Wrist & Carpus MCQs

A 22-year-old man falls onto an outstretched hand and has pain in the anatomic snuffbox. Initial radiographs are negative for a fracture. What is the most appropriate initial management?

A 60-year-old female sustains a volar Barton's fracture of the distal radius. Which of the following ligaments remains attached to the displaced volar marginal articular fragment, causing the carpus to translate volarly with the fracture?

A 60-year-old female undergoes open reduction and internal fixation of a distal radius fracture with a volar locking plate. Six months postoperatively, she presents with an inability to actively flex the interphalangeal joint of her thumb. This complication is most directly related to plate placement in relation to which anatomical landmark?

A 65-year-old female sustains an undisplaced distal radius fracture and is treated non-operatively in a cast. Six weeks later, she complains of a sudden, painless inability to actively extend her thumb at the interphalangeal joint. What is the primary pathomechanism of this complication?

A 28-year-old gymnast presents with ulnar-sided wrist pain, clicking, and a feeling of instability. Physical examination demonstrates severe pain with ulnar deviation and axial loading (TFCC compression test). MRI arthrogram shows a tear of the triangular fibrocartilage complex (TFCC) at its ulnar attachment, specifically involving the fovea at the base of the ulnar styloid. According to the Palmer classification, what type of tear is this, and what is its healing potential?

A 28-year-old gymnast presents with ulnar-sided wrist pain. MRI arthrogram reveals a tear of the triangular fibrocartilage complex (TFCC) at its ulnar attachment to the fovea, with distal radioulnar joint (DRUJ) instability. According to the Palmer classification, what type of tear is this, and what is its healing potential?

A 30-year-old male sustains a distal third radial shaft fracture. Radiographs reveal widening of the distal radioulnar joint (DRUJ) on the PA view and dorsal displacement of the ulna on the lateral view. Following open reduction and internal fixation of the radius with a compression plate, the DRUJ remains grossly unstable in all positions of forearm rotation and irreducible. What is the most appropriate next step in management?

When performing a dorsal approach to the distal radius, Lister's tubercle is identified as a key anatomical landmark that serves as a pulley for the tendon of the third extensor compartment. Which two compartments does Lister's tubercle anatomically separate?

During a volar (Henry) approach to the distal radius, the pronator quadratus must be elevated. To preserve its blood supply and allow for anatomical repair over a volar plate, from which border should it be detached?

A 55-year-old female sustains a nondisplaced distal radius fracture treated conservatively in a cast. Six weeks later, following cast removal, she suddenly loses the ability to actively extend her thumb interphalangeal joint. Rupture of which tendon is most likely responsible, and around which bony prominence does it abruptly change direction?

A 65-year-old female presents 6 weeks after non-operative management of a minimally displaced distal radius fracture. She reports the sudden inability to extend her thumb. Examination reveals a complete lack of active retropulsion of the thumb. An Extensor Pollicis Longus (EPL) rupture is diagnosed. What is the most common anatomic zone implicated in this specific late complication?

A randomized controlled trial comparing two surgical techniques for distal radius fractures concludes there is no significant difference in functional outcomes at 1 year. However, true population data dictates that a significant difference does exist. The investigators committed a Type II error. Which of the following is equal to the probability of avoiding this error?

A 60-year-old female undergoes volar locked plating for a distal radius fracture. Six months later, she presents with an inability to actively flex the interphalangeal joint of her thumb. Which radiographic finding is most predictive of this specific complication?

A 40-year-old manual laborer with a chronic scapholunate ligament tear develops Scapholunate Advanced Collapse (SLAC). Radiographs reveal arthritis limited to the radioscaphoid joint, while the radiolunate joint is spared. Which ligament is primarily responsible for preserving the radiolunate articulation in the typical SLAC wrist progression?

A 55-year-old female undergoes volar locking plate fixation for a displaced distal radius fracture. Six months postoperatively, she suddenly loses the ability to actively flex her thumb interphalangeal joint. This complication is most directly related to plate placement in relation to which anatomic landmark?

During the surgical management of a severely comminuted radial head fracture, the radial head is deemed unsalvageable and is excised without replacement. Three months postoperatively, the patient returns with progressive ulnar-sided wrist pain, grip weakness, and proximal migration of the radius seen on radiographs. Injury to which anatomic structure was most likely missed initially?

A 40-year-old female sustains a high-energy fall, resulting in an acute, highly comminuted, irreparable radial head fracture and severe wrist pain. Examination reveals a positive ulnar variance and distal radioulnar joint (DRUJ) instability. What is the most appropriate initial surgical management?

A 50-year-old patient sustains a volar Barton's fracture, which is an intra-articular fracture-subluxation involving the volar rim of the distal radius. The carpus displaces volarly with the fracture fragment. The carpus remains securely tethered to this volar distal radius fragment primarily due to the intact attachment of which of the following ligaments?