Hand disorders: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Orthopaedics · Hand disorders

Sample item

A 58-year-old man with chronic alcoholic liver disease has painless nodules in his right palm and a progressive inability to extend the ring and little fingers fully at the metacarpophalangeal joints. Which structure is abnormal, and what is the treatment for a significant contracture?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Palmar aponeurosis, treated by fasciectomy or fasciotomy

Dupuytren's contracture is a fibroproliferative disorder of the palmar fascia, associated with alcohol, diabetes, smoking and epilepsy drug therapy, and shows a family history. The ring and little fingers are most often affected. Surgery, such as fasciectomy or fasciotomy, is offered when the metacarpophalangeal contracture is significant.

Option by option

  • A. Flexor digitorum profundus tendon, treated by tendon transfer

    The flexor tendons are normal and are not the problem in Dupuytren's disease.

  • B. Extensor expansion, treated by splinting

    Extensor expansion damage leads to boutonniere or mallet deformities.

  • C. Palmar aponeurosis, treated by fasciectomy or fasciotomy (correct)

    Correct. Nodules and cords in the palmar fascia cause progressive flexion contracture.

  • D. Flexor retinaculum, treated by carpal tunnel release

    Flexor retinaculum compression causes carpal tunnel syndrome with sensory symptoms.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Orthopaedics questions

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is C, Palmar aponeurosis, treated by fasciectomy or fasciotomy. Dupuytren's contracture is a fibroproliferative disorder of the palmar fascia, associated with alcohol, diabetes, smoking and epilepsy drug therapy, and shows a family history.

Why is "Flexor digitorum profundus tendon, treated by tendon transfer" not the answer?

The flexor tendons are normal and are not the problem in Dupuytren's disease.

Why is "Extensor expansion, treated by splinting" not the answer?

Extensor expansion damage leads to boutonniere or mallet deformities.

Why is "Flexor retinaculum, treated by carpal tunnel release" not the answer?

Flexor retinaculum compression causes carpal tunnel syndrome with sensory symptoms.

What concept does this question test?

It tests Hand disorders in Orthopaedics. The ring and little fingers are most often affected. Surgery, such as fasciectomy or fasciotomy, is offered when the metacarpophalangeal contracture is significant.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hand disorders?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.