Hand Surgery — MCQs

Hand Surgery Indian Medical PG Practice Questions and MCQs

Question 141: Most common tumor in the hand is

A. Exostosis
B. Giant cell tumour
C. Enchondroma (Correct Answer)
D. Synovial sarcoma

Explanation: ***Enchondroma*** - **Enchondromas** are the most common primary osseous tumors of the hand, frequently found in the small bones of the **phalanges** and **metacarpals**. - They are **benign cartilaginous tumors** and are often asymptomatic, discovered incidentally, although they can present with pain, swelling, or pathologic fractures. *Exostosis* - An **exostosis** (osteochondroma) is a bony outgrowth capped with cartilage, typically arising from the surface of long bones near growth plates. - While they can occur in the hand, they are less common than enchondromas and usually present as a palpable bony mass. *Giant cell tumour* - **Giant cell tumors (GCTs)** are aggressive but usually benign tumors that most commonly occur around the **knee** (distal femur and proximal tibia). - They are rare in the bones of the hand, accounting for only a small percentage of hand bone tumors. *Synovial sarcoma* - **Synovial sarcoma** is a malignant soft tissue tumor that can occur near joints, but it is **not a bone tumor**. - While it can arise in the extremities, including the hand, it is a tumor of the soft tissues rather than directly from the bone like an enchondroma.

Question 142: What is the primary deforming force on the proximal fragment in a Bennett's fracture?

A. APL (Correct Answer)
B. EPL
C. EPB
D. Adductor Pollicis

Explanation: **APL** - In a **Bennett's fracture**, the **abductor pollicis longus (APL)** tendon inserts onto the **first metacarpal base** and exerts a strong pull that displaces the small, ulnar-sided proximal fragment. - This pull is largely responsible for the typical **subluxation** and **instability** seen in this fracture. *Adductor Pollicis* - The **adductor pollicis** muscle primarily adducts the thumb and acts on the **proximal phalanx**, not the base of the first metacarpal. - Its action tends to *pull the entire first metacarpal toward the palm*, rather than specifically displacing the small fracture fragment. *EPL* - The **extensor pollicis longus (EPL)** extends the interphalangeal joint and assists in extension of the metacarpophalangeal joint of the thumb, inserting on the **distal phalanx**. - It does not have a direct insertion or significant deforming force on the **proximal fragment of the first metacarpal base** in a Bennett's fracture. *EPB* - The **extensor pollicis brevis (EPB)** extends the metacarpophalangeal joint of the thumb, inserting on the **proximal phalanx**. - Similar to the EPL, it does not exert a primary deforming force on the **fracture fragment at the base of the first metacarpal**.

Practice by Chapter

Hand Anatomy and Biomechanics

Practice Questions

Hand Fractures and Dislocations

Practice Questions

Tendon Injuries

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Nerve Injuries in Hand

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Dupuytren's Disease

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Carpal Tunnel Syndrome

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Rheumatoid Hand

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Reconstructive Hand Surgery

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Tendon Transfers

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Congenital Hand Anomalies

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Hand Infections

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Microsurgery in Hand Surgery

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