MSK EXAM 2 ALL SUBJECTS WITH COMPLETE SOLUTIONS
100% VERIFIED 2025-2026!!
Treatment for distal radius fracture - ANSWER>>Depends on type of pattern. Goal is to
restore alignment and joint articulation. Initial: sugar tong splint
Extra-articular, non-displaced: 4-6 week cast (OK to refer to ortho)
Extra-articular, displaced: reduce fracture and place in splint (IF not well-reduced:
Surgery) (CALL ortho, refer)
Intra-articular fracture: open reduction, internal fixation (ORIF) ALWAYS refer
Fracture of the distal ulna- ANSWER>>FOOSH injury (Fall on outstretched hand)
Isolated fracture are rare, usually these are seen with distal radius fractures
can see fracture of ulna styloid
Treat through casting
Scaphoid fracture - ANSWER>>One of the most common fractures of the carpal bones
narrow vascular supply-risk for necrosis
Middle 1/3 of scaphoid most commonly injured
Diagnosis of scaphoid fracture - ANSWER>>Diagnosis made physical exam and
imaging
can be an occult fracture
-if negative x-ray but highly suspicious-get MRI or CT.
,management of scaphoid fracture - ANSWER>>Not clear based on x-ray?
-thumb spica splint for two weeks: repeat radiographs
-refer to ortho
Clear fracture on x-ray
-thumb spica splint
-refer to ortho
Always refer due to non-union or Avascular necrosis
can lead to arthritis, instability
Metacarpal fracture (Fracture of the 5th metacarpal: aka "boxer fracture") -
ANSWER>>Most common fracture: fracture of the 5th metacarpal at the distal neck.
Occurs after blow to the MCP joint (think punching)
MCP fracture exam - ANSWER>>Rotational deformity
*
Swelling and pain over joint affected
*
pain With finger flexion
*
Management of MCP fracture - ANSWER>>Ulnar gutter splint
*
Refer cases to orthopedics/hand surgery
*
Proximal Phalangeal Fracture - ANSWER>>Direct blow of rotational force injury
*
swelling over the area
*
rotational deformity
,*
Distal phalangeal fracture - ANSWER>>Blow or crush injuries
*
pain and swelling at the finger
*
may she a Subungal hematoma (bruising under the nail)
Management for phalangeal fracture - ANSWER>>Depends on fracture, function,
location:
Proximal:
-non-displaced and non-angulated: buddy tape
-Displaced: reduce and splint
-refer
Distal:
-non-displaced: splint
-Displaced, angulated, tendon injury: splint and refer.
Fracture pearls - ANSWER>>Always get an x-ray to assess for fracture (cheap, easy,
no reason not to do it!)
The hand is a complex part of the body and function is critical: you will never be wrong if
you refer/call ortho or a hand surgeon with questions.
Lunate/Perilunate Dislocation - ANSWER>>Most common : Hand rotation forced Hyper
or FOOSH
Management of lunate/perilunate dislocation - ANSWER>>Referral to orthopedics
, immediately for reduction and surgery.
EMERGENCY!! Can cause complications.
Complications of lunate/perilunate dislocation - ANSWER>>Complications:
-Acute: median nerve compression
-Chronic: arthritis, non-union (if fractured)
Phalanx dislocations - ANSWER>>Finger dislocations
PIP most common
dorsal dislocation seen with hyperextension
can be reduced
Management of phalanx dislocations - ANSWER>>Assuming no ligament injury, no
fracture, or open fracture, and not a volar dislocation, can reduce.
if dislocation seen, get x-ray, call orthopedics to help guide in reduction.
after reduction-splint
Dislocation can cause volar plate avulsion injury - ANSWER>>Volar plate avulsion
injury can occur with an extension injury from a dorsal dislocation
Carpal tunnel syndrome - ANSWER>>AKA median nerve neuropathy
100% VERIFIED 2025-2026!!
Treatment for distal radius fracture - ANSWER>>Depends on type of pattern. Goal is to
restore alignment and joint articulation. Initial: sugar tong splint
Extra-articular, non-displaced: 4-6 week cast (OK to refer to ortho)
Extra-articular, displaced: reduce fracture and place in splint (IF not well-reduced:
Surgery) (CALL ortho, refer)
Intra-articular fracture: open reduction, internal fixation (ORIF) ALWAYS refer
Fracture of the distal ulna- ANSWER>>FOOSH injury (Fall on outstretched hand)
Isolated fracture are rare, usually these are seen with distal radius fractures
can see fracture of ulna styloid
Treat through casting
Scaphoid fracture - ANSWER>>One of the most common fractures of the carpal bones
narrow vascular supply-risk for necrosis
Middle 1/3 of scaphoid most commonly injured
Diagnosis of scaphoid fracture - ANSWER>>Diagnosis made physical exam and
imaging
can be an occult fracture
-if negative x-ray but highly suspicious-get MRI or CT.
,management of scaphoid fracture - ANSWER>>Not clear based on x-ray?
-thumb spica splint for two weeks: repeat radiographs
-refer to ortho
Clear fracture on x-ray
-thumb spica splint
-refer to ortho
Always refer due to non-union or Avascular necrosis
can lead to arthritis, instability
Metacarpal fracture (Fracture of the 5th metacarpal: aka "boxer fracture") -
ANSWER>>Most common fracture: fracture of the 5th metacarpal at the distal neck.
Occurs after blow to the MCP joint (think punching)
MCP fracture exam - ANSWER>>Rotational deformity
*
Swelling and pain over joint affected
*
pain With finger flexion
*
Management of MCP fracture - ANSWER>>Ulnar gutter splint
*
Refer cases to orthopedics/hand surgery
*
Proximal Phalangeal Fracture - ANSWER>>Direct blow of rotational force injury
*
swelling over the area
*
rotational deformity
,*
Distal phalangeal fracture - ANSWER>>Blow or crush injuries
*
pain and swelling at the finger
*
may she a Subungal hematoma (bruising under the nail)
Management for phalangeal fracture - ANSWER>>Depends on fracture, function,
location:
Proximal:
-non-displaced and non-angulated: buddy tape
-Displaced: reduce and splint
-refer
Distal:
-non-displaced: splint
-Displaced, angulated, tendon injury: splint and refer.
Fracture pearls - ANSWER>>Always get an x-ray to assess for fracture (cheap, easy,
no reason not to do it!)
The hand is a complex part of the body and function is critical: you will never be wrong if
you refer/call ortho or a hand surgeon with questions.
Lunate/Perilunate Dislocation - ANSWER>>Most common : Hand rotation forced Hyper
or FOOSH
Management of lunate/perilunate dislocation - ANSWER>>Referral to orthopedics
, immediately for reduction and surgery.
EMERGENCY!! Can cause complications.
Complications of lunate/perilunate dislocation - ANSWER>>Complications:
-Acute: median nerve compression
-Chronic: arthritis, non-union (if fractured)
Phalanx dislocations - ANSWER>>Finger dislocations
PIP most common
dorsal dislocation seen with hyperextension
can be reduced
Management of phalanx dislocations - ANSWER>>Assuming no ligament injury, no
fracture, or open fracture, and not a volar dislocation, can reduce.
if dislocation seen, get x-ray, call orthopedics to help guide in reduction.
after reduction-splint
Dislocation can cause volar plate avulsion injury - ANSWER>>Volar plate avulsion
injury can occur with an extension injury from a dorsal dislocation
Carpal tunnel syndrome - ANSWER>>AKA median nerve neuropathy
