
C. Cortisone injection into the tendon two weeks before the injury
D. Age
E. Alcohol consumption - Answer✔(E) is correct - alcohol has not been linked to Achilles'
tendon rupture. All the others are known risk factors. A Cortisone injection should never be
given due to the risk of rupture.
A 20-year-old gymnast twisted her ankle following landing off the bar apparatus. She has
swelling, ecchymosis and pain on the maximal passive inversion of the foot. What is the next
most appropriate management for her injury:
A. Immediate referral to an orthopaedic surgeon.
B. Weight-bearing - continue to excercise through the pain and re-assess in a week.
C. Early anterior talofibular ligament repair.
D. Ice pack over the area, compression bandage with Robert Jones-type bandage, crutches for
non-weight bearing and no gymnastics.
E. Tendon rerouting surgery to prevent recurrence and early return to sport. - Answer✔(D) is
correct, as the majority of all ankle sprains can be treated conservatively
A 40-year-old man presents to the clinic with three months of right elbow pain. He started
playing squash four months previously. On examination, he is tender over the lateral aspect of
the elbow and pain increases with resisted wrist extension. Which of the following muscles is
involved in the pathophysiology of this disease?
A. FCU - Flexor carpi ulnaris.
B. FCR - Flexor carpi radialis.
C. FDS - Flexor digitorum communis.
D. ECRB - Extensor carpi radialis brevis. - Answer✔(D) is correct, as the patient presents with
lateral epicondylitis which involves the origin of the ECRB. The other muscles are all flexor
muscles and are involved in medial epicondylitis.
An 18-year-old male presents with injury to his right knee following a tackle during a soccer
match. He reports severe pain and loss of function. Clinical examination reveals massive knee
effusion, bruising and reduced distal pulses. Plain x-rays are normal. Which of the following is
the most appropriate action?
A. Splint the limb and observe overnight in the emergency unit.
B. Splint the limb, provide analgesia and discharge home.
C. Splint the limb, provide analgesia and emergency referral for special investigations and
review by a specialist (vascular surgeon and orthopaedic surgeon).
3|Page
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D. Splint the limb and refer for specialist review at the next available clinic day.
E. Analgesia, intra-articular steroids and splint. - Answer✔Option (C) is correct. The patient
might have had knee dislocation, which is now reduced but presenting with signs of vascular
injury and internal knee injuries requiring emergency treatment. Other options fail to recognize
the urgency of his condition.
A 21-year-old rugby player presents after injuring his foot in a scrum. The dorsum of the midfoot
is swollen with plantar ecchymosis. He is however able to weight bear on the foot with pain.
What is the most likely diagnosis?
A. Ankle fracture
B. Ankle sprain
C. Achilles tendon injury
D. Lisfranc injury
E. Unlikely to have any injury - Answer✔Answer: (D) is correct. Plantar ecchymosis is
associated with a Lisfranc injury.
When a child presents with a forearm fracture, it is important to (choose the most correct
answer):
A. Interview the family through to exclude non-accidental injury.
B. Take X-rays of the joint above and below to exclude Monteggia or Galleazi fractures.
C. Take X-rays of the contralateral limb to compare.
D. Not apply a circumferential cast due to the risk of compartment syndrome.
E. Refer all patients for orthopaedic assessment, even if the fracture is undisplaced. -
Answer✔The correct answer is (B) - take X-rays of the joint above and below to exclude
Monteggia or Galleazi fractures.
Regarding supracondylar fractures of the humerus in children, which statement is incorrect?
A. Supracondylar fractures are usually caused by a FOOSH
B. Neurovascular injury is common and the ulnar nerve is most frequently involved.
C. Grade I fractures only needs simple immobilization
D. There is a weak spot above the condyles at the level of the olecranon and coronoid fossae.
E. Displaced grade 2 fractures are treated as Grade 3 fracturs with reduction and percutaneous
wiring. - Answer✔(B) is incorrect, as the median nerve is most commonly injured.
