7. Hand and Wrist MCQs

A 60-year-old woman falls on an outstretched hand, sustaining a volar Barton's fracture of the distal radius. Which of the following best describes this fracture pattern and its optimal management?

A 25-year-old male sustains a proximal pole scaphoid fracture. Which of the following best describes the primary vascular supply to the scaphoid that makes this fracture prone to nonunion and avascular necrosis?

A 65-year-old woman is 6 months post-ORIF of a distal radius fracture with a volar locking plate. She presents with inability to actively flex the interphalangeal joint of her thumb. What is the most likely cause of this complication?

During open reduction and internal fixation of a complex intra-articular distal radius fracture using a volar extended flexor carpi radialis (FCR) approach, the surgeon identifies a displaced radial styloid fragment. Releasing the insertion of which of the following muscles is most critical to neutralize the primary deforming force on this specific fragment?

During the treatment of a distal radius fracture via a volar Henry approach, a prominent volar plate is placed distal to the watershed line (Soong grade 2). Which of the following complications is the patient at the highest risk of developing?

Six months following volar locking plate fixation of a distal radius fracture, a 60-year-old female presents with a sudden inability to actively flex the interphalangeal joint of her thumb. Which of the following technical errors during the index procedure is the most likely cause of this complication?

A 6-year-old boy falls from monkey bars and sustains an extension-type supracondylar humerus fracture. Radiographs show posteromedial displacement of the distal fragment. Which nerve is at the highest risk of injury from the proximal metaphyseal spike?

A 50-year-old woman presents with numbness in her right ring and small fingers, along with weakness in hand grip. Which of the following physical examination findings would best differentiate a C8 radiculopathy from cubital tunnel syndrome?

A professional football player sustains a forceful hyperextension injury to his great toe. MRI confirms a complete tear of the plantar plate with proximal retraction of the sesamoids. What is the most appropriate surgical management?

Following a severe crush injury to the forearm, a patient exhibits a complete median nerve palsy. According to the Sunderland classification, a third-degree peripheral nerve injury is characterized by the disruption of the axon and which other structural layer, while the perineurium remains intact?

A 45-year-old man presents with an inability to actively extend his digits at the metacarpophalangeal joints, but he retains normal wrist extension with radial deviation. Entrapment of the involved nerve is most likely to occur at which of the following anatomic structures?

A 45-year-old male presents with an inability to extend his thumb and digits at the metacarpophalangeal joints. Wrist extension is preserved but deviates radially. He has no sensory deficits. The most likely site of nerve compression is:

A 24-year-old man sustains a scaphoid waist fracture. He is at high risk for avascular necrosis of the proximal pole. The primary blood supply to the proximal pole of the scaphoid is derived from which of the following arteries?

A 45-year-old woman presents with vague forearm pain, weakness of the flexor pollicis longus, and numbness in the radial three and a half digits. Radiographs show a bony spur on the anteromedial distal humerus. Which structure is compressed as it passes under the Ligament of Struthers?

A 45-year-old woman with rheumatoid arthritis presents with an inability to extend her thumb. She is diagnosed with a ruptured extensor pollicis longus (EPL) tendon. The EPL tendon travels through which extensor compartment of the wrist, and what bony landmark serves as a pulley for it?

A patient presents with an isolated compression neuropathy of the posterior interosseous nerve (PIN). The most common site of compression is the arcade of Frohse, which is formed by the proximal tendinous edge of which muscle?

When decompressing the ulnar nerve at the wrist in Guyon's canal, a precise understanding of the boundaries is essential. Which of the following accurately describes a boundary of Guyon's canal?

A rock climber presents with a "bowstringing" deformity of the ring finger flexor tendons following a sudden snap during a dynamic climbing move. Which two annular pulleys are biomechanically most critical to prevent this bowstringing?

During surgical repair of a zone II flexor tendon laceration in the index finger, preservation or reconstruction of specific pulleys is critical to prevent bowstringing. Which two pulleys are considered the most biomechanically essential?

While performing a volar approach to the proximal radius (Henry approach), the surgeon must carefully identify and protect the median nerve. Between which two muscle bellies does the median nerve typically pass as it exits the cubital fossa?