Test on Stiff Finger Joints: Diagnosis and Treatment

Question 1: Following Buch's technique for metacarpophalangeal joint capsulotomy and collateral ligament release, mobilization begins 5 to 7 days after surgery.

A. Ano

B. Ne

Explanation: After performing capsulotomy and collateral ligament release using Buch's technique, the metacarpophalangeal joints are splinted in flexion, and mobilization is started 5 to 7 days after the surgery.

Question 2: Which of the following statements accurately describes a technique used for metacarpophalangeal (MP) joint capsulotomy and collateral ligament release, according to the provided study materials?

A. Buch's technique involves a dorsal exposure to divide the sagittal band, perform a capsulotomy, detach collateral ligaments from the metacarpal head, and then flex the joint to 90 degrees.

B. The volar approach described by Young, Wray, and Weeks involves a 2-cm longitudinal incision between the metacarpal heads, tracing lateral bands, and excising a segment of the collateral ligament insertions.

C. Young, Wray, and Weeks' dorsal technique is similar to Buch's but preserves the dorsal half of the collateral ligaments and pins the joint with a K-wire in extension for 2 weeks.

D. The authors' preferred method for MP joint capsulotomy is a volar approach due to its superior results in gaining active motion, as reported by Weeks and colleagues.

Explanation: Buch's technique, as described, uses a dorsal exposure, divides the sagittal band, performs a capsulotomy, detaches collateral ligaments, and flexes the joint to 90 degrees. The volar technique by Young, Wray, and Weeks involves a 2-cm longitudinal incision between metacarpal heads, tracing lateral bands, and detaching/excising collateral ligament insertions. The third option is incorrect because their dorsal technique preserves the volar half of the collateral ligaments and pins the joint in 90 degrees of *flexion*. The fourth option is incorrect as the authors prefer a dorsal approach despite Weeks and colleagues reporting superior results with a volar approach.

Question 3: Ulnar deviation of the digits can occur after MP joint contracture release if the radial collateral ligament is released to a greater degree than the ulnar ligament.

A. Ano

B. Ne

Explanation: Ulnar deviation of the digits may occur if there is an imbalance in the release of the collateral ligaments, specifically if the radial collateral ligament is released to a greater degree than the ulnar ligament.

Question 4: According to the study materials, what is a specific step in Carroll and Taber's method of resection arthroplasty for the PIP joint?

A. The proximal phalanx is exposed laterally, and the head is resected at its neck.

B. A dorsal transverse incision is made just proximal to the MP joints.

C. The lateral bands are resected at the distal half of the proximal phalanx through a separate dorsal incision.

D. A T-shaped incision is made in the dorsal capsule of the joint.

Explanation: The study materials state that in Carroll and Taber's method for resection arthroplasty of the PIP joint, 'The proximal phalanx is exposed laterally and the head is resected at its neck.' The other options describe techniques for intrinsic contractures or MP capsulotomy, not specifically the PIP joint resection arthroplasty as described by Carroll and Taber.

Question 5: The primary surgical approach for PIP joint extension contractures is typically a volar zigzag Bruner incision.

A. Ano

B. Ne

Explanation: The study materials state that the operative approach for extension contractures of the PIP joint can be from a dorsal or dorsolateral approach, not a volar zigzag Bruner incision, which is mentioned for flexion contractures.