Facts from Questions

Question 1

management of acute injuries of sagittal bands?

Answer 1

in normal people can be treated with extension splinting

in professional athletes, acute open repair

Question 2

indication for collagen conduits:

Answer 2

small (<4cm) defects in small diameter, simple sensory nerves
- for most everything more complex, choose autograft (sural or MABC)

Question 3

proper collateral ligament of the digits:

Answer 3

restraint to varus/valgus with joint in flexion

Question 4

accessory collateral ligament of the digits:

Answer 4

restraint to varus/valgus with joint in extension

Question 5

sural artery pedicle is to the:

Answer 5

gastrocnemius - both medial and lateral heads.

85% of the time there isa single vascular supply

Question 6

what causes swan neck deformity?

Answer 6

chronic volar plate ruptures

Question 7

utility of basal joint injections for OA?

Answer 7

no difference between cortisone, hyaluronan, and saline

Question 8

indications for a Darrach procedure?

Answer 8

only in low demand elderly patients

DRUJ arthritis/instabilty

Question 9

best treatment for heavy laborers with DRUJ OA and TFCC insufficiency?

Answer 9

TFCC reconstruction and ulnar hemiresection arthroplasty

Question 10

most common causes of radial tunel syndrome:

Answer 10

• fibrous adhesions between brachialis and BR
• the leash of henry (radial recurrent vessels)
• fibrous edge of ECRB
• arcade of frohse (supinator arch)
• fibrous distal edge of supinator

Question 11

best tendon transfers for PIN palsy:

Answer 11

FCR to the common digital extensors

PL to the EPL

Question 12

Leri-Weill Dyschondrosteosis:

Answer 12

• bilateral Madelung deformities

- SHOX gene mutation

Question 13

SHOX gene mutation is:

Answer 13

Leri-Weill dyschondrosteosis

Question 14

treatment of volar PIP dislocations

Answer 14

reduction and extension splinting for 6 weeks

- frequently with central slip injuries, and if not splinted can lead to boutonniere deformities

Question 15

Merkels skin receptor

Answer 15

• light touch
• pressure
• 2-point discrimination

Question 16

Pacinian corpuscles

Answer 16

• stretching of skin

Question 17

Meisner’s corpuscles

Answer 17

• rapid response to light touch

Question 18

detection of fanconi anemia?

Answer 18

• CBC
• peripheral blood smear
• DNA breakage analysis

Question 19

Apert’s syndrome

Answer 19

facial dysmorphism and complex syndactyly of hands

- FGFR2 mutant

Question 20

FGFR2 mtuation causes

Answer 20

Apert’s syndrome

Question 21

SHH mutations cause:

Answer 21

radial longitudinal deficiencies

Question 22

best flap for defects of the dorsal thumb?

Answer 22

first dorsal metacarpal artery flap (Kite flap/FDMA)

Question 23

outcomes after pisiformectomy?

Answer 23

no deficiency in grip strength, power, or wrist motion

Question 24

after carpal tunnel release, grip and pinch strength should return to normal by:

Answer 24

3 months

Question 25

island volar advancement flaps to the thumb tip can be used for defects up to size:

Answer 25

3.5cm

Question 26

How long does it take split thickness skin graft to re-epithelialize

Answer 26

2-3 weeks

Question 27

Primary pathologic cell in Giant Cell Tumor of Tendon Sheath:

Answer 27

lipid laden foam cell | - disordered cellular lipid metabolism

Question 28

Role of TGF-b in Dupuytren contracture

Answer 28

TGF-b encourages differentiation of myofibroblasts (from fibroblasts) which are the contractile cell type in Dupuytren's

Question 29

Apical ectodermal ridge

Answer 29

controls longitudinal forearm growth | - express Homeobox proteins

Question 30

Wnt signalling in limb development

Answer 30

controls volar/dorsal differentiation

Question 31

Role of Sonic Hedgehog Protein in limb development

Answer 31

controls radio-ulnar differentiation | - ulnar forearm and ulnar 4 digits

Question 32

Principal function of the sagittal bands?

Answer 32

extension of the MP joint

Question 33

Recurrence rates of giant cell tumor of tendon sheath

Answer 33

4-44% - worse with extensive bone involvement, spread to tendons or joint capsule - can consider radiation for extensive disease

Question 34

Most common Martin Gruber anastomosis

Answer 34

type 1 - motor median to ulnar, innervating median intrinsics

Question 35

Which ligament's humeral origin is at the axis of rotation of the elbow

Answer 35

lateral ulnar collateral | - it is isometric and maintains static tension throughout elbow ROM

Question 36

Lipoma arborescens

Answer 36

tumor with frondlike projections histo wtih mature lipocytes suprapatellar or in the elbow replacemnt of the synovial lining with pathologic lipocytes

Question 37

Lack of thumb development would typically be caused by:

Answer 37

SHH concentration abnormally in the anterior region of the ZPA. - typically concentrated in the posterior region of the ZPA which corresponds to the ulna and ulnar 4 digits differentiation - if concentrated whre the thumb wil ldevelop, will fuck up the thumb