7. Hand and Wrist MCQs

During diagnostic elbow arthroscopy, the anteromedial portal is frequently established to view the anterior compartment and radiocapitellar joint. Careful creation of this portal is essential to avoid iatrogenic injury. Which of the following nerves is at greatest risk of injury during the placement of the anteromedial portal?

A 35-year-old bodybuilder undergoes a single-incision anterior approach for the repair of an acute distal biceps tendon rupture. Postoperatively, he notes lateral forearm numbness but retains normal motor function of his fingers and wrist. Which neural structure was most likely injured during the exposure?

A 19-year-old collegiate pitcher fails conservative management for a full-thickness proximal ulnar collateral ligament (UCL) tear. He is indicated for surgical reconstruction. Which surgical technique has been shown to minimize the risk of postoperative ulnar neuropathy?

A 35-year-old bodybuilder experiences a sharp pop in his anterior elbow during a heavy deadlift, followed by ecchymosis and weakness in forearm supination. He undergoes a single-incision anterior surgical repair of the distal biceps tendon. Which nerve is at greatest risk of iatrogenic injury during this specific surgical approach?

A 20-year-old collegiate baseball pitcher presents with medial elbow pain and decreased pitching velocity. MRI arthrogram shows a partial tear of the ulnar collateral ligament (UCL) at its distal attachment. After failure of non-operative management, UCL reconstruction is planned. Which nerve is most at risk during this surgical procedure?

A 5-year-old boy is brought in after sustaining a lateral condyle fracture of the humerus. It is displaced by 4 mm on initial radiographs but the parents refuse surgery. Six months later, the fracture goes on to nonunion. If left untreated, what is the most likely long-term neurologic complication?

Following a severe crush injury to the forearm, a patient suffers a Sunderland fourth-degree nerve injury to the median nerve. Which of the following accurately describes the precise histological status of the nerve architecture?

A 45-year-old carpenter presents with inability to make an "OK" sign with his right hand, demonstrating an extended distal interphalangeal joint of the index finger and interphalangeal joint of the thumb. Which of the following muscles is primarily denervated in this patient?

A patient suffers a full-thickness laceration over the volar wrist, transecting the median nerve proximal to the carpal tunnel. Which of the intrinsic hand muscles will lose their innervation as a direct result of this injury?

In a dorsal surgical approach to the distal radius, Lister's tubercle serves as a critical anatomical landmark. Which tendon utilizes this bony prominence as a mechanical pulley to change its line of pull?

In a patient undergoing an ulnar nerve transposition for cubital tunnel syndrome, the surgeon releases the retinacular band spanning the two heads of the flexor carpi ulnaris. This structure, known as Osborne's ligament, connects which two bony landmarks?

A patient presents with an inability to extend the fingers at the metacarpophalangeal joints but maintains normal wrist extension with radial deviation. The nerve responsible for this deficit is most commonly compressed by which of the following structures?

A cyclist presents with numbness and tingling in the small and ring fingers, along with weakness in finger abduction. Entrapment of the affected nerve is suspected within a canal bounded radially by which of the following carpal bones?

During surgical release of de Quervain's tenosynovitis, the surgeon must carefully identify and release the first dorsal extensor compartment. To prevent painful neuroma formation, which nerve must be protected as it courses directly over this compartment?

When decompressing the ulnar nerve at the elbow for cubital tunnel syndrome, the surgeon must trace its course into the forearm. The ulnar nerve enters the forearm by passing between the two heads of which muscle?

A hand surgeon is performing an ulnar nerve decompression at Guyon's canal for a patient with persistent intrinsic weakness. To completely decompress the deep motor branch of the ulnar nerve, the surgeon must trace the nerve as it dives between which of the following two muscles?

In a complete rupture of the ulnar collateral ligament (UCL) of the thumb metacarpophalangeal joint, a Stener lesion prevents conservative healing. This lesion occurs when the torn UCL becomes displaced superficial to the aponeurosis of which muscle?

A 35-year-old mechanic presents with an inability to extend his thumb and fingers at the MCP joints, but retains normal wrist extension and normal sensation in the hand. The nerve responsible for this deficit is most commonly compressed by the proximal edge of the superficial layer of which muscle?

A 40-year-old mother of a newborn undergoes surgical release for refractory De Quervain's tenosynovitis. Which tendons are released, and what is the most common anatomical variation that can lead to surgical failure if unrecognized?

During an in situ ulnar nerve decompression at the elbow, the surgeon releases the roof of the cubital tunnel. The primary fascial structure forming this roof (Osborne's ligament) connects which of the following bony landmarks?