Ch. 17 WHF, Q3

What condition can result from an unresolved scaphoid fracture?

• Smith's fracture

• Preiser's disease

• Keinbocks disease

• Dupuytren's contracture

Answer explanation

Preiser disease – idiopathic avascular necrosis (AVN) of the scaphoid – is an uncommon disorder that was first reported by Preiser in 1910. AVN of the scaphoid has been reported in patients with no significant history of trauma but who complained of increasing, severe radial wrist pain with spontaneous onset.

A patient presents with paresthesia and pain in the thumb, index finger, long finger, and lateral side of the ring finger. Pain is worse at night and sometimes relieved with shaking the hand, which are symptoms associated with carpal tunnel syndrome. Which tests might be helpful in confirming a diagnosis?

• Finkelstein Test

• Phalen's Test

• Scaphoid Compression Test

• Tinel's Sign

• TFCC Grind Test

Answer explanation

The modified is more encouraged due to pt. self-compression of the medial brand of the BP as it passes through the thoracic outlet.

What do you suspect from this figure?

• Boutenniere deformity

• Lunate dislocation

• Trigger finger

• Spiral fracture of phalanx or metacarpal

Answer explanation

Rotational malalignment of the third finger associated with a spiral fracture of the phalanx or metacarpal.

Carpal fractures most often involve which of the following bones?

• Lunate

• Hamate

• Scaphoid

• Pisiform

Answer explanation

The lunate is the most commonly dislocated.

A patient presents with pain on the ulnar side of their hand, proximal to the fifth metacarpal. They state the pain began when they fell on their hand while holding a racquet. Based on this information, what conditions should be included in your differential diagnoses?

• Colles' Fx

• Hook of the Hamate Fx

• Scapholunate dissociation

• TFCC injury

• Trapezium Fx

Answer explanation

The "Assessment" should be Hook of the Hamate Fx, but TFCC injury hould be r/o also.