Criteria for the diagnosis of symptomatic neuroma include:

1. Patient symptoms
2. Physical examination findings
3. Diagnostic nerve blocks
4. Radiologic imaging
5. All of the above

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The most impactful motor deficit resulting from an isolated, high median nerve injury is most commonly:

1. Loss of radial hand sensation
2. Weak lumbrical function
3. Weak thumb IP flexion and index finger DIP flexion
4. Weak supination
5. Weak pronation

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One cluster of perforators emerging from the radial artery is found in close proximity to the radial styloid, and a second cluster is found at the following distance from the radial styloid to the lateral epicondyle?

1. ~10% of the distance from radial styloid to lateral epicondyle
2. ~25% of the distance from radial styloid to lateral epicondyle
3. ~40% of the distance from radial styloid to lateral epicondyle
4. ~60% of the distance from radial styloid to lateral epicondyle
5. ~80% of the distance from radial styloid to lateral epicondyle

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Which of the following is an established (proven) benefit of supercharge nerve transfers?

1. Improved outcomes in all scenarios in which supercharging is possible
2. Preservation of distal motor targets
3. The addition of donor axons into a recipient nerve
4. Adequate recovery regardless of proximal regeneration
5. Improved outcomes compared with end to end transfers

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A patient presents with intermittent paresthesia in their little finger and ulnar half of their ring finger. There is no history of trauma. A nerve conduction study supports a diagnosis of cubital tunnel syndrome. In advising the patient on the risks/benefits of a mini-open or endoscopic in situ release verses a subcutaneous transposition, they can be informed that:

1. Transposition has been shown to give superior results
2. There is less morbidity with an in situ release
3. There is greater risk of nerve instability following transposition
4. The nerve must be transposed to relieve traction neuritis
5. There is a higher risk of medial antebrachial cutaneous nerve injury with in situ release

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When the wrist sustains an axial load, the scaphoid is forced into flexion. What are the most likely ligament constraints that prevent excess flexion?

1. Volar scapholunate, dorsal lunotriquetral
2. Dorsal scapholunate, dorsal scaphotriquetral
3. Volar scapholunate, dorsal scaphotriquetral
4. Dorsal lunotriquetral, dorsal scaphotriqutral
5. Volar scapholunate, volar lunotriquetral

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What percentage of patients with cubital tunnel syndrome who obtain relief of symptoms from surgery show no signs of ulnar neuropathy on preoperative electrodiagnostic studies?

1. 25%
2. 48%
3. 66%
4. 75%

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A patient is undergoing an index radial collateral ligament reconstruct of the index finger MP joint. If the surgeon desires to anatomically replicate the ligament origin and insertion, the proper location for each would be:

1. Dorsal 1/3 of the metacarpal head and volar 1/3 of the proximal phalanx
2. Dorsal 1/4 of the metacarpal head and volar 1/4 of the proximal phalanx
3. Dorsal 1/3 of the metacarpal head and volar 1/4 of the proximal phalanx
4. Dorsal 1/4 of the metacarpal head and volar 1/3 of the proximal phalanx
5. Central metacarpal head and volar 1/3 proximal phalanx

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A 3 month-old child presents with a brachial plexus birth injury. His parents state that he was initially unable to move his right upper extremity at all but has regained some elbow flexion and finger flexion. However these are still weak and he has not moved his shoulder at all. What is the most appropriate treatment?

1. Brachial plexus exploration and neurolysis
2. Spinal accessory to suprascapular nerve transfer
3. Referral to an occupational therapist
4. Botulinum toxin injection to the shoulder internal rotators

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In the supraclavicular approach for exploration of the brachial plexus, what nerve can be identified on the anterior scalene muscle and should be protected during the exposure?

1. Suprascapular nerve
2. Ansa cervicalis
3. Spinal accessory nerve
4. Phrenic nerve

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What is the most common pattern of shoulder deformity in brachial plexus birth injury?

1. Internal rotation contracture
2. External rotation contracture
3. Abduction contracture
4. Adduction contracture

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On average, roughly what percent of patients who previously underwent a hand surgical procedure recall any risks of the procedure having been reviewed with them?

1. 10
2. 30
3. 50
4. 70
5. 90

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Answer: C In a postoperative survey of 54 hand surgery patients, approximately one half of patients could not remember a single risk being reviewed with them.



Ref: Yu M, Von Schroeder HP. “Uninformed” Consent: Patient Recollection From Surgical Consent in Hand Surgery—A Quality Improvement Initiative. HAND 2021, Vol. 16(4) 528–534

When compared to withholding antibiotics preoperatively, the administration of IV pre operative antibiotics for elective, soft tissue hand procedures such as carpal tunnel syndrome has been shown to result in:

1. No difference in infection rates
2. A statistically significant reduction of superficial infection rates
3. A statistically significant increase of superficial infection rates
4. A statistically significant reduction of deep infections requiring a return trip to the operating room
5. A statistically significant increase of deep infections requiring a return trip to the operating room

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In a multi-fragmentary distal radius fracture, inadequate stabilization of which fracture fragment can lead to volar radiocarpal instability?

1. Radial styloid
2. Dorsal ulnar corner (lunate facet)
3. Volar rim (lunate facet)
4. Free intra-articular fragment
5. Dorsal wall

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Brachioradialis distal tenotomy without tendon repair, at the time of surgical management of an unstable distal radius fracture, results in what functional change?

1. Increase in elbow extension torque
2. Decrease in elbow extension torque
3. Increase in elbow flexion torque
4. Decrease in elbow flexion torque
5. No change in any elbow flexion or extension torque

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For an acute scaphoid fracture stabilized with a single headless compression screw (HCS), what percentage of fracture union is necessary for the scaphoid-HCS construct to be at least as strong as the native scaphoid?

1. 90–100%
2. 70-80%
3. 50-60%
4. 30-40%
5. 10-20%

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