Test on Pediatric Congenital Thumb Deformities

Question 1: During pollicization, only nonabsorbable suture material is used for the fixation of the index MP joint into hyperextension.

A. Ano

B. Ne

Explanation: Fixation of the index MP joint into hyperextension is achieved with a nonabsorbable suture placed through the epiphysis and dorsal capsule. Additionally, a double-ended Kirschner wire is driven through the metacarpal physis and out the PIP joint or end of the thumb for easy fixation and thumb positioning.

Question 2: According to the provided study materials, what are the key objectives for the skin incision and subsequent web space management during a pollicization procedure?

A. To allow for glabrous skin coverage along the palmar aspect of the pollicized digit.

B. To create a thumb-index web space and provide adequate exposure of all structures.

C. To ensure adequate coverage without scar formation in the new thumb-index web space.

D. To prevent buckling of the flexor tendons by releasing the first annular pulley to the index finger.

Explanation: The study materials state that the skin incision is for "Creation of a thumb-index web space, adequate exposure of all structures Ezaki design" and "to allow glabrous skin coverage along the palmar aspect of the pollicized digit." Additionally, it mentions "Adequate coverage without scar in the thumb-index web space" as a goal for skin inset. Releasing the first annular pulley, however, is a separate step mentioned to "Prevent buckling of the flexor tendons" and is not a direct objective of the skin incision or web space management itself.

Question 3: Pollicization is the procedure of choice for type IIIB, IV, and V hypoplasia.

A. Ano

B. Ne

Explanation: The study materials state that pollicization is the procedure of choice for type IIIB, IV, and V hypoplasia.

Question 4: According to the study materials, which of the following conditions can be associated with a triphalangeal thumb?

A. Holt-Oram syndrome

B. Fanconi's anemia

C. Polysyndactyly

D. Type IIIB thumb hypoplasia

Explanation: The study materials state that a triphalangeal thumb can be associated with systemic abnormalities such as Holt-Oram syndrome or Fanconi’s anemia. It can also occur with other congenital differences like polysyndactyly or thumb hypoplasia. Therefore, options 0, 1, and 2 are correct. The material mentions 'thumb hypoplasia' generally as an associated congenital difference, not specifically 'Type IIIB thumb hypoplasia' in the context of triphalangeal thumb associations.

Question 5: Persistent instability after pediatric thumb surgery rarely requires further surgical intervention, such as ligament reconstruction or arthrodesis.

A. Ano

B. Ne

Explanation: Persistent instability combined with limited motion requires ligament reconstruction or arthrodesis to reliably restore stability and alignment.