Paediatric Hand and Nail Injuries — Board-Style Questions

What this deck covers

The Child’s Hand: What the Nail Hides, and What the Fist Reveals in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. Caught in a closing door
2. Struck on the back of a finger
3. About to throw it away
4. Will it need a graft
5. Straight when it lies flat
6. Caught the ball badly
7. He will not do as he is asked
8. It looks superficial
9. Whatever is comfortable
10. Tape it and discharge him
11. There is something in there
12. How long will it take
13. Four children, one afternoon
14. He will not let anyone look
15. Caught in the rollers
16. Brought in a paper bag
17. A small clean cut
18. Only the injury was written down

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: That the tip will regrow with dressings alone, The extensor tendon itself, Fingers straight and the wrist flat, A referral to a hand therapist.

Clinical pearls from this deck

• A lifted nail is a fracture sign until the film says otherwise.
• Nail intact and stuck down: make a hole, not a wound.
• Put the nail back under the fold. It is a spacer, and it earns its place.
• A young child’s fingertip regrows. Do not graft what will come back.
• Every finger points at the same place in a fist. Ask for one.
• The drooping fingertip in a child is a growth plate, not a tendon.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all MSK and orthopaedics case decks · pediatric reference values.