pathology

Question 1

Leddy type 1 jersey finger

Answer 1

FDP tendon retracted to palm, disruption of vascular supply

Question 2

Leddy type 2 jersey finger

Answer 2

FDP retracts to level of PIP joint

Question 3

Leddy type 3 jersey finger

Answer 3

large avulsion fracture limits retraction to level of DIP joint

Question 4

Leddy type 4 jersey finger

Answer 4

osseous fragment and simultaneous avulsion of tendon from fragment, tendon retracts into palm

Question 5

what tendon can be transferred to repair a chronic EPL rupture?

Answer 5

EIP

Question 6

when are tendon repairs weakest?

Answer 6

POD 6-12

Question 7

what is mallet finger?

Answer 7

disruption of the terminal extensor tendon distal to the DIP joint

Question 8

what is an absolute indication for ORIF or CRPP of a mallet finger?

Answer 8

volar subluxation of distal phalanx

Question 9

what exam finding is typical in sagittal band rupture

Answer 9

ability to maintain MCP extension after passive extension

Question 10

what is the first disruption in lunate dislocation?

Answer 10

scapholunate ligament disrupted

Question 11

what is a Mayfield 1 lunate dislocation?

Answer 11

scapholunate dissociation

Question 12

what is a Mayfield 2 lunate dislocation?

Answer 12

scapholunate dissociation + lunocapitate disruption

Question 13

what is a Mayfield 3 lunate dislocation?

Answer 13

scapholunate dissociation + lunocapitate disruption + lunotriquetral disruption

Question 14

what is a Mayfield 4 lunate dislocation?

Answer 14

scapholunate dissociation + lunocapitate disruption + lunotriquetral disruption + lunate dislocation

Question 15

which direction does the lunate usually dislocate and what is it associated with?

Answer 15

volar, a/w median nerve compression

Question 16

what is the best xray view to see a hook of hamate fracture?

Answer 16

carpal tunnel view

Question 17

what is a milch type 1 fracture?

Answer 17

hook of hamate fracture

Question 18

what is a milch type 2 fracture?

Answer 18

body of hamate fracture

Question 19

why should you avoid longitudinal traction during closed reduction of an MCP dislocation?

Answer 19

could pull the volar plate in and make it irreducible

Question 20

which muscles provide deforming forces in base of thumb fractures?

Answer 20

APL, EPL, adductor pollicis

Question 21

bennett fracture

Answer 21

intra-articular fracture with a palmar radial fragment

Question 22

rolando fracture

Answer 22

Y or T shaped complete intra-articular fracture

Question 23

what structure is damaged in a thumb CMC dislocation?

Answer 23

dorsoradial ligament torn, anterior oblique ligament is intact but peeled off the first metacarpal base

Question 24

what is a felon?

Answer 24

subcutaneous abscess of the fingertip pulp

Question 25

what bug is most common in a felon?

Answer 25

staph aureus, gram negative in immunosuppressed, eikenella in diabetics who bite their nails

Question 26

what are the kanavel signs?

Answer 26

signs of flexor teno 1. flexed posturing of involved digit 2. TTP over tendon sheath 3. marked pain with passive extension 4. fusiform swelling of digit

Question 27

what are primary indications for finger replantation?

Answer 27

thumb at any level, multiple digits, through the palm, wrist level or proximal to the wrist, almost anything in children

Question 28

what is the blood supply in a medial gastroc flap?

Answer 28

medial sural artery

Question 29

what is the blood supply in a gracilis flap?

Answer 29

medial femoral circumflex artery

Question 30

what is the blood supply and nerve at risk in a groin flap?

Answer 30

blood supply = superficial circumflex iliac artery, nerve = lateral femoral cutaneous nerve

Question 31

what are the potential sites of entrapment in pronator syndrome?

Answer 31

supracondylar process, ligament of struthers, lacertus fibrosus, between ulnar and humeral heads of pronator teres, FDS aponeurotic arch

Question 32

what nerve is compressed in pronator syndrome?

Answer 32

median

Question 33

most common sites of entrapment in cubital tunnel syndrome

Answer 33

between 2 heads of FCU/aponeurosis, within Arcade of Struthers, between Osborne's ligament and MCL

Question 34

most common cause of ulnar tunnel syndrome

Answer 34

ganglion cyst

Question 35

what are the possible sites of compression in PIN syndrome?

Answer 35

between brachialis and brachioradialis, Leash of Henry, edge of ECRB, Arcade of Frohse, distal edge of supinator

Question 36

what is radial tunnel syndrome?

Answer 36

compressive neuropathy of the PIN with only pain, no sensory/motor dysfunction

Question 37

where is the point of max tenderness in radial tunnel syndrome?

Answer 37

3-5 cm distal to lateral epicondyle

Question 38

what is wartenberg's syndrome?

Answer 38

compressive neuropathy of the superficial radial sensory nerve

Question 39

what can cause intrinsic minus hand?

Answer 39

ulnar or median nerve palsy, charcot-marie-tooth

Question 40

what is the mechanism of a boutonierre deformity?

Answer 40

rupture of the central slip over the PIP joint

Question 41

what is the primary lesion in a swan neck deformity?

Answer 41

lax volar plate that allows hyperextension of PIP

Question 42

what causes the quadrigia effect?

Answer 42

functional shortening of the FDP tendon (FDP of long, middle, and ring finger share a common muscle belly, excursion is equal to shortest tendon)

Question 43

what causes trigger finger?

Answer 43

entrapment of the flexor tendon at the A1 pulley

Question 44

what is the inheritance pattern of dupuytrens?

Answer 44

autosomal dominant with variable penetrance

Question 45

what is the dominant cell type in dupuytrens?

Answer 45

myofibroblasts

Question 46

what is intersection syndrome and what causes it?

Answer 46

inflammation at crossing points of 1st and 2nd dorsal compartments, repetitive wrist motion