PACKRATSurgery ExamQuestions with Correct Answers/Already Grade A+/ latest 2024/2025

An 18-year-old patient has a tibia/fibula fracture following a motorcycle crash. Twelve hours later the patient presents with increased pain despite adequate doses of analgesics and immobilization. Which of the following is the most likely diagnosis? A. avascular necrosis B. myositis ossificans C. compartment syndrome D. reflex sympathetic dystrophy - Answer EXPLANATIONS: (u) A. Avascular necrosis occurs primarily in muscles post-traumatically and may not arise for several months after an injury. (u) B. Myositis ossificans is a late complication of fracture resulting from disruption of the blood supply to the bone. (c) C. Compartment syndrome is characterized by a pathological increase of pressure within a closed space and results from edema or bleeding within the compartment. It may occur as an early local complication of fracture. (u) D. Reflex sympathetic dystrophy is characterized by painful wasting of the hand muscles that may be secondary to injury and could occur as a late complication. A patient presents to the Emergency Department with complaints of increasing pain in the right lower extremity. He has a history of a non-displaced proximal tibial fracture treated with application of a long leg cast 2 days prior. On exam there is marked swelling of the toes and the patient refuses to move them secondary to pain. An injection of meperidine fails to relieve the patient's pain. Clinical intervention is needed to prevent what complication? A. osteomyelitis B. traumatic arthritis C. Volkmann's contracture D. malunion of fracture fragments - Answer EXPLANATIONS: (u) A. Osteomyelitis results from a source of infection that may include an open fracture, but not a closedfracture. (u) B. Traumatic arthritis only occurs as a result of fractures that involve the articular surface. (c) C. This patient has classic findings of acute compartment syndrome. Volkmann's contracture may occur from an untreated compartment syndrome or an arterial injury. (u) D. Malunion of the fracture fragments occur when there is poor reduction of the fracture fragments. Non-displaced fractures do not require reduction.