Hand

Question 1

List the extensor compartments of the wrist/hand.

Answer 1

1 - EPB, APL (De Quervain's)
2 - ECRL, ECRB (Intersection)
3 - EPL
4 - EDC, EIP
5 - EDM
6 - ECU

Question 2

Which portion of the SL ligament is the strongest?

Answer 2

Dorsal

SL injuries cause DISI; dorsal dorsal

Question 3

Which portion of the LT ligament is strongest?

Answer 3

Volar

LT injuries cause VISI; volar volar

Question 4

Describe the stages of SLAC wrist.

Answer 4

Watson
Stage 1: OA at radial styloid & scaphoid
Stage 2: OA at entire radio-scaphoid facet
Stage 3: OA at luno-capitate articulation

Question 5

Describe how to measure the SL angle.

Answer 5

Lateral wrist radiograph. One line down the long axis of the scaphoid. One line perpendicular to the poles of the lunate. Normal is 30-60. Over 60 is DISI, under 30 is VISI

Question 6

Describe the Giessler Classification of wrist ligament tears.

Answer 6

Arthroscopic classification scheme.
Grade 1: some attenuation, hemmorhage on the RC side, MC side is normal
Grade 2: partial tear on RC side
Grade 3: complete tear, can get a probe through
Grade 4: complete tear, can drive a scope through

Question 7

VISI deformity posture requires which two ligaments to be disrupted?

Answer 7

LT (volar fibers are stronger) and DRC ligament

Question 8

Lack of compound muscle action potentials (CMAPs) on neuromotor testing is indicative of what?

Answer 8

Chronic denervation, and likely inability of muscle to be reinnervated, even with axonal regeneration.

Question 9

Cross finger flap indications?

Answer 9

Full thickness volar finger tip injuries.

Question 10

Reverse cross finger flap indications?

Answer 10

Full thickeness dorsal finger tip injuries.

Question 11

What is the deforming force on a 5th CMC dislocation?

Answer 11

ECU pulls the base of the 5th metacarpal dorsally and proximally

Question 12

Draw the brachial plexus

Answer 12

Did you do it? Nerd

Question 13

Review the Leddy Packer Classification?

Answer 13

Classification for Zone 1 FDP ruptures:
Type 1: Retraction to the palm, vascular supply torn, needs early repair
Type 2: Retraction to PIPJ
Type 3: Large avulsion fracture, limits retraction to the DIPJ
Type 4: Avulsion and rupture (double rupture)
Type 5: Comminuted tip

Question 14

Describe transient ischemia of the lunate following a lunate or perilunate?

Answer 14

Transient, non-symptomatic ischemia of the lunate following perilunate injuries. Rarely progresses to symptomatic or sustained issues, as in Kienbock’s

Question 15

What is the preferred approach for PIPJ arthroplasty?

Answer 15

Volar (versus dorsal) approach with a silicone implant results in best motion, lowest extensor lag, lowest revision rates.

Question 16

Position of greatest stability for dynamic ECU subluxation?

Answer 16

Pronation, extension radial deviation is the position patients should be splinted in