SHOULDER AND ELBOW SELF-
SCORED SELF-ASSESSMENT
EXAMINATION
AAOS 2025
,Shoulder and Elbow Self-Scored Self-Assessment Examination 2025 Ahmed Altaei
CLINICAL VSITUATION VFOR VQUESTIONS V1 VTHROUGH V4
A V55-year-old Vman Vfalls Von Vhis Voutstretched Varm Vand Vsustains Vthe Vinjury Vshown Vin Vthe V3-
dimensional VCT Vscans Vin VFigures V1a Vand V1b.
Question V1 Vof V100
Which Vligamentous Vstructure Vattaches Vto Vthe Vfracture Vfragment?
1- Lateral Vulnar Vcollateral Vligament
2- Radial Vcollateral Vligament
3- Posterior Vmedial Vcollateral Vligament V(MCL)
4- Anterior VMCL
PREFERRED VRESPONSE: V4- VAnterior VMCL
Question V2 Vof V100
The Vbony Vlandmark Vis Vknown Vas Vthe
1- crista Vsupinatoris.
2- sublime Vtubercle.
3- radial Vnotch.
4- coronoid.
PREFERRED VRESPONSE: V2- Vsublime Vtubercle.
1
,Shoulder and Elbow Self-Scored Self-Assessment Examination 2025 Ahmed Altaei
Question V3 Vof V100
The Vcritical Vweight-bearing Vportion Vof Vthe Velbow Vjoint Vthat Vis Vdamaged Vin Vthis Vfracture Vis Vthe
1- anteromedial Vcoronoid Vfacet.
2- posteromedial Volecranon Vfacet.
3- coronoid.
4- radial Vnotch.
PREFERRED VRESPONSE: V1- Vanteromedial Vcoronoid Vfacet.
Question V4 Vof V100
Treatment Vof Vthis Vfracture Vshould Vconsist Vof
1- closed Vreduction, Vlimited Vimmobilization V(1-2 Vweeks), Vand Vearly Vfunctional Vrehabilitation.
2- limited Vimmobilization Vin Va Vlong-arm Vcast V(4 Vweeks) Vand Vearly Vfunctional Vrehabilitation.
3- open Vreduction Vand Vinternal Vfixation.
4- open Vreduction, Vcapsular Vrepair, Vand Vsuture Vfixation Vof Vthe Vbony Vfragment Vand Vligament.
PREFERRED VRESPONSE: V3- Vopen Vreduction Vand Vinternal Vfixation.
DISCUSSION
Varus Vposteromedial Vrotatory Vinstability Vis Va Vcomplex Vinjury Vpattern Vthat Vstarts Vwith Vvarus
Vstress Vresulting Vin Va Vfracture Vof Vthe Vanteromedial Vcoronoid. VThe Vanterior VMCL Vattaches Vto
Vthe Vsublime Vtubercle, Vwhich Vis Vpart Vof Vthe Vanteromedial Vcoronoid Vfacet. VThe Vposterior
VMCL Vattaches Vto Vthe Vposterior Vmedial Vaspect Vof Vthe Vulna. VThe Vradial Vcollateral Vand Vlateral
Vulnar Vcollateral Vattach Vto Vthe V Vulna Vat Vthe Vcrista Vsupinatoris. VThe Vbony Vlandmark Vis Vthe
Vsublime Vtubercle; Vas Vnoted Vabove, Vthe Vcrista Vsupinatoris Vis Vlateral Von Vthe Vulna. VThe Vradial
Vnotch Vis Valso Vlateral Vand Vis Vthe Varticulation Vbetween Vthe Vproximal Vulna Vand Vproximal
Vradius. VThe Vanteromedial Vcoronoid Vfacet Vis Vpart Vof Vthe Vcoronoid, Vwhich Vextends Vmore
Vlateral Vand Vanterior Vthan Vthe Vanteromedial Vfacet. VThe Vanteromedial Vfacet Vrepresents V Vthe
Vcritical Vweight-bearing Vportion Vof Vthe Vulnohumeral Vjoint. VDamage Vto Vthis Vstructure Vcauses
Vposteromedial Vsubluxation Vthat Voften Vresults Vin Vsevere Vprogressive Varthritis. VThe Vcoronoid
Vis Vthe Vlarger Vstructure Vof Vwhich Vthe Vanteromedial Vcoronoid Vfacet Vis Va Vportion. VThe
Vposteromedial Vcoronoid Vfacet Vdoes Vnot Vappear Vto Vbe Vcritical Vin Vweight Vbearing. VThe Vradial
Vnotch Vis Vnot Vassociated Vwith Vincreased Vstress Vwith Vweight Vbearing. VThe Vtreatment Vof
Vdisplaced Vfractures Vof Vthis Vstructure Vis Vopen Vreduction Vand Vinternal Vfixation Vutilizing
Vbuttress Vplating. VClosed Vtreatment Vis Vacceptable Vonly Vfor Vnondisplaced Vfractures Vwith
Vappropriate Vradiographic Vfollow-up. VSuture Vfixation Vis Vnot Vadvocated Vbecause Vof Vinadequate
Vstrength.
