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8. MSK > 1. Trauma/Overuse: Wrist/hand > Flashcards

1. Trauma/Overuse: Wrist/hand Flashcards

1
Q

Five structrures you only need to know in TFCC

A
  1. Triangular Fibrocartilage (Articular Disc)
  2. Volar & Dorsal Radioulnar Ligaments
  3. Meniscus Homologue
  4. UCL
  5. Tendon Sheath of the UCU
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2
Q

Of the 5 structures you need to know in TFCC

Hand surgeons only really gives a shit about these 2:

A

Articular Disc and Radioulnar Ligaments

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3
Q

“TFC Proper” (Articular Disc) on MRI:

A

“TFC Proper” (Articular Disc) on MRI: will be dark on every sequence.

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4
Q

You can group TFCC injuries into these groups

A

“Class 1” Acute Injuries: Usually via fall onto extended wrist.

“Class 2” Chronic Degeneration: These are more common, and associated with positive ulnar variance and ulnar impaction.

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5
Q

What side of injuriy is relatively avascular and less likely to heal in a TFC injury?

A

Radial sided injuries are relatively avascular and less likely to heal.

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6
Q

Positive Ulnar Variance =

A
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7
Q

Negative Ulnar Variance =

A
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8
Q
A

Ulnar Impaction Syndrome (Ulnar Abutment)

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9
Q
A

Kienbocks

AVN of the lunate, seen in people in their 20s-40s

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10
Q

AVN of the lunate + Negatve ulnar variance =

A

Kienbocks

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11
Q

Distal Metaphysis Fx + Extra-articular + Dorsal angulation”

A

Colles fracture

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12
Q

“Dinner Fork Deformity ’

A

Colles fracture

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13
Q

Commonly Associated fracture with Colles

A

Ulnar styloid fracture

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14
Q

Distal Metaphysis Fx + Extra-Articular (usually ~ 85%)
+ Volar Angulation

A

Smth fracture

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15
Q

An Intra-Articular Smith Fracture (15%) is called

A

“Reverse Barton”

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16
Q

Which fracture can result in carpal tunnel syndrome?

A

Smith

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17
Q

Intra-Articular Dorsal Radius Fracture “Radial Rim” + Dorsal angulation

A

Barton

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18
Q

Intra-Articular Dorsal Radius Fracture “Radial Rim” + Volar angulation

A

Reverse Barton

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19
Q

“hallmark” of BArton fracture

A

Radial-Carpal dislocation

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20
Q

This is an intra- articular fracture of the radial styloid.

A

Hutchinson / Chauffeur Fracture

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21
Q

normal volar tilt

A

11 degrees

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22
Q

more common after a non-displaced fracture of the radius

A

Rupture of teh Extensor pollicis longus (EPL ruputre)

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23
Q

How many extensors are there?

A

5 fingers + 1 for good luck

24
Q

What wrist tendons are affected by Dequervains?

A

APL and EPB

25
Q

What conpartment of teh Extensor pollicis longus tendon courses beside the Lister’s tubercle?

A

Third

26
Q

what does NOT go through the carpal tunnel?

A

-Flexor Carpi Radialis
-Flexor Carpi Ulnaris
-Palmaris Longus (if you have one)
-Flexor Pollicis BREVIS

27
Q

WHat is not truly seen in the carpal tunnel?

A

Flexor Carpi Radialis

28
Q

Median Nerve Distribution

A

Thumb-radial aspect of the 4th digit

29
Q
A

Carpal tunnel syndrome

30
Q

Carpal Tunnel Syndrome (CTS) is associated with what conditions?

A

DIALYSIS
Pregnancy
DM
Hypothyroidism

31
Q

What is entrapped in Guyon’s Canal Syndrome?

A

Ulnar nerve as it passes the canal (pisiform + hamate)

32
Q

handle bars ‘‘handle bar palsy.”

A

Guyon’s Canal Syndrome

33
Q

This refers to a traumatic dislocation to the extensor carpi ulnaris

A

Sub-Sheath Tear / Dislocation

the direction of dislocation is medial.

34
Q

Sequential Extensor Tendon Ruptures - seen with worsening Rheumatoid Arthritis of the Distal Radioulnar Joint (DRUJ)

A

Vaughan-Jackson Syndrome

35
Q

An inflammation of the tendon manifesting as increased fluid seen around the tendon.

A

Tenosynovitis

36
Q

What are the diffuse Tenosynovitis?

A
  1. Tuberculous or Nontuberculous Mycobacterial
  2. Rheumatoid Arthritis
37
Q

What are the focal Tenosynovitis?

A
  1. Penetrating infection
  2. Overuse
38
Q

What are the most common tendons affected in TB/Non TB mycobacterial tenosinovitis?

A

Hand and Wrist

39
Q

Diffuse exuberant tenosynovitis

spares the muscles + immunocompromised + “RICE BODIES”

A

Tuberculous or Nontuberculous MycobacterialIsolated Extensor Carpi Ulnaris if early

40
Q

Diffuse exuberant tenosynovitis

+ Isolated extensor Carpi ulnaris

A

Rheumatoid arthritis

41
Q

Diffuse exuberant tenosynovitis + Vughan Jackson Syndrome (Sequential ruptures (5>4>3>2)

A

Rheumatoid arthritis

42
Q

So called “Washer Woman’s Sprain” or “Mommy Thumb.”

A

De Quervain’s Tenosynovitis

43
Q

Affected Tendon in De Quervain’s Tenosynovitis

A

First Extensor Compartment

(Extensor Pollicis Brevis and Abductor Pollicis Longus

44
Q
A

De Quervain’s Tenosynovitis

Increased fluid within the first extensor tendon compartment

MRI: increased T2 signal in the tendon sheath

45
Q
A

De Quervain’s Tenosynovitis

46
Q

Pain on passive ulnar deviation.

A

Finkelstein Test in De Quervain’s Tenosynovitis

47
Q

Occurs where the first extensor tendons, “intersects” the second extensor compartment tendons. The result is extensor carpi radialis brevis and longus tenosynovitis.

A

Intersection Syndrome

48
Q

Tenosynovitis of the 3rd compartment (extensor pollicis longus - EPL).

A

Drummer’s Wrist

49
Q

Commintuted fracture - base of teh first metacarpal

A

Rolando

50
Q

Fracture at the bases of the 1st metacarpal

A

Bennet

51
Q

what causes the dorsolateral dislocation in the Bennett
Fracture

A

The pull of the Abductor PoUicis Longus (APL)

52
Q

Avulsion fracture at the base of the proximal first phalanx + ulnar collateral ligament disruption

A

Gamekeeper’s Thumb (Skier)

53
Q

when the Adductor tendon aponeurosis gets caught in the tom edges of the UCL

Wont heal - requires surgery

A

“Stener Lesion.”

54
Q

The idea is the overuse /
repetitive trauma causes scarring in the flexor tendon sheath.

A

Trigger Finger

55
Q
A

8. MSK (27 decks)

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