KVV E-Modules

The proximal tibia forms the:

A: Hip joint B: Knee joint C: Ankle joint D: Elbow joint

The most common mechanism of tibial plateau fracture in young adults is:

A: Low-energy twisting injury B: High-energy road traffic accident C: Birth injury D: Overuse injury

In elderly patients, proximal tibial fractures commonly result from:

A: Gunshot injury B: Low-energy fall with osteoporosis C: Sports injury D: Electric shock

The lateral tibial plateau is fractured more commonly because:

A: It is stronger B: It is weaker and subjected to valgus forces C: It has thicker cortex D: It bears less load

The most widely used classification for tibial plateau fractures is:

A: Garden B: Schatzker C: Neer D: Lauge-Hansen

A patient with a tibial plateau fracture usually presents with:

A: Shoulder pain B: Knee pain, swelling, inability to bear weight C: Wrist pain D: Neck pain

Hemarthrosis is commonly seen in:

A: Tibial plateau fractures B: Clavicle fractures C: Radius fractures D: Metacarpal fractures

The most important clinical examination before treatment is:

A: Dental examination B: Neurovascular examination C: Eye examination D: Ear examination

Initial imaging includes:

A: MRI only B: AP and lateral X-ray of the knee C: Ultrasound only D: PET scan

CT scan is especially useful for:

A: Skin injuries B: Defining fracture pattern and planning surgery C: Muscle tears only D: Ligament injuries only

MRI is most useful for:

A: Bone shortening B: Associated meniscal and ligament injuries C: Skin wounds D: Fracture healing

The artery most at risk in proximal tibial fractures is:

A: Femoral artery B: Popliteal artery C: Radial artery D: Axillary artery

The nerve most commonly injured is:

A: Median nerve B: Common peroneal nerve C: Ulnar nerve D: Radial nerve

Foot drop following proximal tibial fracture suggests injury to:

A: Tibial nerve B: Common peroneal nerve C: Femoral nerve D: Sural nerve

Loss of dorsiflexion indicates injury to:

A: Tibial nerve B: Common peroneal nerve C: Sciatic nerve D: Obturator nerve

Absent dorsalis pedis pulse indicates possible:

A: Meniscal tear B: Vascular injury C: Ligament sprain D: Tendinitis

Which pulse should always be examined?

A: Radial B: Popliteal, dorsalis pedis and posterior tibial C: Temporal D: Facial

If distal pulses are absent after reduction, the next investigation is:

A: Bone scan B: CT angiography C: MRI spine D: ECG

Delay in diagnosis of popliteal artery injury may result in:

A: Gastritis B: Limb loss C: Cataract D: Pneumonia

Documentation of neurovascular status should be done:

A: Before treatment only B: Before and after reduction/splinting C: After discharge only D: Only after surgery

Acute compartment syndrome is a:

A: Skin disease B: Surgical emergency C: Bone infection D: Ligament injury

The earliest symptom is:

A: Fever B: Severe pain disproportionate to injury C: Swelling of fingers D: Vomiting

Pain increases on:

A: Active muscle contraction only B: Passive stretching of muscles C: Deep breathing D: Sitting

The earliest clinical sign is:

A: Pulselessness B: Pain out of proportion C: Paralysis D: Pallor

The "5 P's" of compartment syndrome include all except:

A: Pain B: Pallor C: Pulselessness D: Pyrexia

The most reliable early finding is:

A: Pulselessness B: Pain on passive stretch C: Cyanosis D: Cold limb

Normal compartment pressure is approximately:

A: 0–10 mmHg B: 50 mmHg C: 80 mmHg D: 100 mmHg

Compartment syndrome is suspected when pressure exceeds:

A: 10 mmHg B: 20 mmHg C: About 30 mmHg or ΔP ≤30 mmHg D: 100 mmHg

Definitive treatment is:

A: Ice application B: Fasciotomy C: Plaster cast D: Massage

Delayed fasciotomy may lead to:

A: Volkmann ischemic contracture B: Migraine C: Pneumonia D: Cataract

Initial management includes:

A: Splinting and limb elevation to heart level B: Vigorous massage C: Walking D: Heat application

Displaced tibial plateau fractures usually require:

A: ORIF B: Sling C: POP only D: Observation

The commonly used implant is:

A: Locking proximal tibial plate B: Dynamic hip screw C: Rush nail D: K-wire alone

The aim of surgery is:

A: Restore joint congruity and alignment B: Shorten the limb C: Delay mobilization D: Produce ankylosis

Early knee movement helps prevent:

A: Diabetes B: Knee stiffness C: Cataract D: Asthma

The most common complication after tibial plateau fracture is:

A: Knee stiffness B: Peptic ulcer C: Cataract D: Gallstones

Malunion may lead to:

A: Valgus or varus deformity B: Blindness C: Deafness D: Nephritis

Post-traumatic osteoarthritis occurs due to:

A: Articular incongruity B: Fever C: Hypertension D: Hyperglycemia

The prognosis is best when:

A: Anatomical reduction is achieved B: Treatment is delayed C: Weight-bearing starts immediately after injury D: Fracture is ignored

The most important learning point in proximal tibial fractures is:

A: Apply POP immediately B: Always assess and document neurovascular status and watch for acute compartment syndrome C: Avoid imaging D: Ignore associated ligament injuries

A 28-year-old male sustains a high-energy road traffic accident. He has a swollen knee, severe pain on passive toe extension, …

A: Deep vein thrombosis B: Acute compartment syndrome C: Cellulitis D: Septic arthritis

A patient with a lateral tibial plateau fracture cannot dorsiflex the ankle and has numbness over the dorsum of the …

A: Tibial nerve B: Common peroneal nerve C: Femoral nerve D: Sural nerve

After reduction of a tibial plateau fracture-dislocation, the foot becomes cold and the dorsalis pedis pulse is absent. The next …

A: Discharge the patient B: CT angiography and urgent vascular surgery consultation C: Physiotherapy D: Apply a tighter cast

The definitive treatment for confirmed acute compartment syndrome is:

A: Limb elevation above heart level for 24 hours B: Four-compartment fasciotomy of the leg C: Intravenous antibiotics alone D: Ice compression bandage

Which statement is TRUE regarding proximal tibial fractures?

A: Neurovascular examination is optional. B: Acute compartment syndrome can occur even when distal pulses are present. C: Pain is a late feature of compartment syndrome. D: CT scan is never required.