ABPS Hand Surgery & Upper Extremity Reconstruction 3

Question 1

According to Seddon's nerve injury classification, which type involves disruption of axons with an intact endoneurium, allowing spontaneous recovery along the preserved neural tube?

Accepted Answer

Axonotmesis

Answer

In axonotmesis, the axon is disrupted but the endoneurium (and usually perineurium) remains intact, providing a conduit for axon regeneration at approximately 1 mm/day.

Question 2

Radial nerve palsy complicating humeral shaft fractures most commonly results from injury at which anatomical location?

Accepted Answer

Radial (spiral) groove of the humerus

Answer

The radial nerve is most vulnerable in the spiral (radial) groove of the mid-humerus, where it is tethered and directly at risk from midshaft humeral fractures.

Question 3

What is the gold standard technique for peripheral nerve repair when primary tension-free repair is not achievable?

Accepted Answer

Autologous nerve graft (sural nerve)

Answer

Autologous nerve grafting using the sural nerve remains the gold standard for bridging nerve gaps, providing a scaffold with intact Schwann cells and endoneurial tubes to guide axon regeneration.

Question 4

Extensor tendon injuries in Zone VIII (musculotendinous junction) are technically challenging primarily because of which factor?

Accepted Answer

Proximal muscle belly retraction making suture purchase difficult

Answer

At the musculotendinous junction (Zone VIII), the proximal muscle belly retracts and the tissue is friable, making suture fixation technically difficult and increasing the risk of repair failure.

Question 5

When a palmar flexor tendon is exposed without intact paratenon following trauma or infection, which coverage option is most appropriate to achieve durable wound closure?

Accepted Answer

Local or regional vascularized flap

Answer

Exposed tendons without paratenon cannot support skin graft take; vascularized flap coverage (local, regional, or free) provides the necessary blood supply for tendon gliding and long-term durability.

(ABPS) Certified American Board of Plastic Surgery Practice Test

(ABPS) Certified American Board of Plastic Surgery Practice Test

ABPS Hand Surgery & Upper Extremity Reconstruction 3