Test Bank For Miller's Review of Orthopaedics, 9th Edition
Authors: Edited by Stephen R. Thompson, MD, MEd, FRCSC and Mark D.
Miller, MD, PE, Col USAF (Ret)
,Chapter 1: Basic Sciences
Miller’s Review of Orthopaedics, 9th Edition.
MCQs (1–30)
1. Fracture Healing Phases
A 25-year-old male sustains a closed tibial shaft fracture. Which phase of fracture healing
is primarily responsible for early stabilization within the first 1–3 weeks?
A. Remodeling phase
B. Hard callus formation
C. Soft callus formation
D. Consolidation phase
Answer: C
Explanation:
• Correct (C): Soft callus formation
o Occurs within 1–3 weeks
o Fibrocartilaginous bridge stabilizes fracture
Step-by-step reasoning:
• Hematoma → inflammation → soft callus → hard callus → remodeling
Anatomy/Pathophysiology:
• Periosteum supplies osteoprogenitor cells
Why others are wrong:
• A: Remodeling occurs months-years later
• B: Hard callus = mineralized bone, later stage
• D: Consolidation is not a distinct early phase
Management relevance:
, • Stability at this stage determines healing outcome
2. AO Fracture Classification
Which best describes AO type A fracture?
A. Simple fracture
B. Wedge fracture
C. Complex fracture
D. Open fracture
Answer: A
Explanation:
• Type A = simple (two fragments)
Others:
• B = Type B (wedge)
• C = Type C (complex)
• D = unrelated classification
3. Bone Blood Supply
Primary blood supply to long bones comes from:
A. Periosteal vessels
B. Nutrient artery
C. Epiphyseal vessels
D. Metaphyseal vessels
Answer: B
Explanation:
• Nutrient artery supplies medullary canal + inner 2/3 cortex
Others:
• Periosteal = outer cortex only
, • Epiphyseal = end regions in children
• Metaphyseal = secondary contribution
4. Compartment Syndrome Pressure
Diagnosis is strongly suggested when intracompartmental pressure exceeds:
A. 10 mmHg
B. 20 mmHg
C. 30 mmHg
D. 50 mmHg
Answer: C
Management:
• Fasciotomy if Δ pressure < 30 mmHg or absolute >30–40
Others:
• 10–20 mmHg: normal/elevated but not diagnostic
• 50 mmHg: late ischemia (irreversible risk)
5. Scaphoid Fracture Risk
Most common complication of untreated scaphoid waist fracture:
A. Malunion
B. Avascular necrosis
C. Osteomyelitis
D. Radial nerve injury
Answer: B
Anatomy:
• Retrograde blood flow via dorsal carpal branch
Others:
• Malunion less common
Authors: Edited by Stephen R. Thompson, MD, MEd, FRCSC and Mark D.
Miller, MD, PE, Col USAF (Ret)
,Chapter 1: Basic Sciences
Miller’s Review of Orthopaedics, 9th Edition.
MCQs (1–30)
1. Fracture Healing Phases
A 25-year-old male sustains a closed tibial shaft fracture. Which phase of fracture healing
is primarily responsible for early stabilization within the first 1–3 weeks?
A. Remodeling phase
B. Hard callus formation
C. Soft callus formation
D. Consolidation phase
Answer: C
Explanation:
• Correct (C): Soft callus formation
o Occurs within 1–3 weeks
o Fibrocartilaginous bridge stabilizes fracture
Step-by-step reasoning:
• Hematoma → inflammation → soft callus → hard callus → remodeling
Anatomy/Pathophysiology:
• Periosteum supplies osteoprogenitor cells
Why others are wrong:
• A: Remodeling occurs months-years later
• B: Hard callus = mineralized bone, later stage
• D: Consolidation is not a distinct early phase
Management relevance:
, • Stability at this stage determines healing outcome
2. AO Fracture Classification
Which best describes AO type A fracture?
A. Simple fracture
B. Wedge fracture
C. Complex fracture
D. Open fracture
Answer: A
Explanation:
• Type A = simple (two fragments)
Others:
• B = Type B (wedge)
• C = Type C (complex)
• D = unrelated classification
3. Bone Blood Supply
Primary blood supply to long bones comes from:
A. Periosteal vessels
B. Nutrient artery
C. Epiphyseal vessels
D. Metaphyseal vessels
Answer: B
Explanation:
• Nutrient artery supplies medullary canal + inner 2/3 cortex
Others:
• Periosteal = outer cortex only
, • Epiphyseal = end regions in children
• Metaphyseal = secondary contribution
4. Compartment Syndrome Pressure
Diagnosis is strongly suggested when intracompartmental pressure exceeds:
A. 10 mmHg
B. 20 mmHg
C. 30 mmHg
D. 50 mmHg
Answer: C
Management:
• Fasciotomy if Δ pressure < 30 mmHg or absolute >30–40
Others:
• 10–20 mmHg: normal/elevated but not diagnostic
• 50 mmHg: late ischemia (irreversible risk)
5. Scaphoid Fracture Risk
Most common complication of untreated scaphoid waist fracture:
A. Malunion
B. Avascular necrosis
C. Osteomyelitis
D. Radial nerve injury
Answer: B
Anatomy:
• Retrograde blood flow via dorsal carpal branch
Others:
• Malunion less common
