7. Hand and Wrist MCQs

An otherwise healthy 37-year-old man fell off the flatbed of a delivery truck and landed directly on his dominant left hand. Surgical stabilization of a distal radius fracture is performed. An intraoperative radiograph is shown in Figure 22. What is the next most appropriate step in management?

Portions of which of the following normal structures help compose the spiral cord seen in Dupuytren's contracture?

A 66-year-old woman was a restrained passenger in an automobile accident. She sustained a direct blow to her nondominant left hand as the airbag in her automobile deployed and she now reports pain, swelling, and difficulty moving her fingers. Radiographs are shown in Figures 58a and 58b. Appropriate definitive treatment should consist of

Six weeks after undergoing closed reduction and cast application for a nondisplaced distal radius fracture, a 55-year-old woman suddenly loses the ability to actively extend her thumb at the interphalangeal joint. She denies any new trauma. What is the most appropriate definitive management?

A 24-year-old man has a displaced waist fracture of the scaphoid.

You plan for percutaneous fixation and request a CT scan to accurately evaluate the fracture morphology and degree of humpback deformity. To optimally visualize the true anatomy, the CT scan images should be reconstructed in which of the following planes?

A 65-year-old woman underwent volar locking plate fixation for a displaced intra-articular distal radius fracture six months ago.

She presents to the clinic complaining of a sudden inability to actively lift her thumb off the table when the hand is resting flat. Which of the following technical errors during the index procedure is the most likely cause of this complication?

A 65-year-old right-hand-dominant woman is treated nonoperatively in a short arm cast for a nondisplaced distal radius fracture.

Six weeks post-injury, her cast is removed, and she immediately notes an inability to actively extend the interphalangeal joint of her right thumb, with her thumb adopting a dropped posture. What is the most appropriate surgical management?

A 65-year-old woman is seen in the outpatient clinic 6 weeks after sustaining a non-displaced distal radius fracture treated with a short arm cast. She now complains of a sudden inability to actively extend the interphalangeal joint of her thumb. She denies any new trauma. What is the most appropriate definitive surgical management for her condition?

A 65-year-old woman falls on her outstretched dominant hand and sustains a distal radius fracture. Closed reduction is performed in the emergency department. Which of the following post-reduction radiographic parameters falls outside the acceptable criteria for nonoperative management in an active adult?

A 55-year-old woman sustains a highly comminuted intra-articular distal radius fracture. She undergoes open reduction and internal fixation with a volar locking plate. To minimize her risk of developing post-traumatic radiocarpal arthrosis, which of the following radiographic parameters is most critical to accurately restore?

A 55-year-old man sustains a perilunate dislocation and undergoes open reduction and ligament repair. To restore carpal stability, the surgeon identifies and repairs the primary ligamentous stabilizers. Which of the following intrinsic/extrinsic ligaments is considered the primary volar stabilizer of the lunate to the radius?

A 55-year-old woman presents with the inability to flex the interphalangeal joint of her thumb 6 months after undergoing open reduction and internal fixation of a distal radius fracture. Radiographs show a healed fracture, but the volar locking plate is positioned distal to the watershed line of the radius. Which of the following tendons is most likely injured?

A 55-year-old woman is evaluated 4 months after undergoing open reduction and internal fixation of a distal radius fracture with a volar locking plate. She complains of new-onset inability to actively flex the interphalangeal (IP) joint of her thumb. Radiographs reveal the volar plate is positioned distal to the watershed line. What is the most likely cause of her symptom?

A 21-year-old college student fell from a balcony and landed on his outstretched right hand. He is seen in the emergency department 4 hours later and reports wrist pain and diffuse hand numbness. The volar forearm compartment is soft and there is no pain with passive finger extension. Radiographs are shown in Figures 25a and 25b. Definitive treatment should consist of

A 65-year-old woman presents with an isolated closed, highly displaced distal radius fracture. She undergoes closed reduction and splinting in the emergency department. Which of the following nerves is at greatest risk of developing an acute compression neuropathy following this specific injury and manipulation?

Six months after open reduction and internal fixation of a volar Barton's distal radius fracture using a volar locked plate, a 65-year-old female presents with sudden inability to actively flex the interphalangeal (IP) joint of her thumb. What is the most likely etiology of this complication?

A 55-year-old woman undergoes volar locked plating for a displaced intra-articular distal radius fracture. Six weeks postoperatively, she suddenly loses the ability to actively extend her thumb interphalangeal joint. What is the most likely etiology of this complication?

A 60-year-old woman presents to the emergency department after a fall onto an outstretched hand, sustaining a severely displaced, apex volar distal radius fracture. She complains of dense numbness in her thumb, index, and long fingers, and severe pain. What is the most appropriate next step in management?

A 55-year-old female undergoes volar locking plate fixation for a displaced distal radius fracture. Six months postoperatively, she presents with an inability to actively flex the interphalangeal joint of her thumb. Which of the following technical errors most likely contributed to this complication?