7. Hand and Wrist MCQs

A 42-year-old male sustains a puncture wound to his index finger. Two days later, he presents with symmetric digit swelling, flexed resting posture, tenderness along the flexor sheath, and severe pain with passive extension. Which organism is the most common cause of this condition, and what is the definitive management?

A 28-year-old skier falls while holding a ski pole, forcibly abducting his thumb. Examination shows gross laxity of the thumb MCP joint with valgus stress in 30 degrees of flexion. MRI confirms a Stener lesion. What anatomical structure is interposed between the ruptured ends of the ligament?

Which of the following is the most common site of ulnar nerve compression leading to cubital tunnel syndrome?

A 65-year-old woman sustains a displaced, non-operatively managed distal radius fracture. Eight weeks later, she presents with inability to actively extend her thumb interphalangeal joint, secondary to tendon rupture around Lister's tubercle. In which extensor compartment does this ruptured tendon normally travel?

A 35-year-old carpenter suffers a deep laceration at the level of the proximal carpal tunnel, completely transecting the median nerve. Which of the following intrinsic muscles of the hand would lose its innervation as a direct result?

You are reviewing axial CT imaging of the upper extremity. In the proximal forearm, the median nerve passes between the two heads of the pronator teres. Which of the following structures passes between the ulnar and humeral heads of the flexor carpi ulnaris (FCU)?

During a pre-operative imaging review for a severe cubital tunnel syndrome extending into the wrist, an axial MRI highlights Guyon's canal. Which structure forms the floor of this anatomic tunnel?

In evaluating an axial MRI of the wrist for ulnar tunnel syndrome, which anatomical structure serves as the floor of Guyon's canal?

During an in situ decompression of the ulnar nerve at the elbow, the surgeon must release a distinct fascial band that bridges the two heads of the flexor carpi ulnaris (FCU) from the medial epicondyle to the olecranon. What is the name of this structure?

A deep laceration to the palm severs the deep motor branch of the ulnar nerve. This injury will result in direct denervation of which of the following lumbrical muscles?

A 55-year-old woman underwent volar locking plate fixation for a distal radius fracture 6 months ago. She now presents with an inability to actively flex the interphalangeal joint of her thumb. She reports a sudden pop without significant trauma. What is the most likely cause?

A 65-year-old female presents with wrist pain after a fall. Radiographs reveal a volar Barton's fracture of the distal radius. Which of the following describes the pathognomonic feature of this fracture pattern?

A 60-year-old female presents with a wrist injury after falling on an outstretched hand. Radiographs reveal a fracture of the volar lip of the distal radius with volar subluxation of the carpus along with the fracture fragment. Which of the following describes the fundamental mechanical instability of this fracture?

A 22-year-old male presents with chronic wrist pain and is diagnosed with a scaphoid nonunion demonstrating a humped back deformity and avascular necrosis of the proximal pole on MRI. Which of the following graft options is most appropriate to restore scaphoid length, correct the deformity, and address the avascular necrosis?

Madelung deformity results from a localized growth disturbance of the volar-ulnar aspect of the distal radius physis. This condition is characterized by a tethering anomalous ligament known as:

A 5-year-old sustains an injury to the elbow. Radiographs reveal a displaced lateral condyle fracture.

Which of the following is a classic long-term complication associated with an untreated nonunion of this fracture type?

A 10-year-old boy sustains a medial epicondyle fracture of the humerus following a fall. Which of the following represents an absolute indication for open reduction and internal fixation?

A 6-year-old boy sustains a completely displaced extension-type supracondylar humerus fracture.

Following closed reduction and percutaneous pinning, he cannot flex his interphalangeal joint of the thumb and the distal interphalangeal joint of the index finger. Which nerve is most likely injured?

A patient sustains a deep laceration to the mid-palm, resulting in pulsatile bleeding from the deep palmar arch. Anatomically, the deep palmar arch is primarily formed by the terminal continuation of the radial artery. How does the radial artery anatomically enter the deep palm to form this arch?