A 20-year-old male presents with a stab wound to the back of his hand and inability to extend his
index finger. What tendon or tendons has he injured?
A. EPL
4|Page
MCQs – Orthopaedics Exam Questions And
Answers 100% Pass.
A 24-year-old male patient presents with a left sided Monteggia fracture-dislocation after a fall
from a height. He complains of pain in his forearm ans elbow. Your examination shows that he
has a drop wrist (cannot dorsiflex his wrist). Which nerve is most likely to be injured in this
fracture pattern?
A. Ulnar nerve
B. Posterior interosseous nerve
C. Median nerve
D. Anterior interosseous nerve
E. Lateral antebrachial cutaneous nerve - Answer✔B. PIN
The radial nerve divides into two branches in the antecubital fossa (deep/motor and
superficial/sensory) with the deep motor branch passing through the heads of the supinator
muscles to become the posterior interosseous nerve (PIN) which winds around the radial neck
and innervates the muscles of the extensor (posterior) compartment of the forearm, which are
responsible for wrist extension.
What is the most critical urgent strategy in femur fractures?
A. Call an orthopaedic surgeon.
B. Apply a Thomas splint.
C. Manage fluids.
D. Administer morphine. - Answer✔(B) is correct, as a Thomas splint reduces blood loss, pain
and risk for FES.
A dislocated knee should be treated as an emergency, representing a threatened limb. The
immediate reduction should be undertaken without waiting for radiography. Popliteal artery
disruption is seen in 20% to 60% of cases.
True or false - Answer✔True
1|Page
, ©BRIGHSTARS 2024/2025 ALL RIGHTS RESERVED.
A dislocated knee may be part of multiple injuries in a patient and, therefore, ATLS principles
should form part of the initial assessment and management of the patient.
True or False - Answer✔True
Knee dislocations are disabling injuries, and they need appropriate early care to reduce
morbidity.
True or False - Answer✔True
A 58-year-old female with diabetes presents with a bimalleolar ankle fracture to the ER. The
fibula is fractured above the level of the syndesmosis. Management of the injury should include:
A.Below knee circular cast with crutches for 2 weeks followed by a moonboot for another 4
weeks.
B. Fixation of the lateral malleolus only and cast application.
C.Medial and lateral malleolus surgical fixation with immediate weight bearing.
D.This is a stable injury and can be treated in a cast for 8 weeks.
E. This is an unstable injury that needs medial and lateral fixation as well as fixation of the
syndesmosis followed by casting for 6 to 8 weeks. - Answer✔E. Medial and Lateral ORIF + 6-8
weeks of casting
Achilles' tendon ruptures and ligament and meniscal injuries to the knee should be referred to an
orthopaedic surgeon for further assessment and possible surgical intervention.
True or False - Answer✔True
A 24-year-old male rugby player is injured during a game when his foot is locked on the ground,
and his knee is twisted. The knee swells up immediately, and he is unable to bear weight. The
most likely structure injured is:
A. Posterior cruciate ligament
B. Medial meniscus
C. Anterior cruciate ligament
D. Lateral collateral ligament
E. Patella tendon - Answer✔(C) is correct, as this is the typical history described by the patient
with an acute ACL injury
A 54-year-old male is running at his daughter's school in the father-daughter race. Halfway down
the track, he hears a pop and is unable to continue running. Which of these is not a risk factor for
Achilles' tendon rupture:
2|Page
, ©BRIGHSTARS 2024/2025 ALL RIGHTS RESERVED.
A. Systemic steroid use
B. Course of ciprofloxacin for UTI a week ago
C. Cortisone injection into the tendon two weeks before the injury
D. Age
E. Alcohol consumption - Answer✔(E) is correct - alcohol has not been linked to Achilles'
tendon rupture. All the others are known risk factors. A Cortisone injection should never be
given due to the risk of rupture.
