AAOS Shoulder and Elbow Scored and Recorded Self-Assessment Examination | Latest 2025/2026 Orthopaedic Exam Prep & Answer Guide | American Academy of Orthopaedic Surgeons

ABSTRACT
Shoulder and Elbow Scored and Recorded Self-
Assessment Examination 2025




2025

,Question 1 of 100 T T T




Figure 1 is the radiograph of a 27-year-old man who is involved in a motorcycle collision and
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sustains a right femoral and tibial shaft fracture, in addition to the injury shown in Figure 1. All
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fractures are closed. In addition to intramedullary nailing of the tibia and femur, appropriate
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treatment and weight-bearing status of the humeral shaft fracture should include
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Figure 1 T




A. fracture bracing with full weight bearing.
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B. coaptation splinting with non-weight bearing.
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C. plate fixation with full weight bearing.
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D. plate fixation with non-weight bearing for 4 weeks, followed by full weight bearing.
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,Correct Answer: C T T




• Discussion

Bell and associates and Tingstad and associates both showed that immediate, full weight
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bearing through the upper extremity can be safely allowed for a humeral shaft fracture fixed
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using a plate and screw construct. Tingstad and associates showed no difference in malunion or
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nonunion rate following non-weight bearing or full weight bearing. Because he is a polytrauma
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patient, the patient would benefit from operative fixation of his humerus to expedite recovery
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and facilitate mobilization. A coaptation splint and a fracture brace would be appropriate
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treatment options for a non-polytrauma patient, but in neither case would full weight bearing
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generally be allowed immediately following the injury.
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• Recommended Readings T




Tingstad EM, Wolinsky PR, Shyr Y, Johnson KD. Effect of immediate weightbearing on plated
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fractures of the humeral shaft. J Trauma. 2000 Aug;49(2):278-80. PubMed
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Bell MJ, Beauchamp CG, Kellam JK, McMurtry RY. The results of plating humeral shaft
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fractures in patients with multiple injuries. The Sunnybrook experience. J Bone Joint Surg Br.
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1985 Mar;67(2):293-6. PubMed
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Question 2 of 100 T T T




A 23-year-old left-hand dominant professional football player sustains a left shoulder injury after being
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tackled and lands directly on his shoulder 1 month ago. The patient was diagnosed with a Rockwood
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type 2 acromioclavicular separation. Following physical therapy, his symptoms have improved. He has
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good scapular control and shoulder strength. What physical examination test would help determine the
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contribution of the acromioclavicular joint injury to his residual symptoms?
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A. O'Brien test T


B. Hawkins-Kennedy test T


C. Dynamic labral shear test (DLST) T T T T


D. Upper cut test T T




Correct Answer: A T T




• Discussion

The clinical scenario describes an athlete who is recovering from a type 2 acromioclavicular
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joint separation. The goal of this question is to stress the importance of the physical
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examination to guide treatment decisions, as well as recovery. It is important to recognize
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which factors can aid
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, in decision making especially with type type 2 acromioclavicular joint separation injuries as the
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Tdata are still not clear as to who would best be served with surgical versus nonsurgical
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management. The active compression test as described by O’Brien and associates in 1998 was
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Tequally as effective at assessing the acromioclavicular joint as it was for assessment of the
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Tintegrity of the superior labrum. The Hawkins-Kennedy test has demonstrated utility in the
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Tdiagnosis of rotator cuff impingement, wherein the greater tuberosity comes into contact with
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Tthe coracoacromial ligament. The DLST has been described for the diagnosis of superior labral
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Tanterior-posterior (SLAP) tears, wherein the patient reports pain and a click felt withT T T T T T T T T T T T


Tmovement of the shoulder through an arc of abduction with the shoulder externally rotated.
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TThe upper cut test has been described in the setting of biceps tendinopathy and SLAP tears.
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• Recommended Readings T




Simovitch R, Sanders B, Ozbaydar M, Lavery K, Warner JJ. Acromioclavicular joint injuries:
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diagnosis and management. J Am Acad Orthop Surg. 2009 Apr;17(4):207-19. Full text
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O'Brien SJ, Pagnani MJ, Fealy S, McGlynn SR, Wilson JB. The active compression test: a new
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and effective test for diagnosing labral tears and acromioclavicular joint abnormality. Am J
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Sports Med. 1998 Sep-Oct;26(5):610-3. PubMed
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Kibler WB, Sciascia AD, Morris BJ, Dome DC. Treatment of Symptomatic Acromioclavicular
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Joint Instability by a Docking Technique: Clinical Indications, Surgical Technique, and
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Outcomes. Arthroscopy. 2017 Apr;33(4):696-708.e2. doi: 10.1016/j.arthro.2016.08.023. Epub
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2016 Nov 17. PubMed
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Question 3 of 100 T T T




Figure 1 is the radiograph of a 54-year-old man who has increasing weakness and numbness in his
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lateral arm. No prior surgery or injury is reported. What is the most appropriate next diagnostic test?
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