ABFAS Practice exam RRA UPDATED
Questions and CORRECT Answers
A 45-year-old male sustained a crush-type injury with early soft tissue necrosis to the left
foot. Radiographs are negative for fracture or dislocation. Which of the following tests would
be most helpful for determining skin-flap viability?
fluorescein dye study.
distal plethysmography.
segmental pressure gradients.
indium scan. - CORRECT ANSWER✔✔- Rationale: Fluorescein dye studies might not be
routinely ordered, but of the available answer choices, this would provide the best
information on soft tissue viability following a crush injury. Digital plethysmography and
segmental pressure gradient would provide information about macrovascular perfusion, but
not microvascular skin-flap tissue viability. An indium scan is non-specific for skin-flap
viability.
A patient presents eight weeks after sustaining a fracture through the talar neck. Which
finding is a prognostic indicator that the vascular supply is intact?
resorption of subchondral bone of the talar dome.
increased trabecular pattern across the fracture.
increased sclerosis of the talar body.
absence of degenerative arthritis. - CORRECT ANSWER✔✔- Resorption or subchondral
lucency of the talar dome usually indicates that there is sufficient vascularity in the talus,
often termed Hawkins sign. Increased sclerosis of the talar body may suggest avascular
necrosis. Absence of degenerative arthritis and increased trabecular pattern across the fracture
are not prognostic findings for an intact vascular supply.
For which condition is a bone stimulator most efficacious?
synovial pseudarthrosis.
hypertrophic nonunion.
fibrous nonunion.
fibrous malunion. - CORRECT ANSWER✔✔- Rationale: Hypertrophic nonunion is the
most appropriate answer choice for a bone stimulator because it is the only non union
amongst the available answer choices listed that theoretically has sufficient vascularity to
heal. A hypertrophic non union may be lacking stability or normal axial alignment, but is able
to heal at a cellular level. Synovial pseudoarthrosis, fibrous non union and malunion are all
, caused by inadequate immobilization and inadequate blood supply and may be more limited
in its ability to heal.
A 25-year-old female sustained an inversion ankle sprain 24 hours ago. The area is severely
edematous and ecchymotic. Diagnostic tests show rupture of the lateral collateral ligaments.
What should the treatment consist of at this time?
compression dressing for 24 to 48 hours.
open ligament repair.
posterior splint and warm compresses for 24 to 48 hours.
short leg walking cast. - CORRECT ANSWER✔✔- Acute soft-tissue ankle injuries),
Rationale: Compression dressing for 24 to 48 hours is the best answer. An open ligament
repair is not indicated this early due to the severe edema. A posterior splint may be indicated
but the warm compress is not indicated, as icing would be more appropriate. A short leg cast
can be used however the patient has severe edema so this is not the best answer as it does not
address the swelling.
A 30-year-old male complains of a painful right ankle after sustaining a forced plantarflexion
injury. Plantarflexion of the foot and dorsiflexion of the hallux greatly exacerbate the
symptoms of pain at the posterior ankle. What is the most probable diagnosis?
flexor digitorum longus tendinitis.
fracture of the sustentaculum tali.
fracture of the posterior lip of the tibia.
fracture of the posterior tubercle of the talus. - CORRECT ANSWER✔✔- Rationale: The
injury mechanism, combined with the current symptoms point to an injury at the posterior
ankle, specifically fracture of the posterior tubercle of the talus, irritated by movement of the
flexor hallucis longus tendon. Flexor digitorum longus tendinitis is incorrect since the patient
indicates he has pain with great toe motion. Fracture of the sustentaculum tali is incorrect
since the patient expresses pain at the posterior ankle, not medial. Fracture of the posterior lip
of the tibia is incorrect since pain with plantar flexion of the ankle and dorsiflexion of the toe
would point to motion at the talar groove as the likely cause of the pain. The other options are
not the most appropriate answer for this question based on the choices given.
The radiograph is for a 14-year-old male who fell six feet and presented to the emergency
department two hours later. What other diagnostic test is appropriate to rule out concomitant
injury in the emergency room?
axial radiography of the foot.
computed tomography of the foot.
