Test on Proximal Interphalangeal Joint Injuries and Treatment
PIP Joint Injuries and Treatment: A Student's Guide
Test: PIP joint injury overview, PIP fracture-dislocation treatment, Hand fracture surgery - fractures & ligaments, Hand fracture surgery - fixation & reconstruction, PIP reconstruction and surgery, MCP and thumb joint injuries, UCL / thumb ligament injuries - General Injuries, UCL / thumb ligament injuries - Diagnosis & Types, UCL / thumb ligament injuries - Surgical Repair, UCL / thumb ligament injuries - Rehabilitation & Recovery, UCL / thumb ligament injuries - Reconstruction Procedures, Thumb CMC injuries and surgery
20 questions
Question 1: The differentiation between a Stener lesion and other UCL injuries can usually be made clinically, despite the difficulty in clinically diagnosing a Stener lesion.
A. Ano
B. Ne
Explanation: The study materials state that 'It is crucial to distinguish between acute complete and partial ruptures of the UCL. This differentiation can usually be made clinically'. It also notes that 'Clinical diagnosis of a Stener lesion is difficult', but this difficulty does not preclude the general ability to differentiate between types of UCL injuries clinically.
Question 2: What is the typical mechanism of an acute Ulnar Collateral Ligament (UCL) injury of the thumb among skiers?
A. A direct blow to the ulnar side of the thumb while skiing.
B. Sudden, forced radial deviation (abduction) of the thumb, often resulting from gripping a ski pole during a fall.
C. Repetitive strain from flexing and extending the thumb during long ski runs.
D. Forced adduction of the thumb while attempting to release a ski pole.
Explanation: The study materials state that the mechanism of injury for UCL of the MP joint of the thumb is sudden, forced radial deviation (abduction), often resulting from a fall on an outstretched hand with the thumb abducted. Specifically, in skiing, if a person falls while gripping the ski pole, the handle abducts the thumb.
Question 3: During a pull-out suture technique for UCL repair, the suture ends are tied over the proximal phalanx on the ulnar side.
A. Ano
B. Ne
Explanation: The study materials state that the Keith needles exit percutaneously on the radial side, and the ends of the suture are tied over a felt-padded button or rubber catheter, not directly over the proximal phalanx on the ulnar side.
Question 4: During the open repair of a thumb metacarpophalangeal joint ulnar collateral ligament (UCL) injury, what is specifically observed regarding the adductor aponeurosis when a Stener lesion is present?
A. It is incised transversely to gain access to the joint.
B. It appears as an edematous, rounded mass that may obscure its otherwise well-defined proximal border.
C. It is reflected dorsally to expose the ulnar aspect of the MP joint.
D. It is repaired with a rapidly absorbable suture at the end of the procedure.
Explanation: According to the study materials, when a Stener lesion is present, the adductor aponeurosis appears as an edematous, rounded mass that may obscure its otherwise well-defined proximal border. A longitudinal incision is made in the aponeurosis, and it is reflected volarly, not dorsally. It is also repaired with a slowly absorbable suture, not rapidly absorbable.
Question 5: Stiffness resulting from reattaching the ulnar collateral ligament in a nonanatomic location is primarily avoided by ensuring the patient avoids heavy lifting for 8 weeks post-surgery.
A. Ano
B. Ne
Explanation: Stiffness can be avoided by careful attention to the detail of where the sutures or suture anchors are placed in reattaching the ligament and testing with a single knot so that adjustments can be made as needed, not by avoiding heavy lifting for 8 weeks.