Radial Nerve - Pre-test

1. In planning a tendon transfer for radial nerve palsy, a wrist flexor (amplitude 33 mm) is chosen to motor the finger extensors (amplitude 50 mm). In order to obtain full finger extension from the transfer, the effective amplitude of the donor wrist flexor tendon can be increased by: 

A. Following the vector of the original muscle
B. Synergism of the wrist extensors with the finger extensors 
C. Using the donor tendon to motor both the EPL and the EDC tendons. 
D. Selecting a donor muscle possessing strength equal to or greater than recipient 
E. Converting the donor muscle from monoarticular to multiarticular 

2. Compression of the superficial branch of the radial nerve in the distal forearm (Wartenberg syndrome) most commonly occurs between which structures? 

A. Extensor carpi radialis longus and extensor carpi radialis brevis 
B. Extensor carpi radialis longus and brachioradialis 
C. Brachioradialis and flexor carpi radialis 
D. Abductor pollicis longus and extensor pollicis brevis 
E. Abductor pollicis longus and extensor pollicis longus 

3. A 34 year-old man has persistent radial nerve deficit 6 weeks following a closed nondisplaced humeral shaft fracture that is nearly healed with splinting. The patient has no clinical or electromyographic sign of nerve recovery. Which of the following is the most appropriate treatment? 

A. Nerve grafting 
B. Neurolysis 
C. Tendon transfers 
D. Nerve transfers 
E. Observation 

4. A 45 year-old patient presents with the radiograph shown in Figure 1 and a chief complaint of weakness after sustaining a non-dominant humeral shaft fracture. He states that he has not felt the back of his hand, extended his fingers, or extended his wrist since his initial injury 2 years ago. On exam, he has extrinsic atrophy and no radial nerve function distal to the triceps. What surgical plan is most appropriate to offer him? 

A. External neurolysis of the radial nerve and collagen conduit treatment 
B. Radial nerve grafting at the level of the fracture 
C. FCR and palmaris nerve branches to posterior interosseous nerve transfer 
D. FCU to ECRB, FDS IV to EDC, and abductor digiti minimi opponens tendon transfers 
E. Pronator teres to ECRB, FCR to EDC, and palmaris longus to EPL tendon transfers 

5. When performing tendon transfers for complete radial nerve palsy, in the absence of a palmaris longus, which procedure is the most appropriate?

A. Extensor pollicis longus tenodesis 
B. Flexor capri ulnaris to extensor pollicis longus 
C. Brachioradialis to extensor pollicis longus 
D. Flexor digitorum superficialis to extensor pollicis longus 
E. Interphalangeal arthrodesis 

6. A 38 year-old factory worker sustained a laceration from a piece of sheet metal resulting in numbness in the following distribution image. This most likely represents a laceration of which nerve:  

A. Ulnar 
B. Lateral Antebrachial Cutaneous 
C. Medial Antebrachial Cutaneous 
D. Superficial Radial 
E. Posterior Interosseous  


7. A 35 year-old laborer presents 15 months after ORIF of an open distal humerus fracture with no return of radial nerve function. At the index surgery, the nerve was described in the operative report as “hemorrhagic, and stretched but intact”. Recent EMG demonstrates no polyphasic waveforms in the brachioradialis. The most appropriate treatment at this time is: 

A. Continued observation and repeat EMG in 6 months 
B. Humeral osteotomy with anterior radial nerve transposition 
C. Double fasicular nerve transfer 
D. Tendon transfers 
E. Contralateral C7 nerve transfer 

8. What is the indication for demonstrated tendon transfer in Figure 1? 

A. Posterior interosseous nerve (PIN) injury at the supinator 
B. Median nerve injury at the antecubital level 
C. Ulnar nerve injury at the cubital tunnel 
D. Lower trunk brachial plexus injury 
E. Radial nerve injury at the midhumeral level