Questions and CORRECT Answers
A 45-year-old male sustained a crush-type injury with early soft tissue necrosis to the left
foot. Radiographs are negative for fracture or dislocation. Which of the following tests would
be most helpful for determining skin-flap viability?
fluorescein dye study.
distal plethysmography.
segmental pressure gradients.
indium scan. - CORRECT ANSWER✔✔- Rationale: Fluorescein dye studies might not be
routinely ordered, but of the available answer choices, this would provide the best
information on soft tissue viability following a crush injury. Digital plethysmography and
segmental pressure gradient would provide information about macrovascular perfusion, but
not microvascular skin-flap tissue viability. An indium scan is non-specific for skin-flap
viability.
A patient presents eight weeks after sustaining a fracture through the talar neck. Which
finding is a prognostic indicator that the vascular supply is intact?
resorption of subchondral bone of the talar dome.
increased trabecular pattern across the fracture.
increased sclerosis of the talar body.
absence of degenerative arthritis. - CORRECT ANSWER✔✔- Resorption or subchondral
lucency of the talar dome usually indicates that there is sufficient vascularity in the talus,
often termed Hawkins sign. Increased sclerosis of the talar body may suggest avascular
necrosis. Absence of degenerative arthritis and increased trabecular pattern across the fracture
are not prognostic findings for an intact vascular supply.
For which condition is a bone stimulator most efficacious?
synovial pseudarthrosis.
hypertrophic nonunion.
fibrous nonunion.
fibrous malunion. - CORRECT ANSWER✔✔- Rationale: Hypertrophic nonunion is the
most appropriate answer choice for a bone stimulator because it is the only non union
amongst the available answer choices listed that theoretically has sufficient vascularity to
heal. A hypertrophic non union may be lacking stability or normal axial alignment, but is able
to heal at a cellular level. Synovial pseudoarthrosis, fibrous non union and malunion are all
, caused by inadequate immobilization and inadequate blood supply and may be more limited
in its ability to heal.
A 25-year-old female sustained an inversion ankle sprain 24 hours ago. The area is severely
edematous and ecchymotic. Diagnostic tests show rupture of the lateral collateral ligaments.
What should the treatment consist of at this time?
compression dressing for 24 to 48 hours.
open ligament repair.
posterior splint and warm compresses for 24 to 48 hours.
short leg walking cast. - CORRECT ANSWER✔✔- Acute soft-tissue ankle injuries),
Rationale: Compression dressing for 24 to 48 hours is the best answer. An open ligament
repair is not indicated this early due to the severe edema. A posterior splint may be indicated
but the warm compress is not indicated, as icing would be more appropriate. A short leg cast
can be used however the patient has severe edema so this is not the best answer as it does not
address the swelling.
A 30-year-old male complains of a painful right ankle after sustaining a forced plantarflexion
injury. Plantarflexion of the foot and dorsiflexion of the hallux greatly exacerbate the
symptoms of pain at the posterior ankle. What is the most probable diagnosis?
flexor digitorum longus tendinitis.
fracture of the sustentaculum tali.
fracture of the posterior lip of the tibia.
fracture of the posterior tubercle of the talus. - CORRECT ANSWER✔✔- Rationale: The
injury mechanism, combined with the current symptoms point to an injury at the posterior
ankle, specifically fracture of the posterior tubercle of the talus, irritated by movement of the
flexor hallucis longus tendon. Flexor digitorum longus tendinitis is incorrect since the patient
indicates he has pain with great toe motion. Fracture of the sustentaculum tali is incorrect
since the patient expresses pain at the posterior ankle, not medial. Fracture of the posterior lip
of the tibia is incorrect since pain with plantar flexion of the ankle and dorsiflexion of the toe
would point to motion at the talar groove as the likely cause of the pain. The other options are
not the most appropriate answer for this question based on the choices given.
The radiograph is for a 14-year-old male who fell six feet and presented to the emergency
department two hours later. What other diagnostic test is appropriate to rule out concomitant
injury in the emergency room?
axial radiography of the foot.
computed tomography of the foot.
