3.9 of 37 Ratings
A 34-year-old right-hand-dominant squash player falls onto an outstretched hand during a qualifying match. Since this fateful match, he has had ulnar-sided wrist pain, decreased range of motion, and periodic clicking in his wrist. The physical exam finding in Figure A is noted, in which you are able to manipulate and easily translate the ulna against the radius. This finding is not present on his contralateral wrist. The deep portion of the injured ligamentous structure inserts on what anatomical landmark?
Dorsal radio-ulnar capsule
Dorsal oblique band of the interosseous membrane
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A 30-year-old male laborer sustained a right wrist injury 9 months ago. He continues to have symptoms of recurrent ulnar-sided wrist pain that impairs his ability to work. An MRI is performed and shows a triangular fibrocartilage complex (TFCC) injury. Which of the following is an indication to combine a Wafer procedure with arthroscopic TFCC debridement?
Ulnar styloid fracture
Radial styloid fracture
2 mm of positive ulnar variance and ulnocarpal impingment
2 mm of negative ulnar variance and radiocarpal joint arthritis
Scapholunate ligament injury
A 20-year-old park ranger trips and falls onto his right wrist with the wrist in extension and pronation. The local urgent care orders both radiographs and a CT, which you review and determine to be normal. The patient complains of ulnar-sided wrist pain. On exam, his tenderness is localized to the fovea. Ulnar deviation also causes him pain. There is no snapping sensation with wrist supination, flexion, and ulnar deviation. He otherwise has 5/5 strength to his first dorsal interosseous muscle with 4mm static two-point discrimination on the ulnar side of the 4th digit. Which of the following injuries is most likely responsible for his symptoms and exam?
Hook of hamate fracture
Ulnar nerve injury in Guyon's canal
The most common mechanism of injury to the triangular fibrocartilage complex (TFCC) involves
wrist extension and forearm pronation.
wrist extension and forearm supination.
wrist flexion and forearm pronation.
wrist flexion and forearm supination.
axial load in ulnar deviation.
A 19-year-old football player suffers a fall onto a pronated, extended wrist. He has pain with resisted ulnar deviation and is tender to palpation just distal to the ulnar styloid. He has no tenderness over the extensor carpi ulnaris (ECU) tendon. Current radiographs are shown in in Figures A and B and and MRI of the wrist is shown in FIgure C. Which of the following is the most likely diagnosis?
ECU tendon rupture
Triangular fibrocartilaginous complex (TFCC) tear
Scapholunate ligament injury
Which of the following structures is an anatomical component of the triangular fibrocartilage complex?
Extensor carpi ulnaris tendon sheath
Lunotriquetral interosseous ligament
Extensor digiti minimi tendon sheath
Flexor carpi ulnaris tendon sheath