Nick Smith
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Since the new test has a very high sensitivity, that translates to that if the test is negative then there is a high likelihood that you can rule out RC tear. This means there should not be very many false negatives. There could be a lot of false positives however with a specificity of 25% or when the test is positive you can’t feel confident to rule in the dx. Hope this helps.
Nick
Hi michaela
The main take away here is that the fifth metacarpal is most often managed conservatively. Surgical fixation usually occurs with open fractures or crush injuries. All of the other metacarpals have a much lower tolerance to angulation and would most likely require surgery to preserve function. Basically if on the exam there is mention of splinting for the 5th metacarpal after fracture that is usually a good bet. Here is a reference for you van Aaken J, Fusetti C, Luchina S, Brunetti S, Beaulieu JY, Gayet-Ageron A, Hanna K, Shin AY, Hofmeister E. Fifth metacarpal neck fractures treated with soft wrap/buddy taping compared to reduction and casting: results of a prospective, multicenter, randomized trial. Arch Orthop Trauma Surg. 2016 Jan;136(1):135-42
Happy studying
Nick
Hi Brittany, you are correct! We will fix the answer and sorry for the inconvenience. Good luck with the test
Nick
Amanda, thank you so much for catching that error. It should say “rotation” vs pronation as I was looking at the total pronation supination arc to be considered functional at around 50 degrees of each. I will have that question amended. The correct answer will still be 125 flexion and 98 total rotation. Thanks again and don’t hesitate to reach out again in the future!
NickHi Kendra and thanks for the question! While I would not spend a lot of time on this subject matter due to the low percentage of questions, it may be a good idea to memorize/visualize some splinting techniques. Also this is an area to drive home about 1-2 weeks before the test. Below is the title of an article with good pictures of some common techniques and fracture management.
Casting and splinting management for hand injuries in the in-season contact sport athlete
Katherine H Carruthers, Olivia O’Reilly, Martin Skie, John Walters, Patrick Siparsky
Good luck with your preparation and reach out with any other questions you may have!
Nick
Kendra,
Thanks for the question!
Currently they are embedded into the study guides per section. You will also find many examples in the practice questions. We are currently in the process of creating a standalone document which should be available in the next few weeks! Stay tuned.Happy studying,
Nick
Natasha, I can definitely see your reasoning on this, however what I was trying to go for in the question was pointing out that the plantar flexors which will be innervated by the tibial nerve are weaker than the dorsiflexors as shown in the manual muscle testing. Also the clinical picture points strongly to posterior tibial tendon dysfunction which would also be innervated by the tibial nerve. When you sit down and take the actual OCS test keep in mind that a lot of the times two answers will seem correct but dive back into the question to see if there’s any evidence to further validate one choice or the other.
Let me know if you have any further questions and happy studies!
