Test on Reconstructive Hand Surgery for Rheumatic Conditions
Reconstructive Hand Surgery for Rheumatic Conditions
Test: Rheumatoid hand surgical practice, Rheumatoid hand clinical disorders, Rheumatic hand conditions, Hand surgery in scleroderma, Tenosynovectomy and tendon disease - Extensor tenosynovitis, Tenosynovectomy and tendon disease - Wrist tenosynovectomy, Tenosynovectomy and tendon disease, Tenosynovectomy and tendon disease - Flexor tenosynovectomy, Tenosynovectomy and tendon disease - Rheumatoid tendon rupture & reconstruction, Tenosynovectomy and tendon disease - Extensor tendon rupture & reconstruction, Tenosynovectomy and tendon disease - Hand tendon reconstruction, Wrist surgery — Rheumatoid conditions, Wrist surgery — DRUJ & ulnar procedures, Wrist surgery — Arthrodesis & fusion techniques, Metacarpophalangeal joint surgery - Rheumatoid disease, Metacarpophalangeal joint surgery - General hand procedures, Metacarpophalangeal joint surgery - Arthroplasty techniques, PIP joint surgery techniques, PIP joint deformity management, Rehabilitation and techniques, Rheumatoid PIP joint treatment, PIP joint arthroplasty, Thumb surgery
20 questions
Question 1: Bringing the lateral bands dorsally is a component of extensor mechanism reconstruction for a moderate boutonnière deformity.
A. Ano
B. Ne
Explanation: For correcting an established boutonnière deformity, the procedures aim to restore extensor power to the PIP joint by shortening the central slip and bringing the lateral bands dorsally. Longitudinal relaxing incisions are made to allow the lateral bands to be brought dorsally and sutured.
Question 2: Which of the following describes a step in the reconstruction of the extensor mechanism involving central slip shortening for a moderate boutonnière deformity?
A. The central slip is divided proximally, leaving a cuff of tendon attached to the base of the middle phalanx.
B. Approximately 1/4 inch (6 mm) of the central slip is excised.
C. The remaining central slip is reattached to the distal phalanx.
D. After the central slip has been reattached, the PIP joint should be passively flexed 20 or 30 degrees.
Explanation: During the reconstruction of the extensor mechanism, the central slip is divided distally, not proximally, while leaving a cuff of tendon attached to the base of the middle phalanx. Approximately 1/4 inch (6 mm) of the central slip is excised. The remaining portion is reattached to the cuff of the central slip insertion at the base of the middle phalanx. After reattachment, it should be possible to flex the PIP joint passively 70 or 80 degrees.
Question 3: The lateral band mobilization technique for stiff swan neck deformities always requires releasing the collateral ligaments to achieve full passive flexion.
A. Ano
B. Ne
Explanation: Lateral band mobilization involves freeing the lateral bands from the central slip, which allows the joint to be manipulated gently into full flexion without releasing the collateral ligaments or lengthening the central slip.
Question 4: According to the study materials, what is an expected outcome regarding Proximal Interphalangeal (PIP) joint flexion after an intrinsic release procedure?
A. PIP joint flexion should be improved with the MP joint extended or radially deviated.
B. PIP joint flexion will be lost after skin closure.
C. PIP joint flexion is only improved if combined with temporary Kirschner wire fixation.
D. PIP joint flexion becomes limited in all positions.
Explanation: The study materials state: 'After release, PIP joint flexion with the MP joint extended or radially deviated should be improved.' This directly supports option 0. The other options are not supported by the text for intrinsic release.
Question 5: The duration of symptoms is explicitly listed as a factor to consider when deciding between PIP fusion or arthroplasty for stiff proximal interphalangeal joints with advanced intra-articular changes.
A. Ano
B. Ne
Explanation: Factors explicitly listed for deciding between PIP fusion or arthroplasty are the fingers involved, the status of adjacent joints, the status of supporting ligamentous structures, and the status of the flexor tendons. The duration of symptoms is not mentioned as a factor.