ABOS Surgery of the Hand study plan

Differentiate extra-articular, simple intra-articular, and complex intra-articular distal radius fracture patterns, and justify volar plating, dorsal plating, fragment-specific fixation, or spanning external fixation for each.

Explain radiographic parameters (radial inclination, volar tilt, ulnar variance, articular step-off, DRUJ congruity) that define operative versus nonoperative treatment thresholds.

Rank the stages of scapholunate and lunotriquetral instability and select repair, capsulodesis, reconstruction, or salvage (four-corner, proximal row carpectomy) for each stage.

Formulate a treatment algorithm for scaphoid fractures by location and vascularity, including the rationale for vascularized grafting in proximal pole nonunion.

Predict the complications of distal radius malunion and define the indications, timing, and planning steps of corrective osteotomy.

Select fixation constructs for metacarpal shaft, neck, and base fractures and for phalangeal shaft, condylar, and intra-articular fractures, defending each choice against closed reduction and cast treatment.

Diagram the flexor tendon zones and match each zone to an appropriate repair technique, suture core strand number, and rehabilitation protocol (early active versus controlled passive).

Compare primary repair, nerve graft, conduit, and transfer for digital, median, and ulnar nerve lacerations based on gap size, level, and timing.

Distinguish extensor tendon zones and identify the mallet finger, boutonniere, and sagittal band variants requiring operative rather than splint treatment.

Identify the pitfalls of tendon repair and nerve coaptation that produce adhesions, rupture, or neuroma, and state the intraoperative countermeasure for each.

Differentiate osteoarthritis, rheumatoid arthritis, and crystalline arthropathy by clinical and radiographic hallmarks, and match each to its surgical options.

Compare trapeziectomy, ligament reconstruction and tendon interposition, and implant arthroplasty for thumb carpometacarpal arthritis using durability, pinch strength, and complication data.

Outline the staging and surgical indications for metacarpophalangeal and proximal interphalangeal joint reconstruction in inflammatory arthritis, including tendon transfers for ulnar drift.

Classify Dupuytren contracture by joint involvement and distinguish needle aponeurotomy, collagenase injection, and limited fasciectomy by recurrence rate and indication.

Explain the pathology of the digital cords and the technical steps that protect the neurovascular bundles during fasciectomy, and recognize flare and recurrence.

Localize median, ulnar, and radial nerve compression by provocative test, sensory distribution, and electrodiagnostic pattern, and select release versus transposition versus grafting.

Justify the timing and technique of carpal tunnel release in advanced thenar atrophy and in recurrent cases, and list the structures at risk in revision surgery.

Outline the indications and microsurgical steps for free tissue transfer, digital replantation, and toe-to-hand transfer, including vessel selection and vein graft use.

Compare local, regional, and free flaps for soft tissue defects of the hand and distal forearm by defect location, size, and donor morbidity.

Explain the physiology of nerve regeneration and the factors that determine outcomes after grafting and conduit reconstruction.

Differentiate benign and malignant hand tumors (ganglion cyst, giant cell tumor of tendon sheath, enchondroma, glomus tumor, squamous cell carcinoma, melanoma) by presentation, imaging, and biopsy strategy.

Explain the staging and margin requirements for soft tissue sarcoma and melanoma of the hand and the consequences of unplanned excision.

Apply Kanavel signs to distinguish flexor tenosynovitis, deep space infection, and collar-button abscess, and specify the surgical drainage approach for each.

Formulate antibiotic and debridement plans for human bite, clenched-fist, and necrotizing soft tissue infections of the hand.

Distinguish Kienbock disease stages, complex regional pain syndrome, and compartment syndrome of the hand by diagnostic criteria and initial management.

Classify syndactyly, polydactyly, and thumb hypoplasia (Blauth) and justify the timing and staging of surgical reconstruction for each.

Explain the sequence of reconstruction in radial longitudinal deficiency and the rationale for centralization versus radialization versus observation.

Differentiate pediatric supracondylar, lateral condyle, and phalangeal fractures by classification, displacement criteria, and complication risk including nonunion and avascular necrosis.

Formulate treatment for trigger thumb, congenital clinodactyly, and camptodactyly, distinguishing observation from operative release.

Identify the growth-plate principles that govern pediatric fracture fixation and the remodeling potential at each location.

Retrieve high-yield facts across all five domains using spaced self-testing rather than rereading, and flag every item missed twice for focused remediation.

Reattempt the two lowest-scoring domain quizzes from weeks 1 through 6 and record the reason for each repeated error (knowledge gap, misread, or reasoning error).

Synthesize cross-domain topics such as wrist instability in rheumatoid arthritis and nerve compression after trauma into integrated explanatory answers.

Rehearse concise oral definitions of key classifications (AO distal radius, Blauth, Kanavel, Dupuytren, Lichtman) under one-minute time pressure.

Simulate exam conditions with two timed 100-item mixed practice sets and complete both without reference material.

Analyze every incorrect or guessed item to classify the failure mode and confirm the correct concept from a primary source.

Re-drill the remediation list from week 7 until each concept can be recalled accurately on two consecutive attempts.

Consolidate a final one-page summary of the classifications and treatment thresholds most likely to be tested across all five domains.