The JBJS Quiz of the Month is a collection of 10 relevant questions from each orthopaedic subspecialty. The questions are drawn from JBJS Clinical Classroom, which houses over 4,500 questions and 3,100 learning resources. Take the Quiz to see how you score against your peers!

NOTE: This quiz does not earn users CME credits. The questions must be answered within Clinical Classroom to earn CME credits.

A 37-year-old male patient who is a construction worker presents after suffering a thumb injury during a fall 1 week ago. He has pain and bruising on the ulnar side of the thumb metacarpophalangeal (MCP) joint. There is greater than 40° of valgus laxity, both in extension and 30° of MCP joint flexion. There is no appreciable endpoint during stress testing. Plain radiographs show no fracture. Which of the following is the most appropriate next step in management?

  • Repair of the thumb ulnar collateral ligament
  • Thumb spica cast with repeat examination in 2 weeks
  • Closed reduction and transarticular pinning of the thumb MCP joint
  • Reconstruction of the thumb ulnar collateral ligament with a tendon graft