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ABFAS TRAUMA SECTION TEST PACK WITH VERIFIED ANSWERS
DETAILED RATIONALES GRADED A+
SECTION 1: ANKLE FRACTURES — CLASSIFICATION & MANAGEMENT (Questions 1–40)
Question 1.
A 35-year-old male sustains an ankle injury with the foot in supination and
external rotation. According to the Lauge-Hansen classification, which type of
injury is most likely?
A) Supination-Adduction
B) Supination-External Rotation
C) Pronation-Abduction
D) Pronation-External Rotation
Correct Answer: B
Rationale: The Lauge-Hansen classification describes injury patterns based on foot
position and deforming force. Supination-External Rotation is the most common ankle
fracture pattern, involving the foot in supination with an external rotational force,
resulting in a spiral fracture of the lateral malleolus, disruption of the deltoid ligament or
medial malleolus, and possible syndesmotic injury.
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Question 2.
A patient presents with an ankle fracture and a fracture line at the level of the
tibial plafond with associated syndesmotic disruption. According to the Danis-
Weber classification, what type of fracture is this?
A) Type A
B) Type B
C) Type C
D) Type D
Correct Answer: C
Rationale: The Danis-Weber classification is based on the level of the fibular fracture
relative to the ankle joint. Type C fractures are located above the level of the
syndesmosis and are associated with syndesmotic disruption, requiring fixation of the
syndesmosis.
Question 3.
A 45-year-old female sustains an ankle fracture and is found to have a positive
external rotation stress test. What does this indicate?
A) Deltoid ligament injury
B) Syndesmotic injury
C) Achilles tendon rupture
D) Lateral collateral ligament injury
Correct Answer: B
Rationale: A positive external rotation stress test indicates syndesmotic instability. This
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is an important finding because syndesmotic injuries require surgical fixation to restore
ankle stability and prevent post-traumatic arthritis.
Question 4.
A 28-year-old male presents with an isolated medial malleolus fracture. What is
the most appropriate management?
A) Non-weight-bearing cast immobilization
B) Open reduction and internal fixation
C) Elastic bandage and early mobilization
D) Below-knee walking boot
Correct Answer: B
Rationale: Isolated medial malleolus fractures that are displaced or involve more than
25% of the articular surface typically require open reduction and internal fixation to
restore ankle stability and prevent nonunion.
Question 5.
A 38-year-old female presents with an ankle fracture and is found to have a "log
splitter" injury. What does this refer to?
A) Vertical shear fracture of the medial malleolus
B) Spiral fracture of the lateral malleolus
C) Comminuted fracture of the posterior malleolus
D) Transverse fracture of the medial malleolus
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Correct Answer: A
Rationale: A "log splitter" injury refers to a vertical shear fracture of the medial
malleolus, which occurs when the talus is driven into the medial malleolus. This requires
anatomic reduction and internal fixation.
Question 6.
According to the Lauge-Hansen classification, which injury pattern involves a
transverse fracture of the medial malleolus or deltoid ligament tear followed by a
spiral oblique fracture of the lateral malleolus?
A) Supination-Adduction
B) Supination-External Rotation
C) Pronation-Abduction
D) Pronation-External Rotation
Correct Answer: B
Rationale: Supination-External Rotation is the most common ankle fracture pattern. The
stages progress from anterior tibiofibular ligament injury to spiral lateral malleolus
fracture, posterior malleolus fracture, and finally medial malleolus fracture or deltoid
rupture.
Question 7.
A patient has a Danis-Weber Type A ankle fracture. What is the level of the fibular
fracture relative to the ankle joint?
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ABFAS TRAUMA SECTION TEST PACK WITH VERIFIED ANSWERS
DETAILED RATIONALES GRADED A+
SECTION 1: ANKLE FRACTURES — CLASSIFICATION & MANAGEMENT (Questions 1–40)
Question 1.
A 35-year-old male sustains an ankle injury with the foot in supination and
external rotation. According to the Lauge-Hansen classification, which type of
injury is most likely?
A) Supination-Adduction
B) Supination-External Rotation
C) Pronation-Abduction
D) Pronation-External Rotation
Correct Answer: B
Rationale: The Lauge-Hansen classification describes injury patterns based on foot
position and deforming force. Supination-External Rotation is the most common ankle
fracture pattern, involving the foot in supination with an external rotational force,
resulting in a spiral fracture of the lateral malleolus, disruption of the deltoid ligament or
medial malleolus, and possible syndesmotic injury.
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,Page 2 of 130
Question 2.
A patient presents with an ankle fracture and a fracture line at the level of the
tibial plafond with associated syndesmotic disruption. According to the Danis-
Weber classification, what type of fracture is this?
A) Type A
B) Type B
C) Type C
D) Type D
Correct Answer: C
Rationale: The Danis-Weber classification is based on the level of the fibular fracture
relative to the ankle joint. Type C fractures are located above the level of the
syndesmosis and are associated with syndesmotic disruption, requiring fixation of the
syndesmosis.
Question 3.
A 45-year-old female sustains an ankle fracture and is found to have a positive
external rotation stress test. What does this indicate?
A) Deltoid ligament injury
B) Syndesmotic injury
C) Achilles tendon rupture
D) Lateral collateral ligament injury
Correct Answer: B
Rationale: A positive external rotation stress test indicates syndesmotic instability. This
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is an important finding because syndesmotic injuries require surgical fixation to restore
ankle stability and prevent post-traumatic arthritis.
Question 4.
A 28-year-old male presents with an isolated medial malleolus fracture. What is
the most appropriate management?
A) Non-weight-bearing cast immobilization
B) Open reduction and internal fixation
C) Elastic bandage and early mobilization
D) Below-knee walking boot
Correct Answer: B
Rationale: Isolated medial malleolus fractures that are displaced or involve more than
25% of the articular surface typically require open reduction and internal fixation to
restore ankle stability and prevent nonunion.
Question 5.
A 38-year-old female presents with an ankle fracture and is found to have a "log
splitter" injury. What does this refer to?
A) Vertical shear fracture of the medial malleolus
B) Spiral fracture of the lateral malleolus
C) Comminuted fracture of the posterior malleolus
D) Transverse fracture of the medial malleolus
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Correct Answer: A
Rationale: A "log splitter" injury refers to a vertical shear fracture of the medial
malleolus, which occurs when the talus is driven into the medial malleolus. This requires
anatomic reduction and internal fixation.
Question 6.
According to the Lauge-Hansen classification, which injury pattern involves a
transverse fracture of the medial malleolus or deltoid ligament tear followed by a
spiral oblique fracture of the lateral malleolus?
A) Supination-Adduction
B) Supination-External Rotation
C) Pronation-Abduction
D) Pronation-External Rotation
Correct Answer: B
Rationale: Supination-External Rotation is the most common ankle fracture pattern. The
stages progress from anterior tibiofibular ligament injury to spiral lateral malleolus
fracture, posterior malleolus fracture, and finally medial malleolus fracture or deltoid
rupture.
Question 7.
A patient has a Danis-Weber Type A ankle fracture. What is the level of the fibular
fracture relative to the ankle joint?
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