Wrist & Carpus MCQs

A 9-year-old boy undergoes closed reduction and casting for a midshaft both-bone forearm fracture. During healing, he develops an angular malunion. Loss of which of the following anatomic features is most likely to significantly restrict his functional supination and pronation?

In a Galeazzi fracture-dislocation, which of the following stabilizing structures is most commonly disrupted, leading to instability of the distal radioulnar joint (DRUJ)?

A 55-year-old woman sustained a nondisplaced distal radius fracture treated in a short arm cast. Two weeks after the cast was removed (6 weeks post-injury), she notes a sudden inability to actively extend the interphalangeal joint of her thumb. Radiographs confirm the distal radius fracture is healing well in anatomic alignment. What is the most appropriate surgical treatment?

A 28-year-old male falls on his outstretched hand and presents with a displaced distal third radial shaft fracture.

After anatomic rigid plate fixation of the radius, how should the distal radioulnar joint (DRUJ) be managed?

A 65-year-old woman treated nonoperatively for a minimally displaced distal radius fracture presents 6 weeks later unable to actively extend her thumb interphalangeal joint. What is the most appropriate definitive management?

In a healthy 40-year-old patient with a closed distal radius fracture, which of the following radiographic parameters is universally considered a primary indication for operative intervention to minimize post-traumatic arthritis?

Following volar plate fixation of a distal radius fracture, which tendon is most at risk for attrition and eventual rupture if screws prominently penetrate the dorsal cortex?

A 55-year-old woman sustained a distal radius fracture. To minimize the risk of developing complex regional pain syndrome (CRPS), which of the following oral medications has been shown in prospective studies to be beneficial?

In a patient with a distal radius fracture, which radiographic parameter is considered unacceptable for non-operative management and warrants surgical intervention?

A 60-year-old female presents with an inability to flex the interphalangeal joint of her thumb 6 months after undergoing volar locked plating of a distal radius fracture.

Radiographs show the plate is positioned distal to the watershed line. Attritional rupture of which of the following tendons has most likely occurred?

A 45-year-old male sustains a distal radius fracture. Closed reduction and cast application are performed. Which of the following radiographic parameters is generally considered the maximum acceptable threshold for radial shortening to minimize the risk of symptomatic distal radioulnar joint (DRUJ) arthrosis?

A 55-year-old woman is evaluated 8 weeks following a nondisplaced distal radius fracture treated in a short arm cast. She suddenly loses the ability to actively extend the interphalangeal joint of her thumb. Radiographs reveal a healed fracture. What is the most appropriate surgical treatment?

A 62-year-old woman sustains a nondisplaced Colles fracture treated in a short arm cast. Six weeks later, she reports sudden loss of ability to extend her thumb. Which of the following is the most appropriate management?

What is the maximum acceptable limit for intra-articular step-off when evaluating the reduction of a distal radius fracture to minimize the risk of post-traumatic radiocarpal arthrosis?

A pediatric patient sustains a distal radius fracture with apex volar angulation. Over a year, the bone straightens as formation occurs on the concave side and resorption on the convex side. This biomechanical response is described by:

The triangular fibrocartilage complex (TFCC) acts as the primary stabilizer of the distal radioulnar joint (DRUJ). The TFCC takes its origin from the ulnar styloid and inserts primarily into which of the following structures?

A 40-year-old male falls on an outstretched hand, sustaining a volar Barton's fracture of the distal radius. What is the pathognomonic feature of this fracture?

A 22-year-old athlete sustains a proximal pole scaphoid fracture. What is the primary reason for the high rate of avascular necrosis in this specific fracture pattern?

A 65-year-old female presents with an inability to extend her thumb at the interphalangeal joint 6 weeks after sustaining a nondisplaced distal radius fracture treated with cast immobilization. She reports a sudden, painless loss of motion while grasping a jar. What is the most likely etiology of this complication?

A 32-year-old man sustains a Galeazzi fracture-dislocation. Following anatomic open reduction and internal fixation of the radial shaft, intraoperative evaluation reveals that the distal radioulnar joint (DRUJ) remains unstable in supination. What is the most appropriate next step in management?