RECOMMENDED VREADINGS
2
, Shoulder and Elbow Self-Scored Self-Assessment Examination 2025 Ahmed Altaei
• Pollock VJW, VBrownhill VJ, VFerreira VL, VMcDonald VCP, VJohnson VJ, VKing VG. VThe Veffect Vof
Vanteromedial Vfacet Vfractures Vof Vthe Vcoronoid Vand Vlateral Vcollateral Vligament Vinjury Von Velbow
Vstability Vand Vkinematics. VJ VBone VJoint VSurg VAm. V2009 VJun;91(6):1448-58. Vdoi:
V10.2106/JBJS.H.00222.
• Sanchez-Sotelo VJ, VO'Driscoll VSW, VMorrey VBF. VAnteromedial Vfracture Vof Vthe Vcoronoid Vprocess
Vof Vthe Vulna. VJ VShoulder VElbow VSurg. V2006 VSep-Oct;15(5):e5-8. VEpub V2006 VJul V26. VErratum
Vin: VJ VShoulder VElbow VSurg. V2007 VJan-Feb;16(1):127. VPubMed VPMID: V16979044.
Question V5 Vof V100
Figures V5a Vthrough V5d Vare Vthe Vradiographs Vof Va V55-year-old Vhealthy Vwoman Vwho Vfell Vdown
Va Vflight Vof Vsteps Vwhile Vsleepwalking. VWhen Vthe Vsurgeon Vreplace Vthe Vradial Vhead, Vthe
Velbow Vdislocates Vposteriorly Vat V60 Vdegrees Vof Vflexion Vas Vit Vis Vbrought Vout Vfrom Vfull
Vflexion. VWhat Vis Vthe Vbest Vnext Vstep?
1- Only Vrepair Vthe Vlateral Vcollateral Vligament V(LCL)
2- Do Vnothing Vfurther Vand Vplace Vthe Velbow Vin V90 Vdegrees Vof Vflexion
3- Repair Vthe Vposterior Vband Vof Vthe Vmedial Vcollateral Vligament V(MCL)
4- Repair Vthe Vcoronoid Vand Vreassess Vfor Vstability
PREFERRED VRESPONSE: V4- VRepair Vthe Vcoronoid Vand Vreassess Vfor Vstability
DISCUSSION
3
SCORED SELF-ASSESSMENT
EXAMINATION
AAOS 2025
,Shoulder and Elbow Self-Scored Self-Assessment Examination 2025 Ahmed Altaei
CLINICAL VSITUATION VFOR VQUESTIONS V1 VTHROUGH V4
A V55-year-old Vman Vfalls Von Vhis Voutstretched Varm Vand Vsustains Vthe Vinjury Vshown Vin Vthe V3-
dimensional VCT Vscans Vin VFigures V1a Vand V1b.
Question V1 Vof V100
Which Vligamentous Vstructure Vattaches Vto Vthe Vfracture Vfragment?
1- Lateral Vulnar Vcollateral Vligament
2- Radial Vcollateral Vligament
3- Posterior Vmedial Vcollateral Vligament V(MCL)
4- Anterior VMCL
PREFERRED VRESPONSE: V4- VAnterior VMCL
Question V2 Vof V100
The Vbony Vlandmark Vis Vknown Vas Vthe
1- crista Vsupinatoris.
2- sublime Vtubercle.
3- radial Vnotch.
4- coronoid.
PREFERRED VRESPONSE: V2- Vsublime Vtubercle.
1
,Shoulder and Elbow Self-Scored Self-Assessment Examination 2025 Ahmed Altaei
Question V3 Vof V100
The Vcritical Vweight-bearing Vportion Vof Vthe Velbow Vjoint Vthat Vis Vdamaged Vin Vthis Vfracture Vis Vthe
1- anteromedial Vcoronoid Vfacet.
2- posteromedial Volecranon Vfacet.
3- coronoid.
4- radial Vnotch.
PREFERRED VRESPONSE: V1- Vanteromedial Vcoronoid Vfacet.
Question V4 Vof V100
Treatment Vof Vthis Vfracture Vshould Vconsist Vof
1- closed Vreduction, Vlimited Vimmobilization V(1-2 Vweeks), Vand Vearly Vfunctional Vrehabilitation.
2- limited Vimmobilization Vin Va Vlong-arm Vcast V(4 Vweeks) Vand Vearly Vfunctional Vrehabilitation.
3- open Vreduction Vand Vinternal Vfixation.
4- open Vreduction, Vcapsular Vrepair, Vand Vsuture Vfixation Vof Vthe Vbony Vfragment Vand Vligament.
PREFERRED VRESPONSE: V3- Vopen Vreduction Vand Vinternal Vfixation.
