CHT exam prep – Hand UPDATED ACTUAL Exam Questions
and CORRECT Answers
!@#$%%%%%
What is the primary stabilizer of the thumb CMC joint anteriorly? - (ANSWERS)Oblique beak
ligament - helps prevent dorsal subluxation of metacarpal base %%%%%%
What is the "critical corner"? - (ANSWERS)At PIP joint where the PCL (proper collateral
ligament) and ACL (accessory collateral ligament) and volar plate converge. Important in joint
stability
What does the transverse retinacular ligament do? - (ANSWERS)- With flexion pulls lateral
bands volarly, with extension prevents excessive dorsal movement of lateral bands
- Arises from the A2 pulley near prox phalanx and inserts on lateral bands
- lies volar to PIP joint and dorsal to DIP joint (facilitates DIP extension)
- stretch it - keep PIP extended and flex DIP - (ANSWERS)Oblique retinacular ligament (ORL)
What does the triangular ligament do? - (ANSWERS)Connects lateral bands and stabilizes on
dorsal aspect of finger
What is Bunnell-Littler test? - (ANSWERS)- test for intrinsic tightness
- Hold MP in full ext and passive flex PIP, note ROM
- Hold MP into flexion and passive flex PIP, note ROM
- If more PIP flexion when MP is flexed then there is intrinsic tightness
What the extrinsic tendon tightness test? - (ANSWERS)- Hold MP in full ext and passive flex PIP,
note ROM
- Hold MP into flexion and passive flex PIP, note ROM
- If increased PIP flexion with MP in ext then there is extrinsic tightness
What is the oblique retinacular ligament test? - (ANSWERS)- Hold PIP in ext passively flex DIP
- Retest DIP flexion with PIP flexed
- positive if DIP has greater PROM with PIP flexed
- If ROM is limited in both positions the patient may have a joint contracture
What makes up 50-60% of all hand fractures? - (ANSWERS)- metacarpals
- common in 1st and 5th digits - very mobile
What accounts for 50% of finger fractures? - (ANSWERS)Distal phalanx fractures
- thumb and middle most commonly crushed
What is a Bennett's fracture? - (ANSWERS)Fracture at base of first metacarpal. Fracture
dislocation at CMC
, CHT exam prep – Hand UPDATED ACTUAL Exam Questions
and CORRECT Answers
!@#$%%%%%
What is a Rolando fracture? - (ANSWERS)Comminuted intra-articular fracture of the base of the
first metacarpal %%%%%%
What is Elson's test? - (ANSWERS)- assessing if central slip is injured
- place PIP in full flexion against opposite hand then asked patient to extend DIP. If they can
extend DIP then there is a central slip injury
How can you determine Boutonniere vs Pseudo-boutonniere deformity? - (ANSWERS)-
Significant ORL tightness with Boutonniere, typically from DIP hyperextension
- Pseudo-Boutonniere DIP joint remains passively flexible, often from PIP hyperextension injury,
PIP flex contracture, neg ORL test, no central slip injury
What is a grade 1 ligament injury? - (ANSWERS)Damage to individual fibers, no loss of stability
or disruption of ligament
What is grade 2 ligament injury? - (ANSWERS)- partial disruption of ligament
- passively unstable
- actively stable through full ROM
What is a grade 3 ligament injury? - (ANSWERS)- dislocation
- complete disruption of ligament
- actively and passively unstable
- avulsion fracture
PIP ROM accounts for how much motion when grasping? - (ANSWERS)85%
What is the most common ligament injury in the hand? - (ANSWERS)Collateral ligament injury
at PIP
Eaton classification type 1 for sprain/dislocations - (ANSWERS)hyperextension injury with
avulsion of volar plate and longitudinal tear of collateral ligaments, critical corners intact
Eaton classification type 2 for sprain/dislocations - (ANSWERS)Dorsal dislocation of the PIP
joint with avulsion of the volar plate with complete tear between the accessory and proper
collaterals
Eaton classification type 3 for sprain/dislocations - (ANSWERS)fracture with dorsal dislocation
with avulsed small fragment, <40% of articular surface, dorsal aspect of collateral ligament
remains attached to middle phalanx
Eaton classification type 4 for sprain/dislocations - (ANSWERS)Fracture dislocation with
fracture or impaction of the articular surface of more than 40%
