Revise by topic
Hand is the category where examination findings and anatomy carry the most weight. It covers hand anatomy and examination, fingertip and nailbed injuries, fractures and dislocations, and flexor and extensor tendon injuries by zone, with repair technique and rehabilitation. Nerve compression covers carpal and cubital tunnel syndromes. Dupuytren’s disease, scaphoid fractures and carpal instability, osteoarthritis and rheumatoid arthritis, hand infection and congenital hand differences complete the syllabus. Most questions describe a patient with a precise mechanism and a precise examination finding, and the best answer depends on identifying exactly which structure is injured and what current UK practice offers for it. Options that are standard abroad or historically, but not in the UK today, are deliberate distractors.
Topics in this domain
From the free sample — original, referenced, with the full explanation. Rate your confidence first.
A 31-year-old skier fell onto an abducted thumb. There is a firm, tender lump on the ulnar side of the thumb metacarpal neck, and under local anaesthetic the MCP joint opens 45 degrees on radial stress in 30 degrees of flexion with no end point. Radiographs show no fracture.
What is the most appropriate management?
A 32-year-old scaffolder is six weeks after four-strand zone II repair of both flexor tendons of the index finger, rehabilitated with an early active regime. The splint has been discarded and he has good active flexion without triggering. He asks when he can resume heavy lifting and forceful gripping.
At what point after repair is unrestricted heavy loading most appropriate?
Drag to rotate, tap the hotspots, press play.
Also in this domain: Radial forearm flap, Flexor tendon sheath & pulleys (coming soon)
No. Collagenase (Xiapex) was withdrawn from the UK and EU market around 2020, so current UK options are needle fasciotomy, limited fasciectomy and dermofasciectomy. Treat it as a distractor in UK-based questions.
Both flexor tendons run within the tight fibro-osseous sheath there, so adhesions and rupture are the main risks. Questions test multi-strand core repair, pulley handling and early active motion.
Always. A wound over the knuckle from a punch should be presumed to enter the joint until proven otherwise, and it needs exploration and washout in theatre plus antibiotics.
Create a free account, filter the bank to this domain and rate your confidence as you go. Upgrade when you want the full bank and two-paper mocks.