DISCUSSION
Varus Vposteromedial Vrotatory Vinstability Vis Va Vcomplex Vinjury Vpattern Vthat Vstarts Vwith Vvarus
Vstress Vresulting Vin Va Vfracture Vof Vthe Vanteromedial Vcoronoid. VThe Vanterior VMCL Vattaches Vto
Vthe Vsublime Vtubercle, Vwhich Vis Vpart Vof Vthe Vanteromedial Vcoronoid Vfacet. VThe Vposterior
VMCL Vattaches Vto Vthe Vposterior Vmedial Vaspect Vof Vthe Vulna. VThe Vradial Vcollateral Vand Vlateral
Vulnar Vcollateral Vattach Vto Vthe V Vulna Vat Vthe Vcrista Vsupinatoris. VThe Vbony Vlandmark Vis Vthe
Vsublime Vtubercle; Vas Vnoted Vabove, Vthe Vcrista Vsupinatoris Vis Vlateral Von Vthe Vulna. VThe Vradial
Vnotch Vis Valso Vlateral Vand Vis Vthe Varticulation Vbetween Vthe Vproximal Vulna Vand Vproximal
Vradius. VThe Vanteromedial Vcoronoid Vfacet Vis Vpart Vof Vthe Vcoronoid, Vwhich Vextends Vmore
Vlateral Vand Vanterior Vthan Vthe Vanteromedial Vfacet. VThe Vanteromedial Vfacet Vrepresents V Vthe
Vcritical Vweight-bearing Vportion Vof Vthe Vulnohumeral Vjoint. VDamage Vto Vthis Vstructure Vcauses
Vposteromedial Vsubluxation Vthat Voften Vresults Vin Vsevere Vprogressive Varthritis. VThe Vcoronoid
Vis Vthe Vlarger Vstructure Vof Vwhich Vthe Vanteromedial Vcoronoid Vfacet Vis Va Vportion. VThe
Vposteromedial Vcoronoid Vfacet Vdoes Vnot Vappear Vto Vbe Vcritical Vin Vweight Vbearing. VThe Vradial
Vnotch Vis Vnot Vassociated Vwith Vincreased Vstress Vwith Vweight Vbearing. VThe Vtreatment Vof
Vdisplaced Vfractures Vof Vthis Vstructure Vis Vopen Vreduction Vand Vinternal Vfixation Vutilizing
Vbuttress Vplating. VClosed Vtreatment Vis Vacceptable Vonly Vfor Vnondisplaced Vfractures Vwith
Vappropriate Vradiographic Vfollow-up. VSuture Vfixation Vis Vnot Vadvocated Vbecause Vof Vinadequate
Vstrength.
RECOMMENDED VREADINGS
2
, Shoulder and Elbow Self-Scored Self-Assessment Examination 2025 Ahmed Altaei
• Pollock VJW, VBrownhill VJ, VFerreira VL, VMcDonald VCP, VJohnson VJ, VKing VG. VThe Veffect Vof
Vanteromedial Vfacet Vfractures Vof Vthe Vcoronoid Vand Vlateral Vcollateral Vligament Vinjury Von Velbow
Vstability Vand Vkinematics. VJ VBone VJoint VSurg VAm. V2009 VJun;91(6):1448-58. Vdoi:
V10.2106/JBJS.H.00222.
• Sanchez-Sotelo VJ, VO'Driscoll VSW, VMorrey VBF. VAnteromedial Vfracture Vof Vthe Vcoronoid Vprocess
Vof Vthe Vulna. VJ VShoulder VElbow VSurg. V2006 VSep-Oct;15(5):e5-8. VEpub V2006 VJul V26. VErratum
Vin: VJ VShoulder VElbow VSurg. V2007 VJan-Feb;16(1):127. VPubMed VPMID: V16979044.
Question V5 Vof V100
Figures V5a Vthrough V5d Vare Vthe Vradiographs Vof Va V55-year-old Vhealthy Vwoman Vwho Vfell Vdown
Va Vflight Vof Vsteps Vwhile Vsleepwalking. VWhen Vthe Vsurgeon Vreplace Vthe Vradial Vhead, Vthe
Velbow Vdislocates Vposteriorly Vat V60 Vdegrees Vof Vflexion Vas Vit Vis Vbrought Vout Vfrom Vfull
Vflexion. VWhat Vis Vthe Vbest Vnext Vstep?
1- Only Vrepair Vthe Vlateral Vcollateral Vligament V(LCL)
2- Do Vnothing Vfurther Vand Vplace Vthe Velbow Vin V90 Vdegrees Vof Vflexion
3- Repair Vthe Vposterior Vband Vof Vthe Vmedial Vcollateral Vligament V(MCL)
4- Repair Vthe Vcoronoid Vand Vreassess Vfor Vstability
PREFERRED VRESPONSE: V4- VRepair Vthe Vcoronoid Vand Vreassess Vfor Vstability
DISCUSSION
3
