Surgical: Radial Tunnel Syndrome

1. A 45-year-old construction worker sustains a fall and presents with an isolated injury to his upper extremity. Radiographs of the affected wrist are shown in Figure A. After soft tissue swelling subsides, open reduction and internal fixation of the distal radius is performed. Following fixation, a "shuck" test is performed and shows persistent instability of the distal radioulnar joint. Incompetence of which of the following anatomic structures is the most likely etiology of this finding?

2. A 54-year-old male falls from a ladder and sustains the fracture shown in Figure A. Which of the following factors has been associated with redisplacement of the fracture after closed manipulation?

3. A 65-year-old female sustains a fall onto her outstretched right hand. The injury is closed and she is neurovascularly intact. There is no median nerve paresthesias. Radiographs are shown in Figures A and B. What is the next best step in management of this patient?

4.A 63-year-old female sustained a distal radius and associated ulnar styloid fracture 3 months ago after being involved in a motor vehicle collision. Radiographs obtained at the time of injury are shown in Figure A. She underwent open reduction and fixation of the distal radius fracture, and current radiographs are shown in Figure B. At the time of the index operation, there was no distal radioulnar joint instability after plating of the radius. Which of the following is true post-operatively regarding this patient's ulnar styloid fracture?

5.A 46-year-old woman sustains an extra-articular fracture of the distal radius and undergoes open reduction and internal fixation with a volar plate and screw construct. During postoperative recovery from this injury, what benefit does formal physical therapy have as compared to a patient-guided home exercise program?

6. Twelve months after open reduction and internal fixation of a comminuted distal radius fracture as seen in Figure A and B, which of the following tendons is at greatest risk of rupture?

8.A 68-year-old male falls onto his outstretched hand and suffers the injury shown in Figures A and B. Undergoes operative treatment of his fracture, and immediate post-op radiographs are shown in Figure C. Two weeks later he presents with significantly increased pain and deformity. He denies any new trauma, and has followed all post-operative activity restrictions. Current radiographs are shown in Figure D and a clinical photograph of the affected wrist is shown in Figure E. Which of the following is the most likely cause for failure of fixation in this patient?

11. Spontaneous rupture of the extensor pollicis longus tendon is most frequently associated with which of the following scenarios?

12. A 64-year-old female sustains a nondisplaced distal radius fracture and undergoes closed treatment using a cast. Three months after the fracture she reports an acute loss of her ability to extend her thumb. What is the most likely etiology of her new loss of function?

13. A 51-year-old female presents with an acute inability to extend her thumb, four months after she was treated with cast => immobilization for a minimally-displaced distal radius fracture. What is the most appropriate treatment at this time?

14. A 32-year-old ballet dancer sustains a distal radius fracture, and is subsequently closed reduced and casted. She presents => 11 months later with the radiograph seen in Figure A, complaining of significant wrist pain. What is the appropriate surgical treatment at this time?

15. A 17-year-old male falls from a retaining wall onto his left arm. He sustains the injury shown in Figure A. The patient undergoes open reduction and internal fixation of the fracture. Upon discharge from the hospital the medication reconciliation includes an order for daily Vitamin C 500mg supplementation. This medication is given in an effort to decrease the incidence of which of the following

16. A 70-year-old woman with known osteoporosis sustains a distal radius fracture of her dominant arm with some metaphyseal comminution. Adequate maintenance of reduction by non-operative treatment is unsuccesful. Which plating option provides the most appropriate treatment of this fracture?

17. The most common complication in the distal radial fracture, especially in case of Smith fracture is :

18. In the following sentences, which one explant the characteristic of Colles’ fracture of distal radius fracture?

19. In the following sentences, which one explant the characteristic of Smith’ fracture of distal radius fracture?

21. In the following sentences which one represents the indication of nonoperative treatment of distal radius fracture?

22. In distal radius fracture, what kind of fracture Generally closed reduction and cast immobilization can be indicated?