ABFAS PRACTICE EXAM QUESTIONS & DEFINITIVE ANSWERS
LATEST 25/26 REVIEW
A 25-year-old ballet dancer presents with an eight-month
history of ankle pain after an ankle sprain. On physical
examination, there is joint swelling, and radiographs are
unremarkable. Physical therapy and nonsteroidal anti-
inflammatory drugs have not decreased her symptoms. What is
the next appropriate step in the management of this patient?
Magnetic resonance imaging of the ankle.
Steroid injection to the ankle.
Diagnostic ankle arthroscopy.
Additional physical therapy. <<<answers>>>mri
What is the most appropriate shoe modification for a patient who
has undergone a well-aligned ankle arthrodesis?
Extra-depth shoe with a plastazote insert.
Ankle-foot orthosis.
Rocker sole shoe.
Medial heel and sole wedge <<<answers>>>a rocker sole
improves ambulation following ankle arthrodesis. Extra-depth
shoe with a plastazote insert does not specifically address the
needs of a patient with an ankle arthrodesis. Afo would typically
not be necessary with a fully fused well aligned ankle
arthrodesis. Medial heel and sole wedge are not necessary in a
well-aligned fusion, and most patients would not tolerate posting
well after an ankle fusion.
,A 64-year-old female presents with a planovalgus deformity to
the foot. She cannot perform a single-heel rise and complains of
pain and swelling behind the medial malleolus. On examination,
she has a nonreducible rearfoot valgus deformity. Orthotics and
bracing have failed. What is the most appropriate treatment
based on this information given?
Ankle fusion.
Lapidus procedure.
Double arthrodesis.
Posterior tibial tendon debridement. <<<answers>>>: patient has
obvious posterior tibial tendon dysfunction with probable
tear/rupture. Her rearfoot valgus deformity is non-reducible;
therefore she is a johnson and strom stage iii. A rigid deformity
is not amenable to just soft tissue procedures such as a tendon
debridement or reconstruction. The patient would require
arthrodesis. The double arthrodesis will address her rearfoot
valgus deformity, while the lapidus and the ankle fusion will not.
Avascular necrosis of the talus is best evaluated by which
diagnostic modality?
Magnetic resonance imaging.
Computed tomography.
Radiography.
Bone scan. <<<answers>>>rationale: mri is considered the gold
standard for diagnosis of avascular necrosis as it is the most
sensitive and specific. A ct scan can be considered but is not as
, sensitive or specific, whereas a positron emission tomography-
ct (pet-ct) is highly sensitive and specific. An x-ray or bone scan
is not as sensitive as an mri. Bone scan is 85% sensitive and mri
is 95% sensitive.
What is the main goal in the repair of syndesmotic injuries
associated with ankle fractures?
Anatomic reduction of the fibula in the fibular notch.
Primary repair of the syndesmotic ligaments.
Primary repair of the deltoid ligament.
Anatomic reduction of the medial malleolar fracture.
<<<answers>>>rationale: although syndesmotic repair can assist
in healing of the syndesmotic ligaments, deltoid ligaments, and
medial malleolar fracture, anatomic reduction of the fibula in the
fibular notch is the main goal in repairing the syndesmosis,
which allows for secondary healing of syndesmotic ligaments
while restoring the ankle mortise.
Which complication is most likely to occur in an appropriately
reduced and immobilized juvenile tillaux fracture?
Nonunion.
Osteoarthritis.
Valgus ankle deformity.
Limb length discrepancy. <<<answers>>>subject area:
complications, rationale: as juvenile tillaux fractures occur close
to distal tibial physis closure, angular deformities and limb
LATEST 25/26 REVIEW
A 25-year-old ballet dancer presents with an eight-month
history of ankle pain after an ankle sprain. On physical
examination, there is joint swelling, and radiographs are
unremarkable. Physical therapy and nonsteroidal anti-
inflammatory drugs have not decreased her symptoms. What is
the next appropriate step in the management of this patient?
Magnetic resonance imaging of the ankle.
Steroid injection to the ankle.
Diagnostic ankle arthroscopy.
Additional physical therapy. <<<answers>>>mri
What is the most appropriate shoe modification for a patient who
has undergone a well-aligned ankle arthrodesis?
Extra-depth shoe with a plastazote insert.
Ankle-foot orthosis.
Rocker sole shoe.
Medial heel and sole wedge <<<answers>>>a rocker sole
improves ambulation following ankle arthrodesis. Extra-depth
shoe with a plastazote insert does not specifically address the
needs of a patient with an ankle arthrodesis. Afo would typically
not be necessary with a fully fused well aligned ankle
arthrodesis. Medial heel and sole wedge are not necessary in a
well-aligned fusion, and most patients would not tolerate posting
well after an ankle fusion.
,A 64-year-old female presents with a planovalgus deformity to
the foot. She cannot perform a single-heel rise and complains of
pain and swelling behind the medial malleolus. On examination,
she has a nonreducible rearfoot valgus deformity. Orthotics and
bracing have failed. What is the most appropriate treatment
based on this information given?
Ankle fusion.
Lapidus procedure.
Double arthrodesis.
Posterior tibial tendon debridement. <<<answers>>>: patient has
obvious posterior tibial tendon dysfunction with probable
tear/rupture. Her rearfoot valgus deformity is non-reducible;
therefore she is a johnson and strom stage iii. A rigid deformity
is not amenable to just soft tissue procedures such as a tendon
debridement or reconstruction. The patient would require
arthrodesis. The double arthrodesis will address her rearfoot
valgus deformity, while the lapidus and the ankle fusion will not.
Avascular necrosis of the talus is best evaluated by which
diagnostic modality?
Magnetic resonance imaging.
Computed tomography.
Radiography.
Bone scan. <<<answers>>>rationale: mri is considered the gold
standard for diagnosis of avascular necrosis as it is the most
sensitive and specific. A ct scan can be considered but is not as
, sensitive or specific, whereas a positron emission tomography-
ct (pet-ct) is highly sensitive and specific. An x-ray or bone scan
is not as sensitive as an mri. Bone scan is 85% sensitive and mri
is 95% sensitive.
What is the main goal in the repair of syndesmotic injuries
associated with ankle fractures?
Anatomic reduction of the fibula in the fibular notch.
Primary repair of the syndesmotic ligaments.
Primary repair of the deltoid ligament.
Anatomic reduction of the medial malleolar fracture.
<<<answers>>>rationale: although syndesmotic repair can assist
in healing of the syndesmotic ligaments, deltoid ligaments, and
medial malleolar fracture, anatomic reduction of the fibula in the
fibular notch is the main goal in repairing the syndesmosis,
which allows for secondary healing of syndesmotic ligaments
while restoring the ankle mortise.
Which complication is most likely to occur in an appropriately
reduced and immobilized juvenile tillaux fracture?
Nonunion.
Osteoarthritis.
Valgus ankle deformity.
Limb length discrepancy. <<<answers>>>subject area:
complications, rationale: as juvenile tillaux fractures occur close
to distal tibial physis closure, angular deformities and limb
