Ortho Forearm, wrist, hand

Question 1

Incomplete fracture with cortical disruption and periosteal tearing on the convex side of the fracture (intact periosteum on the concave side) “bowing”

Answer 1

Greenstick fx

Question 2

Incomplete fracture with wrinkling or bump on the metaphyseal-diaphyseal junction (where the dense bone meets the more porous bone) due to axial loading.

Answer 2

Torus (buckle fx)

Question 3

Most common site of radial nerve injury

Answer 3

humerus Fx

Question 4

Tx for humerus fx

Answer 4

sugar tong splint

Question 5

What fx can potentially cause a median nerve, brachial artery and radial nerve injury?

Answer 5

Supracondylar Fracture

Question 6

Tx for nondisplaced Supracondylar Fx

Answer 6

splint

Question 7

Tx for radial head Fx

Answer 7

sling + long arm splint 90 degrees

Question 8

Tx for nursemaids elbow

Answer 8

supination-flextion technique

Question 9

How does a nightstick Fx happen?

Answer 9

direct blow

Question 10

Isolated fractures of the ulna, typically transverse and located in the mid-diaphysis and usually resulting from a direct blow.

Answer 10

Nightstick (ulnar shaft) Fx

Question 11

Proximal Ulnar shaft Fx with radial head dislocation

Answer 11

Monteggia Fx

“GRUM”: Galeazzi, Radius and Ulnar, Monteggia

Question 12

What nerve may be injured in a Monteggia Fx?

Answer 12

Radial Nerve (wrist drop)

Question 13

Tx for Monteggia Fx

Answer 13

ORIF

Question 14

Distal radial shaft fracture with dislocation of the ulnar-radial joint

Answer 14

Galeazzi Fx

Question 15

Cubital Tunnel Syndrome effects which nerve?

Answer 15

Ulnar Nerve: tingling and numbness in 1/2 of 3rd, 4th and 5th digits

Question 16

PE will show what for cubital tunnel syndrome

Answer 16

+tinels sign

+ Fromen’t sign

Question 17

What is a + froments sign

Answer 17

seen in cubital tunnel syndrome

pt grasps paper between pointer finger and thumb and pt not able to hold paper when paper pulled away by provider

Question 18

T for cubital tunnel syndrome

Answer 18

wrist immobilization w/sleep, NSAIDS

Question 19

inflammation of tendon insertion of extensor carpi radialis brevis

Answer 19

Tenis Elbow (Lateral epicondylitis)

Question 20

inflammation of pronator teres-flexor carpi radialis

Answer 20

Medial Epicondylitis (Golfers elbow)

Question 21

Lateral epicondylitis Presentation

Answer 21

pain w/gripping, pronating forearm & wrist extension

Question 22

Medial epicondylitis Px

Answer 22

pain w/ wrist flexion against resistance & worse with pulling activities

Question 23

MC type of elbow dislocation (opposite of MC shoulder D/L)

Answer 23

Posterior

Question 24

Pt presents with flexed elbow & marked olecranon prominence

Answer 24

Elbow dislocation

Question 25

Tx for elbow dislocation

Answer 25

**Emergent reduction!! Posterior splint**

Question 26

What nerve injuries must you rule out with an **elbow dislocation**?

Answer 26

**brachial artery & median/ulnar/radial nerve injury**

Question 27

Complication with scaphoid Fx

Answer 27

avascular necrosis

Question 28

anatomical snuffbox tenderness w/ what Fx?

Answer 28

scaphoid Fx

Question 29

Scaphoid Fx Tx

Answer 29

thumb spica

Question 30

Scapholunate dissociation tx

Answer 30

radial gutter splint

Question 31

dinner fork deformity

Answer 31

colles fracture

Question 32

dorsal posterior angulation in wrist fracture

Answer 32

colles fracture (dinner fork Deformity)

Question 33

Diagnosis for Colles and Smith FX

Answer 33

Lateral X ray so you can differentiate between Colles and Smith

Question 34

garden spade deformity

Answer 34

smith fx

Question 35

ventral anterior angulation of this wrist fracture

Answer 35

smith fracture (garden spade deformity)

Question 36

complication of colles Fx

Answer 36

extensor pollicus longus tendon rupture

Question 37

complication of smith fracture

Answer 37

Median nerve injury: can develop into carpal tunnel syndrome

Question 38

Tx for colles and smith fx

Answer 38

sugar tong splint/cast ORIF if unstable or communited

Question 39

piece of pie sign

Answer 39

lunate dislocation

Question 40

lunate D/L

Answer 40

lunate doesn't articulate with capitate or radius

Question 41

tx for lunate dislocation

Answer 41

unstable: ORIF

Question 42

what is the most serious carpal fracture

Answer 42

lunate fracture

Question 43

kienbocks disease

Answer 43

avascular necrosis of lunate bone

Question 44

sudden blow to tip of an extended finger with forced flexion

Answer 44

mallet (baseball) finger

Question 45

entensor tendon avulsion

Answer 45

mallet (baseball) finger

Question 46

inability to straighten the distal finger (flexed at DIP joint)

Answer 46

mallet (baseball) finger

Question 47

Tx for **mallet finger**

Answer 47

**splint the DIP in uninterrupted extension** x 6 weeks

Question 48

finger flexed @ PIP joint & hyperextended @ DIP joint

Answer 48

Boutonneire deformity

Question 49

finger hyperextended @PIP joint & flexed @ DIP joint

Answer 49

Swan neck deformity

Question 50

sprain or tear of **ulnar collateral ligament of the thumb**--\> instability of MCP joint

Answer 50

Gamekeepers (skiers) thumb

Question 51

difff between skiers thumb and gatekeepers thumb

Answer 51

skiers thumb: acute gamekeepers: chronic hyperabduction injury

Question 52

thumb far away from other digits especially with valgus stress

Answer 52

gamekeepers thumb

Question 53

tx for gamekeepers thumb

Answer 53

thumb spica

Question 54

Fracture of the neck of 5th metacarpal

Answer 54

boxer's Fx

Question 55

Tx for boxer's Fx

Answer 55

ulnar gutter splint

Question 56

**intraarticular fracture** through the base of the 1st metacarpal (MCP) bone

Answer 56

bennet's fracture

Question 57

comminuted Bennett's fracture

Answer 57

Rolando's fracture

Question 58

SALTR Harris classification

Answer 58

S: Same A: Above L: Lower T: Through R: Rammed

Question 59

SALTR HARRIS classification is used for which fractures?

Answer 59

growth (epiphyseal) plate fractures

Question 60

MC SALTR HARRIS Fx

Answer 60

Type II: growth plate fx + fx of metaphysis (good prognosis)

Question 61

de quervain tenosynovitis

Answer 61

stenosing tenosynovitis of the abductor pollicus longus (APL) and extensor pollicus brevus (EPB)

Question 62

pain along radial aspect of wrist radiating to forearm

Answer 62

de quervain tenosynovitis

Question 63

+ finkelstein test

Answer 63

pain w/ulnar deviation or thumb extension

Question 64

Tx for de quervain tenosynovitis

Answer 64

thumb spica splint

Question 65

Obtain repeat radiographs in 2 weeks for what fracture?

Answer 65

scaphoid fx