20250812 Thumb fractures Dr Yong

Which of the following muscles provide the primary deforming forces to Bennett and Rolando fractures (base of the 1st metacarpal fractures)?

• A. Flexor pollicis longus and Extensor pollicis longus

• B. Extensor pollicis longus and Abductor pollicis longus

• C. Adductor pollicis longus and abductor pollicis brevis

• D. Abductor pollicis longus and adductor pollicis

The closed reduction technique used for treatment of the fracture show in the radiographs below are:

• A. Adduction and pronation

• B. Palmar abduction and pronation

• C. Radial abduction and pronation

• D. Radial abduction and supination

A 35 year old male presents with thumb injury seen in the plain radiograph. How would you manage this patient?

• A. Cast immobilisation

• B. Closed reduction and percutaneous pinning

• C. Open reduction and internal fixation

• D. CMCJ arthrodesis

A 25 year old football player came presented with pain after injuring his thumb while catching an incoming football. Examination revealed tender mass over PIPJ with radial instability. Radiograph show no bony injury and MRI revealed injury involving the ulna collateral ligament of the thumb MCPJ. What is the most likely associated pathology that will cause failure of non operative treatment?

• A. The ulna collateral ligament displaced superficial to the adductor aponeurosis

• B. The ulna collateral ligament displaced deep to the adductor aponeurosis

• C. The ulna collateral ligament displaced superficial to the adductor muscle

• D. The ulna collateral ligament displaced deep to the abductor aponeurosis

Creation of a Stener lesion, requires combined tears of the proper and accessory ulnar collateral ligaments in order for the ligament to be displaced by the adductor aponeurosis. Which of the following most accurately describes the role these ulnar collateral ligaments (PCL/ACL) play in thumb MCP joint stability?

• A, PCL is primary restraint to radial deviation with MCPJ in flexion, ACL provides restraint to radial deviation with MCPJ in extension

• B. ACL is primary restraint to radial deviation with MCPJ in flexion, PCL provides restraint to radial deviation with MCPJ in extension

• C. PCL is primary restraint to radial deviation with MCPJ in extension, ACL provides restraint to radial deviation with MCPJ in extension

• D. ACL is primary restraint to ulnar deviation with MCPJ in flexion, PCL provides restraint to ulnar deviation with MCPJ in extension