Multiple Choice Questions MCQ

Question 65# Print Question

In replantation of an avulsed thumb:

A. Avoid shortening the bone

B. Flexor pollicis longus (FPL) function should be restored

C. The thumb should be supinated rather than pronated

D. A vein graft from the radial artery in the anatomical snuffbox is often necessary

E. Arteries are more resistant to intimal damage than veins

Question 61# In radial dysplasia:
A. The radial nerve can be large
B. The ECRB/L are available for transfer
C. The median artery can be persistent
D. The extensor carpi ulnaris (ECU) is shortened
E. The carpus is subluxed volarly
The median artery can be persistent. The radial structures are hypoplastic and the ulnar soft tissues are not affected.

Question 62# In polydactyly, the following is true except:
A. Stelling Type A can be treated by ligation
B. Ligation leaves a nubbin
C. Reconstruction of the ulnar collateral ligament is necessary
D. Is associated with Ellis van Creveld and Lawrence Moon Bardet Biedl syndromes
E. Can be hereditary
Reconstruction of the ulnar collateral ligament is necessary. This statement is incorrect; reconstruction of the ulnar collateral ligament is unnecessary in most cases of polydactyly which are usually Type A.

Question 63# Which one of the following components of a limb allograft will elicit the most and the least cellular immune response following transplantation?
A. Skin and muscle
B. Skin and subcutaneous tissue
C. Muscle and bone
D. Muscle and vessel
E. Skin and vessel
Muscle and vessel. Although all of the components of a vascularised limb allograft (including skin, subcutaneous tissue, bone, muscle and vessel) are considered highly antigenic, there is a difference between their relative antigenicity. Vascularised muscle allografts can elicit even a stronger cellular response than skin. The least antigenic among these tissues are vessels.

Question 64# Giant cell tumours are associated with all except:
A. Pigmented villonodular synovioma
B. Localised or diffuse presentations
C. Pigmentation
D. Haemosiderin
E. Exclusively synovial origins
Exclusively synovial origins. E is false. Giant cell tumours have been reported in distant sites.

Question 65# In replantation of an avulsed thumb:
A. Avoid shortening the bone
B. Flexor pollicis longus (FPL) function should be restored
C. The thumb should be supinated rather than pronated
D. A vein graft from the radial artery in the anatomical snuffbox is often necessary
E. Arteries are more resistant to intimal damage than veins
A vein graft from the radial artery in the anatomical snuffbox is often necessary. Digital avulsion injuries are accompanied by extended vascular damage with intimal stripping, which require debridement and replacement with good quality vein grafts if replantation is to be successful. Some series quote rates of injuries requiring vein grafts to be in the region of 20%. End-to-side anastomosis of a reversed interpositional vein graft from the radial artery in the snuffbox is one method often used to overcome the vascular gap. The first dorsal metacarpal artery is another useful recipient vessel; this option spares the radial artery in case toe transfer becomes necessary after failed thumb replantation. It is often necessary or desirable to shorten the bone to allow good bony and neurovascular approximation although in the thumb this should be from the amputate and not the residual proximal stump since preservation of length is essential if replantation fails. Repair of FPL should be carried out at the time if possible but secondary reconstruction is sometimes required.