and CORRECT Answers
!@#$%%%%%
What is the primary stabilizer of the thumb CMC joint anteriorly? - (ANSWERS)Oblique beak
ligament - helps prevent dorsal subluxation of metacarpal base %%%%%%
What is the "critical corner"? - (ANSWERS)At PIP joint where the PCL (proper collateral
ligament) and ACL (accessory collateral ligament) and volar plate converge. Important in joint
stability
What does the transverse retinacular ligament do? - (ANSWERS)- With flexion pulls lateral
bands volarly, with extension prevents excessive dorsal movement of lateral bands
- Arises from the A2 pulley near prox phalanx and inserts on lateral bands
- lies volar to PIP joint and dorsal to DIP joint (facilitates DIP extension)
- stretch it - keep PIP extended and flex DIP - (ANSWERS)Oblique retinacular ligament (ORL)
What does the triangular ligament do? - (ANSWERS)Connects lateral bands and stabilizes on
dorsal aspect of finger
What is Bunnell-Littler test? - (ANSWERS)- test for intrinsic tightness
- Hold MP in full ext and passive flex PIP, note ROM
- Hold MP into flexion and passive flex PIP, note ROM
- If more PIP flexion when MP is flexed then there is intrinsic tightness
What the extrinsic tendon tightness test? - (ANSWERS)- Hold MP in full ext and passive flex PIP,
note ROM
- Hold MP into flexion and passive flex PIP, note ROM
- If increased PIP flexion with MP in ext then there is extrinsic tightness
What is the oblique retinacular ligament test? - (ANSWERS)- Hold PIP in ext passively flex DIP
- Retest DIP flexion with PIP flexed
- positive if DIP has greater PROM with PIP flexed
- If ROM is limited in both positions the patient may have a joint contracture
What makes up 50-60% of all hand fractures? - (ANSWERS)- metacarpals
- common in 1st and 5th digits - very mobile
What accounts for 50% of finger fractures? - (ANSWERS)Distal phalanx fractures
- thumb and middle most commonly crushed
What is a Bennett's fracture? - (ANSWERS)Fracture at base of first metacarpal. Fracture
dislocation at CMC
, CHT exam prep – Hand UPDATED ACTUAL Exam Questions
and CORRECT Answers
!@#$%%%%%
What is a Rolando fracture? - (ANSWERS)Comminuted intra-articular fracture of the base of the
first metacarpal %%%%%%
What is Elson's test? - (ANSWERS)- assessing if central slip is injured
- place PIP in full flexion against opposite hand then asked patient to extend DIP. If they can
extend DIP then there is a central slip injury
How can you determine Boutonniere vs Pseudo-boutonniere deformity? - (ANSWERS)-
Significant ORL tightness with Boutonniere, typically from DIP hyperextension
- Pseudo-Boutonniere DIP joint remains passively flexible, often from PIP hyperextension injury,
PIP flex contracture, neg ORL test, no central slip injury
What is a grade 1 ligament injury? - (ANSWERS)Damage to individual fibers, no loss of stability
or disruption of ligament
What is grade 2 ligament injury? - (ANSWERS)- partial disruption of ligament
- passively unstable
- actively stable through full ROM
What is a grade 3 ligament injury? - (ANSWERS)- dislocation
- complete disruption of ligament
- actively and passively unstable
- avulsion fracture
PIP ROM accounts for how much motion when grasping? - (ANSWERS)85%
What is the most common ligament injury in the hand? - (ANSWERS)Collateral ligament injury
at PIP
Eaton classification type 1 for sprain/dislocations - (ANSWERS)hyperextension injury with
avulsion of volar plate and longitudinal tear of collateral ligaments, critical corners intact
Eaton classification type 2 for sprain/dislocations - (ANSWERS)Dorsal dislocation of the PIP
joint with avulsion of the volar plate with complete tear between the accessory and proper
collaterals
Eaton classification type 3 for sprain/dislocations - (ANSWERS)fracture with dorsal dislocation
with avulsed small fragment, <40% of articular surface, dorsal aspect of collateral ligament
remains attached to middle phalanx
Eaton classification type 4 for sprain/dislocations - (ANSWERS)Fracture dislocation with
fracture or impaction of the articular surface of more than 40%
