Deck 23: Orthopedic Management of the Wrist and Hand

Question 1

Which extensor tendon injury occurs in zone 1,places the DIP joint in flexion,and over time can lead to hyperextension of the proximal interphalangeal (PIP)joint?

A) Mallet finger
B) Boutonniere deformity
C) Dupuytren's disease
D) Complex regional pain syndrome

Answer 1

Mallet finger

Question 2

Which of the following is NOT a primary characteristic of complex regional pain syndrome (CRPS)?

A) Flexibility of the wrist joint and pain
B) Trophic changes
C) Autonomic disturbances such as sweating or dryness of the skin
D) Functional impairment such as not using the hand due to pain

Answer 2

Flexibility of the wrist joint and pain

Question 3

Which intervention comes last in the rehabilitation of a hand ligament injury?

A) Elevation,massage,light external compression wraps,and digit active range of motion (AROM)exercise
B) Gentle,active,pain-free motion in all planes
C) Submaximal isometric contractions progressing to resistance exercises
D) Using a metronome to increase the speed of movement and sustained gripping exercises to improve wrist strength

Answer 3

Using a metronome to increase the speed of movement and sustained gripping exercises to improve wrist strength

Question 4

Who is the best qualified health care provider to perform hand rehabilitation for flexor tendon injuries?

A) PTA
B) Physical therapist (PT)
C) Medical doctor
D) Certified hand therapist

Question 5

Which extensor tendon injury occurs in zone III and allows the head of the proximal phalanx to herniate dorsally resulting in deformity?

A) Mallet finger
B) Boutonnière deformity
C) Dupuytren's disease
D) Complex regional pain syndrome

Question 6

Which disease is characterized by increased friction and pressure constricting the nerve in the wrist and producing sensory problems such as decreased sensation,pain and tingling,and motor problems?

A) Dupuytren's disease
B) CTS
C) Mallet finger
D) Complex regional pain syndrome

Question 7

How would a stable,closed,nondisplaced fracture of a phalanx be treated?

A) Full arm cast
B) Partial forearm cast
C) Buddy taping
D) Rigid immobilization

Question 8

Which of the following diseases is characterized by pain on the radial side of the wrist that is aggravated by use of the thumb?

A) Colles fracture
B) De Quervain's disease.
C) TFCC
D) Skier's thumb

Question 9

When do strengthening exercises for the wrist muscles begin following a Colles or Smith fracture?

A) When the fracture is clinically healed
B) After the cast is removed
C) After the patient can move the wrist painlessly
D) While the cast is in place

Question 10

Which fracture occurs at the palmar base of the proximal first metacarpal and results in a fracture dislocation treated with rigid cast immobilization or surgery?

A) Smith
B) Colles
C) Boxer's
D) Bennett

Question 11

Which of the following injuries may be seen more in gymnasts than in golfers or baseball players?

A) Colles fracture
B) Carpal tunnel syndrome (CTS)
C) Triangular fibrocartilage complex
D) Acute sprain of the ulnar collateral ligament of the thumb

Question 12

Why must the physical therapist assistant (PTA)monitor the patient's pain,circulation,and sensation during each therapy session?

A) To prevent complications following fracture such as nonunion and malunion,tendon adhesions,and ischemic contractures
B) To be able to document the progress of the patient in therapy
C) To determine when the therapy session should end
D) None of the above

Question 13

What is the name of the common distal radius fracture that results from a fall on the dorsum of the hand?

A) Smith
B) Colles
C) Boxer's
D) Bennett

Question 14

A skier experiences a complete rupture of the ulnar collateral ligament of his thumb which shows a small fracture of the proximal phalanx.What treatment would you expect to see for this patient?

A) Nonsurgical treatment with a thumb spica cast or rigid immobilization for 3-4 weeks
B) Surgical repair and a short arm thumb spica cast for 4 weeks
C) Continuous uninterrupted splinting of the distal interphalangeal (DIP)joint for 6 weeks in hyperextension
D) Surgery to correct the nerve entrapment,neuroma,or joint derangement

Question 15

Which anatomic fracture has the highest incidence of nonunion and may take as long as 12-24 weeks of immobilization to heal?

A) Fractures of the distal third of the scaphoid bone
B) Fractures of the proximal third of the scaphoid bone
C) Fractures of the middle third of the scaphoid bone
D) None of the above

Question 16

What is the name of the fracture that results from a person striking a hard object with a clenched fist?

A) Smith
B) Colles
C) Boxer's
D) Bennett

Question 17

Which of the following surgeries can result in CRPS?

A) Carpal tunnel
B) De Quervain's release
C) Distal ulnar surgery
D) Dupuytren release
E) All of the above

Question 18

What is the name of the common distal radius fracture that results from a fall on the palm of an outstretched hand?

A) Smith
B) Colles
C) Boxer's
D) Bennett

Question 19

How are fully displaced fractures of the metacarpal bones fixed?

A) Splint
B) Cast
C) Surgery with open fixation or percutaneous techniques
D) None of the above

Question 20

Which of the following recommendations can a PTA make to a patient experiencing CTS?

A) Remove watchbands and bracelets from the affected wrist
B) Wear the splint day and night for the first several weeks
C) Avoid simultaneous wrist and finger flexion
D) All of the above