DEX IOT DAY 2 TEST NEWEST 2026 ACTUAL EXAM 250 QUESTIONS AND CORRECT DETAILED
ANSWERS/NEWEST UPDATE!!!
Question 1
According to the findings of the Ramsey Study, how much does 1mm of lateral talar
displacement affect the contact area in the ankle joint?
A) 10% decrease
B) 25% decrease
C) 42% decrease
D) 55% decrease
E) 75% decrease
Correct Answer: C) 42% decrease
Rationale: The Ramsey study is a foundational piece of orthopedic research highlighting the
importance of anatomic reduction. It proved that just 1mm of talar shift leads to a massive
42% reduction in tibiotalar contact area, which significantly increases the risk of post-
traumatic arthritis.
Question 2
When using the Fibulock intramedullary nail, which fracture pattern is most appropriate for
utilizing the compression hole feature?
A) Comminuted fracture
B) Segmental fracture
C) Transverse fracture
D) Spiral fracture
E) Oblique fracture
Correct Answer: C) Transverse
Rationale: The compression hole in the Fibulock nail is designed to bring two bone
fragments together along the longitudinal axis of the nail. This is most effective and
mechanically sound in transverse fractures where the bone ends are perpendicular to the
nail.
Question 3
How do locking screws in a distal fibula plate impact the final construct compared to non-
locking screws?
A) They allow for more movement at the fracture site
B) They rely entirely on friction between the plate and bone
C) They create a fixed-angle construct that does not rely on plate-to-bone compression
D) They are designed to be removed after 6 weeks
E) They always result in secondary bone healing
Correct Answer: C) They create a fixed-angle construct that does not rely on plate-to-bone
compression
Rationale: Locking screws thread into the plate itself, turning the plate and screws into a
, 2
single rigid unit. This is beneficial in osteoporotic bone because the stability comes from the
fixed angle rather than the tightness of the screw against the bone surface.
Question 4
If a surgeon’s starting point for the Fibulock entry wire is too lateral, what deformity will likely
be induced in the final alignment?
A) Valgus deformity
B) Varus deformity
C) Internal rotation
D) Apex posterior angulation
E) Talus subluxation
Correct Answer: B) Varus deformity
Rationale: The entry point dictates the path of the nail. If the starting wire is too far lateral,
the nail will force the distal fragment toward the midline as it travels up the medullary
canal, resulting in a varus (inward) tilt.
Question 5
If the starting point for the Fibulock entry wire is too medial, what is the resulting clinical
deformity?
A) Varus deformity
B) Valgus deformity
C) Ankle equinus
D) External rotation
E) Shortening of the fibula
Correct Answer: B) Valgus deformity
Rationale: A medial entry point forces the distal end of the fibula outward (laterally) as the
nail is seated, creating a valgus (outward) angulation of the ankle.
Question 6
According to the Henderson System of ankle fracture incidence, what is the most common type
of malleolar fracture?
A) Trimalleolar (7%)
B) Bimalleolar (20%)
C) Unimalleolar (70%)
D) Syndesmotic disruption only
E) Pilon fractures
Correct Answer: C) Unimalleolar 70%
Rationale: The Henderson system classifies the frequency of ankle fractures based on the
number of malleoli involved. Isolated unimalleolar fractures are by far the most common at
70%.
, 3
Question 7
Which three bones comprise the "Ankle Mortise"?
A) Tibia, Fibula, Calcaneus
B) Tibia, Talus, Navicular
C) Tibia, Fibula, Talus
D) Fibula, Talus, Cuboid
E) Tibia, Fibula, Medial Cuneiform
Correct Answer: C) Tibia, Fibula, Talus
Rationale: The mortise is the "socket" of the ankle joint. It is formed by the distal ends of
the tibia and fibula, which cap the body of the talus.
Question 8
What is the recommended placement of the Tightrope relative to the ankle joint plafond?
A) 5cm proximal to the joint
B) Directly at the joint line
C) 1.5 to 2cm proximal to the ankle joint
D) 10cm proximal to the joint
E) Distal to the lateral malleolus
Correct Answer: C) 1.5 to 2cm proximal to the ankle joint
Rationale: Placing the Tightrope 1.5 to 2cm above the joint line ensures it is situated in the
strongest part of the syndesmosis without interfering with the articulation of the talus.
Question 9
In addition to being 1.5-2cm proximal, how should the Tightrope be angled in the transverse
plane?
A) 30 degrees Anterior to Posterior
B) 30 degrees Posterior to Anterior
C) Perfectly horizontal
D) 45 degrees Superior to Inferior
E) 15 degrees Lateral to Medial
Correct Answer: B) 30 degrees Posterior to Anterior
Rationale: Because the fibula sits slightly posterior to the tibia, the drill path must be angled
approximately 30 degrees from posterior-lateral to anterior-medial to hit the center of the
tibia.
Question 10
If a surgeon encounters difficulty throwing the K-wire for the Fibulock, which "bail-out" tools
are available in the system?
