7. Hand and Wrist MCQs

During a medial epicondylectomy for severe cubital tunnel syndrome, the surgeon releases the compressive structures overlying the ulnar nerve. Which of the following forms the primary roof of the cubital tunnel?

A patient undergoes open carpal tunnel release. Postoperatively, they exhibit profound weakness in thumb opposition but normal thumb interphalangeal joint flexion. The recurrent motor branch of the median nerve was likely injured. This branch typically enters the thenar musculature via which of the following variations?

A 24-year-old gymnast sustains a traumatic tear of the triangular fibrocartilage complex (TFCC). Arthroscopy reveals a tear in the central articular disc. What is the healing potential of this specific region, and what is its vascular supply?

A patient presents with inability to form an "OK" sign with their thumb and index finger, but they have no sensory deficits in the hand. Compression of the anterior interosseous nerve (AIN) is suspected. Which of the following muscles is uniquely innervated by the AIN?

A 45-year-old woman presents with dorsal radial wrist pain. Physical examination reveals tenderness just distal to Lister's tubercle. Ultrasound confirms tenosynovitis of the third extensor compartment. Which of the following muscles acts as the primary motor for the tendon located in this compartment?

A 45-year-old avid cyclist presents with intrinsic muscle weakness and numbness in his ring and small fingers. He is diagnosed with handlebar palsy due to compression in Guyon's canal. Which of the following structures forms the anatomic roof of this canal?

A patient suffers a severe forearm crush injury and subsequently demonstrates an inability to make the 'OK' sign, exhibiting extended distal interphalangeal joints of the thumb and index finger. This specific nerve palsy represents denervation to which muscle group?

During wrist arthroscopy for triangular fibrocartilage complex (TFCC) evaluation, the standard 3-4 portal is established. This portal is placed between which two extensor tendon compartments?

During flexor tendon repair in Zone II, preservation or reconstruction of the pulley system is crucial to prevent mechanical bowstringing. Which of the following pulleys arise directly from the periosteum of the proximal and middle phalanges, respectively?

A patient presents with thenar atrophy and inability to oppose the thumb after suffering a distal radius fracture. The affected nerve most commonly branches from the main nerve at which location relative to the transverse carpal ligament?

A 21-year-old collegiate baseball pitcher elects to undergo ulnar collateral ligament (UCL) reconstruction after failing conservative management. Which nerve must be carefully protected, and potentially transposed, during this procedure?

A 45-year-old man undergoes a single-incision anterior approach for an acute distal biceps tendon repair. During the drilling of the posterior radial cortex for a cortical button, which nerve is at the greatest risk of injury?

A 26-year-old snowboarder falls on an extended wrist and presents with dorsal wrist pain. Radiographs demonstrate a scapholunate interval of 4 mm and a scaphoid ring sign on the AP view. What is the most likely diagnosis?

A 20-year-old collegiate baseball pitcher reports medial elbow pain during the late cocking and early acceleration phases of throwing. Examination reveals a positive moving valgus stress test and distinct paresthesias in the ring and small fingers. MRI confirms a full-thickness ulnar collateral ligament (UCL) tear. What is the recommended surgical management?

A 7-year-old boy presents with progressive valgus deformity of his left elbow and paresthesias in his ring and small fingers. He sustained an elbow fracture at age 3 that was treated nonoperatively. Radiographs show a nonunion of the lateral condyle. Which of the following is the most likely cause of his current neurologic symptoms?

A 5-year-old boy sustains a completely displaced, extension-type supracondylar humerus fracture. He is unable to flex the IP joint of his thumb and the DIP joint of his index finger. Which of the following nerve structures is most likely injured?

A 6-year-old boy presents with a displaced lateral condyle fracture of the humerus (Milch Type II). Open reduction and internal fixation is performed. Which of the following long-term complications is most characteristic if this fracture initially went unrecognized and progressed to nonunion?

A 65-year-old woman is managed conservatively in a cast for a non-displaced distal radius fracture. Eight weeks later, she reports the sudden inability to actively extend her thumb interphalangeal joint. Rupture of which of the following tendons is the most likely cause?

Three months following volar plate fixation of a distal radius fracture, a patient experiences a spontaneous rupture of the flexor pollicis longus (FPL) tendon. What is the most likely technical error leading to this complication?