A 20-year-old gymnast twisted her ankle following landing off the bar apparatus. She has
swelling, ecchymosis and pain on the maximal passive inversion of the foot. What is the next
most appropriate management for her injury:
A. Immediate referral to an orthopaedic surgeon.
B. Weight-bearing - continue to excercise through the pain and re-assess in a week.
C. Early anterior talofibular ligament repair.
D. Ice pack over the area, compression bandage with Robert Jones-type bandage, crutches for
non-weight bearing and no gymnastics.
E. Tendon rerouting surgery to prevent recurrence and early return to sport. - Answer✔(D) is
correct, as the majority of all ankle sprains can be treated conservatively
A 40-year-old man presents to the clinic with three months of right elbow pain. He started
playing squash four months previously. On examination, he is tender over the lateral aspect of
the elbow and pain increases with resisted wrist extension. Which of the following muscles is
involved in the pathophysiology of this disease?
A. FCU - Flexor carpi ulnaris.
B. FCR - Flexor carpi radialis.
C. FDS - Flexor digitorum communis.
D. ECRB - Extensor carpi radialis brevis. - Answer✔(D) is correct, as the patient presents with
lateral epicondylitis which involves the origin of the ECRB. The other muscles are all flexor
muscles and are involved in medial epicondylitis.
An 18-year-old male presents with injury to his right knee following a tackle during a soccer
match. He reports severe pain and loss of function. Clinical examination reveals massive knee
effusion, bruising and reduced distal pulses. Plain x-rays are normal. Which of the following is
the most appropriate action?
A. Splint the limb and observe overnight in the emergency unit.
B. Splint the limb, provide analgesia and discharge home.
C. Splint the limb, provide analgesia and emergency referral for special investigations and
review by a specialist (vascular surgeon and orthopaedic surgeon).
3|Page
, ©BRIGHSTARS 2024/2025 ALL RIGHTS RESERVED.
D. Splint the limb and refer for specialist review at the next available clinic day.
E. Analgesia, intra-articular steroids and splint. - Answer✔Option (C) is correct. The patient
might have had knee dislocation, which is now reduced but presenting with signs of vascular
injury and internal knee injuries requiring emergency treatment. Other options fail to recognize
the urgency of his condition.
A 21-year-old rugby player presents after injuring his foot in a scrum. The dorsum of the midfoot
is swollen with plantar ecchymosis. He is however able to weight bear on the foot with pain.
What is the most likely diagnosis?
A. Ankle fracture
B. Ankle sprain
C. Achilles tendon injury
D. Lisfranc injury
E. Unlikely to have any injury - Answer✔Answer: (D) is correct. Plantar ecchymosis is
associated with a Lisfranc injury.
When a child presents with a forearm fracture, it is important to (choose the most correct
answer):
A. Interview the family through to exclude non-accidental injury.
B. Take X-rays of the joint above and below to exclude Monteggia or Galleazi fractures.
C. Take X-rays of the contralateral limb to compare.
D. Not apply a circumferential cast due to the risk of compartment syndrome.
E. Refer all patients for orthopaedic assessment, even if the fracture is undisplaced. -
Answer✔The correct answer is (B) - take X-rays of the joint above and below to exclude
Monteggia or Galleazi fractures.
Regarding supracondylar fractures of the humerus in children, which statement is incorrect?
A. Supracondylar fractures are usually caused by a FOOSH
B. Neurovascular injury is common and the ulnar nerve is most frequently involved.
C. Grade I fractures only needs simple immobilization
D. There is a weak spot above the condyles at the level of the olecranon and coronoid fossae.
E. Displaced grade 2 fractures are treated as Grade 3 fracturs with reduction and percutaneous
wiring. - Answer✔(B) is incorrect, as the median nerve is most commonly injured.
A 20-year-old male presents with a stab wound to the back of his hand and inability to extend his
index finger. What tendon or tendons has he injured?
A. EPL
4|Page