A) Bone cement and wire cutters
B) Flex wire, fracture finger, and parallel guide
C) Hammer and chisel
ANSWERS/NEWEST UPDATE!!!
Question 1
According to the findings of the Ramsey Study, how much does 1mm of lateral talar
displacement affect the contact area in the ankle joint?
A) 10% decrease
B) 25% decrease
C) 42% decrease
D) 55% decrease
E) 75% decrease
Correct Answer: C) 42% decrease
Rationale: The Ramsey study is a foundational piece of orthopedic research highlighting the
importance of anatomic reduction. It proved that just 1mm of talar shift leads to a massive
42% reduction in tibiotalar contact area, which significantly increases the risk of post-
traumatic arthritis.
Question 2
When using the Fibulock intramedullary nail, which fracture pattern is most appropriate for
utilizing the compression hole feature?
A) Comminuted fracture
B) Segmental fracture
C) Transverse fracture
D) Spiral fracture
E) Oblique fracture
Correct Answer: C) Transverse
Rationale: The compression hole in the Fibulock nail is designed to bring two bone
fragments together along the longitudinal axis of the nail. This is most effective and
mechanically sound in transverse fractures where the bone ends are perpendicular to the
nail.
Question 3
How do locking screws in a distal fibula plate impact the final construct compared to non-
locking screws?
A) They allow for more movement at the fracture site
B) They rely entirely on friction between the plate and bone
C) They create a fixed-angle construct that does not rely on plate-to-bone compression
D) They are designed to be removed after 6 weeks
E) They always result in secondary bone healing
Correct Answer: C) They create a fixed-angle construct that does not rely on plate-to-bone
compression
Rationale: Locking screws thread into the plate itself, turning the plate and screws into a
, 2
single rigid unit. This is beneficial in osteoporotic bone because the stability comes from the
fixed angle rather than the tightness of the screw against the bone surface.
Question 4
If a surgeon’s starting point for the Fibulock entry wire is too lateral, what deformity will likely
be induced in the final alignment?
A) Valgus deformity
B) Varus deformity
C) Internal rotation
D) Apex posterior angulation
E) Talus subluxation
Correct Answer: B) Varus deformity
Rationale: The entry point dictates the path of the nail. If the starting wire is too far lateral,
the nail will force the distal fragment toward the midline as it travels up the medullary
canal, resulting in a varus (inward) tilt.
Question 5
If the starting point for the Fibulock entry wire is too medial, what is the resulting clinical
deformity?
A) Varus deformity
B) Valgus deformity
C) Ankle equinus
D) External rotation
E) Shortening of the fibula
Correct Answer: B) Valgus deformity
Rationale: A medial entry point forces the distal end of the fibula outward (laterally) as the
nail is seated, creating a valgus (outward) angulation of the ankle.
Question 6
According to the Henderson System of ankle fracture incidence, what is the most common type
of malleolar fracture?
A) Trimalleolar (7%)
B) Bimalleolar (20%)
C) Unimalleolar (70%)
D) Syndesmotic disruption only
E) Pilon fractures
Correct Answer: C) Unimalleolar 70%
Rationale: The Henderson system classifies the frequency of ankle fractures based on the
number of malleoli involved. Isolated unimalleolar fractures are by far the most common at
70%.
, 3
Question 7
Which three bones comprise the "Ankle Mortise"?
A) Tibia, Fibula, Calcaneus
B) Tibia, Talus, Navicular
C) Tibia, Fibula, Talus
D) Fibula, Talus, Cuboid
E) Tibia, Fibula, Medial Cuneiform
Correct Answer: C) Tibia, Fibula, Talus
Rationale: The mortise is the "socket" of the ankle joint. It is formed by the distal ends of
the tibia and fibula, which cap the body of the talus.
Question 8
What is the recommended placement of the Tightrope relative to the ankle joint plafond?
A) 5cm proximal to the joint
B) Directly at the joint line
C) 1.5 to 2cm proximal to the ankle joint
D) 10cm proximal to the joint
E) Distal to the lateral malleolus
Correct Answer: C) 1.5 to 2cm proximal to the ankle joint
Rationale: Placing the Tightrope 1.5 to 2cm above the joint line ensures it is situated in the
strongest part of the syndesmosis without interfering with the articulation of the talus.
Question 9
In addition to being 1.5-2cm proximal, how should the Tightrope be angled in the transverse
plane?
A) 30 degrees Anterior to Posterior
B) 30 degrees Posterior to Anterior
C) Perfectly horizontal
D) 45 degrees Superior to Inferior
E) 15 degrees Lateral to Medial
Correct Answer: B) 30 degrees Posterior to Anterior
Rationale: Because the fibula sits slightly posterior to the tibia, the drill path must be angled
approximately 30 degrees from posterior-lateral to anterior-medial to hit the center of the
tibia.
Question 10
If a surgeon encounters difficulty throwing the K-wire for the Fibulock, which "bail-out" tools
are available in the system?
A) Bone cement and wire cutters
B) Flex wire, fracture finger, and parallel guide
C) Hammer and chisel
