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Hand Surgery & Upper Extremity Reconstruction Flashcards

7 cards from real ABPS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. In digital replantation, what is the recommended sequence for structural repair?

    Answer: Bone fixation → Tendons → Arteries → Veins → Nerves

    The standard replantation sequence is bone shortening/fixation, extensor then flexor tendon repair, arterial anastomosis, venous anastomosis, nerve repair, and skin closure to minimize ischemia time and allow stable structural repair before revascularization.

  2. De Quervain's tenosynovitis is caused by stenosis of which dorsal compartment of the wrist?

    Answer: First dorsal compartment (APL and EPB)

    De Quervain's tenosynovitis involves inflammation and stenosis of the first dorsal compartment containing the abductor pollicis longus and extensor pollicis brevis.

  3. Dupuytren's contracture most commonly involves which digit first?

    Answer: Ring finger

    Dupuytren's contracture most frequently affects the ring finger (followed by the little finger), causing flexion contracture at the MCP and PIP joints due to palmar fascial cord formation.

  4. Which clinical test is specifically used to evaluate triangular fibrocartilage complex (TFCC) tears?

    Answer: Ulnar fovea sign

    The ulnar fovea sign (tenderness at the fovea between the ulnar styloid and FCU tendon) is sensitive and specific for TFCC peripheral tears and foveal disruptions.

  5. Which factor carries the greatest prognostic significance in high-pressure injection injuries of the hand?

    Answer: Type of injected material

    The type of injected material is the most important prognostic factor; organic solvents and paint cause severe tissue necrosis and amputation rates >50%, while grease and water-based fluids are less destructive.

  6. In trigger finger (stenosing tenosynovitis), which pulley is most commonly responsible for the triggering phenomenon?

    Answer: A1 pulley

    The A1 pulley at the level of the MCP joint is the most common site of constriction in trigger finger, causing the flexor tendon nodule to catch during flexion and extension.

  7. What is the recommended treatment for an acute scaphoid waist fracture with displacement greater than 1 mm?

    Answer: Surgical fixation with a headless compression screw

    Displaced scaphoid waist fractures (>1 mm) require surgical fixation with a headless compression screw (e.g., Herbert screw) to restore alignment, improve union rates, and allow earlier mobilization.