314.A 29-year-old man is 10 ft up on a ladder, painting his barn ceiling when
he loses his balance and falls off the ladder, landing on both of his feet and then
falling to the ground. He is brought to the ED by emergency medical services
(EMS). On examination there are no obvious deformities, but you note
swelling, tenderness, and ecchymosis of the right hindfoot. He has full range of
motion at the ankle, knee, and hip. There is mild tenderness over his lumbar
spine. Hs neurovascular status is normal. Radiographs confirm the diagnosis.
Which of the following statements regarding this type of injury is true?
a. This injury is the second most commonly fractured tarsal bone.
b. 10% are associated with compression fractures of the dorsolumbar spine.
c. 90% are bilateral.
d. The mechanism of injury is usually secondary to rotational force at the subtalar
joint.
e. These fractures require operative repair to avoid gait defects.
315.A 39-year-old woman is brought to the ED by EMS on a backboard
and cervical collar after being involved in a motor vehicle collision. The
primary survey is unremarkable. However, the secondary survey reveals a
deformity of the right arm involving the upper arm and elbow. Which of
the following associations are paired incorrectly?
a. Olecranon fracture and ulnar nerve injury
b. Posterior elbow dislocation and ulnar and median nerve injury
c. Anterior elbow dislocation and brachial artery injury
d. Supracondylar fracture and brachial artery and median nerve injury
e. Humeral shaft fracture and axillary nerve injury
328 Emergency Medicine