Hand Trauma & Infection MCQs

A 34-year-old mechanic presents with an infected puncture wound on his index finger. He exhibits the four cardinal signs of suppurative flexor tenosynovitis (Kanavel's signs). Which of these signs is typically the earliest to manifest and is considered the most sensitive indicator of this condition?

A 39-year-old butcher presents to the ER 48 hours after sustaining a small puncture wound to his right index finger. He exhibits signs of pyogenic flexor tenosynovitis. Which of the following is NOT one of Kanavel's cardinal signs for this condition?

A 32-year-old dishwasher presents with a swollen, throbbing index finger 3 days after sustaining a puncture wound from a dirty wire brush. Examination reveals uniform fusiform swelling of the digit, a semi-flexed posture of the finger, severe pain on passive extension, and exquisite tenderness along the entire flexor tendon sheath. Which of the following organisms is the most common cause of this condition?

A 35-year-old mechanic presents with a swollen, painful index finger 3 days after sustaining a puncture wound. The finger is held in a flexed posture, is uniformly swollen, tender along the volar aspect, and exquisitely painful with passive extension. What is the most appropriate next step in management?

The Stener lesion, which prevents non-operative healing of a complete ulnar collateral ligament (UCL) tear of the thumb, involves the interposition of which structure between the torn ends of the UCL?

In a complete rupture of the ulnar collateral ligament (UCL) of the thumb metacarpophalangeal joint (Skier's thumb), a Stener lesion prevents non-operative healing. This lesion occurs when the torn ends of the UCL are separated by the aponeurosis of which of the following muscles?

A 28-year-old rugby player sustains a hyperextension injury to his thumb during a tackle. Examination reveals significant swelling and tenderness over the ulnar aspect of the thumb metacarpophalangeal (MCP) joint, with instability on valgus stress testing at 30 degrees of flexion. What is the most appropriate initial management?

A 40-year-old construction worker presents with acute onset of severe pain, swelling, and redness over the palmar aspect of his index finger DIP joint, following a minor puncture wound. He is febrile. Examination reveals a tense, exquisitely tender, fusiform swelling of the entire finger with marked pain on passive extension. What is the most appropriate immediate management?

In a traumatic complete rupture of the ulnar collateral ligament of the thumb MCP joint without a bony avulsion, what is the most important anatomical factor that dictates the need for surgical repair?

A patient presents with a swollen, painful index finger. Which of the following is NOT one of Kanavel's four cardinal signs of infectious flexor tenosynovitis?

A 34-year-old diabetic patient presents with a swollen, painful index finger 3 days after a minor puncture wound. Of the four classic Kanavel signs for suppurative flexor tenosynovitis, which is considered the earliest and most reliable indicator of infection?

A 28-year-old male presents with a "fight bite" over the third metacarpophalangeal joint after striking another person in the mouth. Which organism is uniquely associated with this specific injury mechanism, and what is the empiric antibiotic of choice?

A 35-year-old skier presents with pain and weakness in the right thumb after a fall. Examination demonstrates significant laxity of the ulnar collateral ligament (UCL) of the metacarpophalangeal joint. An MRI reveals a 'Stener lesion.' What is the exact anatomical arrangement that defines a Stener lesion?

A 40-year-old carpenter sustains a puncture wound to the volar aspect of his index finger and presents 48 hours later with severe throbbing pain. Which of the following is NOT one of Kanavel's cardinal signs of acute flexor tenosynovitis?

In a patient diagnosed with a 'skier's thumb', the mechanism of a Stener lesion involves the proximal stump of the torn ulnar collateral ligament (UCL) becoming anatomically trapped. Which structure interposes between the torn ends of the UCL?

A 30-year-old mechanic sustains a puncture wound to the volar aspect of his index finger and presents 48 hours later with suspected pyogenic flexor tenosynovitis. Which of the following physical examination findings is clinically considered the earliest and most sensitive of Kanavel's signs?

A 32-year-old manual laborer presents with a swollen, painful index finger three days after a minor puncture wound. He exhibits Kanavel's four cardinal signs of flexor tenosynovitis. Which of these signs is considered the earliest and most sensitive indicator of this condition?

According to Kanavel's cardinal signs for pyogenic flexor tenosynovitis of the hand, which of the following is generally considered the earliest and most reliable clinical indicator?