ABFAS MIDTERM EXAM
COMPREHENSIVE REVIEW QUESTIONS
AND ANSWERS 100% VERIFIED. JUST
RELEASED
1. A 45-year-old patient presents with a stage II posterior tibial tendon dysfunction. During a
clinical exam, you note a significant forefoot varus. Which procedure is specifically designed
to correct this component of the deformity?
A. Cotton (medial cuneiform) osteotomy
B. Evans calcaneal osteotomy
C. Koutsogiannis osteotomy
D. Kidner procedure
Answer: A
Conceptual Explanation: The Cotton osteotomy is a dorsal opening wedge osteotomy of
the medial cuneiform used to plantarflex the first ray and correct residual forefoot
varus/supinatus after the hindfoot has been neutralized.
2. Which Hawkins classification of talar neck fractures is associated with a nearly 100% risk of
avascular necrosis (AVN)?
A. Hawkins Type I
,B. Hawkins Type II
C. Hawkins Type III
D. Hawkins Type IV
Answer: D
Conceptual Explanation: Hawkins Type IV includes a talar neck fracture with dislocation
of the subtalar, tibiotalar, and talonavicular joints, carrying a risk of AVN approaching
100%.
3. In the context of the Gustilo-Anderson classification for open fractures, what is the defining
characteristic of a Type IIIB injury?
A. Extensive soft tissue laceration with adequate bone coverage
B. Extensive soft tissue injury with periosteal stripping and bone exposure requiring a flap
C. Arterial injury requiring repair
D. Laceration less than 1 cm with minimal contamination
Answer: B
Conceptual Explanation: Type IIIB fractures involve extensive soft tissue injury with
periosteal stripping and bone exposure, typically requiring a free or rotational flap for
coverage.
, 4. Which of the following local anesthetics has the longest duration of action and highest
potential for cardiotoxicity if injected intravascularly?
A. Lidocaine
B. Bupivacaine
C. Mepivacaine
D. Procaine
Answer: B
Conceptual Explanation: Bupivacaine is long-acting but is notably more cardiotoxic than
lidocaine because it binds more strongly to cardiac sodium channels.
5. According to the Lauge-Hansen classification, which mechanism of injury results in a
Wagstaffe fracture?
A. Supination-Adduction Stage II
B. Pronation-Abduction Stage III
C. Pronation-External Rotation Stage I
D. Supination-External Rotation Stage II
Answer: D
Conceptual Explanation: A Wagstaffe (or Le Fort-Wagstaffe) fracture is an avulsion of the
anterior-lateral fibula by the AITFL, occurring in Stage II of a Supination-External Rotation
injury.
COMPREHENSIVE REVIEW QUESTIONS
AND ANSWERS 100% VERIFIED. JUST
RELEASED
1. A 45-year-old patient presents with a stage II posterior tibial tendon dysfunction. During a
clinical exam, you note a significant forefoot varus. Which procedure is specifically designed
to correct this component of the deformity?
A. Cotton (medial cuneiform) osteotomy
B. Evans calcaneal osteotomy
C. Koutsogiannis osteotomy
D. Kidner procedure
Answer: A
Conceptual Explanation: The Cotton osteotomy is a dorsal opening wedge osteotomy of
the medial cuneiform used to plantarflex the first ray and correct residual forefoot
varus/supinatus after the hindfoot has been neutralized.
2. Which Hawkins classification of talar neck fractures is associated with a nearly 100% risk of
avascular necrosis (AVN)?
A. Hawkins Type I
,B. Hawkins Type II
C. Hawkins Type III
D. Hawkins Type IV
Answer: D
Conceptual Explanation: Hawkins Type IV includes a talar neck fracture with dislocation
of the subtalar, tibiotalar, and talonavicular joints, carrying a risk of AVN approaching
100%.
3. In the context of the Gustilo-Anderson classification for open fractures, what is the defining
characteristic of a Type IIIB injury?
A. Extensive soft tissue laceration with adequate bone coverage
B. Extensive soft tissue injury with periosteal stripping and bone exposure requiring a flap
C. Arterial injury requiring repair
D. Laceration less than 1 cm with minimal contamination
Answer: B
Conceptual Explanation: Type IIIB fractures involve extensive soft tissue injury with
periosteal stripping and bone exposure, typically requiring a free or rotational flap for
coverage.
, 4. Which of the following local anesthetics has the longest duration of action and highest
potential for cardiotoxicity if injected intravascularly?
A. Lidocaine
B. Bupivacaine
C. Mepivacaine
D. Procaine
Answer: B
Conceptual Explanation: Bupivacaine is long-acting but is notably more cardiotoxic than
lidocaine because it binds more strongly to cardiac sodium channels.
5. According to the Lauge-Hansen classification, which mechanism of injury results in a
Wagstaffe fracture?
A. Supination-Adduction Stage II
B. Pronation-Abduction Stage III
C. Pronation-External Rotation Stage I
D. Supination-External Rotation Stage II
Answer: D
Conceptual Explanation: A Wagstaffe (or Le Fort-Wagstaffe) fracture is an avulsion of the
anterior-lateral fibula by the AITFL, occurring in Stage II of a Supination-External Rotation
injury.
