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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
What conpartment of teh Extensor pollicis longus tendon courses beside the Lister's tubercle?
Third
26
what does NOT go through the carpal tunnel?
-Flexor Carpi Radialis -Flexor Carpi Ulnaris -Palmaris Longus (if you have one) -Flexor Pollicis BREVIS
27
WHat is not truly seen in the carpal tunnel?
Flexor Carpi Radialis
28
Median Nerve Distribution
Thumb-radial aspect of the 4th digit
29
Carpal tunnel syndrome
30
Carpal Tunnel Syndrome (CTS) is associated with what conditions?
DIALYSIS Pregnancy DM Hypothyroidism
31
What is entrapped in Guyon's Canal Syndrome?
Ulnar nerve as it passes the canal (pisiform + hamate)
32
handle bars ''handle bar palsy."
Guyon’s Canal Syndrome
33
This refers to a traumatic dislocation to the extensor carpi ulnaris
Sub-Sheath Tear / Dislocation the direction of dislocation is medial.
34
Sequential Extensor Tendon Ruptures - seen with worsening Rheumatoid Arthritis of the Distal Radioulnar Joint (DRUJ)
Vaughan-Jackson Syndrome
35
An inflammation of the tendon manifesting as increased fluid seen around the tendon.
Tenosynovitis
36
What are the diffuse Tenosynovitis?
1. Tuberculous or Nontuberculous Mycobacterial 2. Rheumatoid Arthritis
37
What are the focal Tenosynovitis?
1. Penetrating infection 2. Overuse
38
What are the most common tendons affected in TB/Non TB mycobacterial tenosinovitis?
Hand and Wrist
39
Diffuse exuberant tenosynovitis spares the muscles + immunocompromised + "RICE BODIES"
Tuberculous or Nontuberculous MycobacterialIsolated Extensor Carpi Ulnaris if early
40
Diffuse exuberant tenosynovitis + Isolated extensor Carpi ulnaris
Rheumatoid arthritis
41
Diffuse exuberant tenosynovitis + Vughan Jackson Syndrome (Sequential ruptures (5>4>3>2)
Rheumatoid arthritis
42
So called “Washer Woman’s Sprain” or “Mommy Thumb.”
De Quervain’s Tenosynovitis
43
Affected Tendon in De Quervain’s Tenosynovitis
First Extensor Compartment (Extensor Pollicis Brevis and Abductor Pollicis Longus
44
De Quervain’s Tenosynovitis Increased fluid within the first extensor tendon compartment MRI: increased T2 signal in the tendon sheath
45
De Quervain’s Tenosynovitis
46
Pain on passive ulnar deviation.
Finkelstein Test in De Quervain’s Tenosynovitis
47
Occurs where the first extensor tendons, “intersects” the second extensor compartment tendons. The result is extensor carpi radialis brevis and longus tenosynovitis.
Intersection Syndrome
48
Tenosynovitis of the 3rd compartment (extensor pollicis longus - EPL).
Drummer’s Wrist
49
Commintuted fracture - base of teh first metacarpal
Rolando
50
Fracture at the bases of the 1st metacarpal
Bennet
51
what causes the dorsolateral dislocation in the Bennett Fracture
The pull of the Abductor PoUicis Longus (APL)
52
Avulsion fracture at the base of the proximal first phalanx + ulnar collateral ligament disruption
Gamekeeper’s Thumb (Skier)
53
when the Adductor tendon aponeurosis gets caught in the tom edges of the UCL Wont heal - requires surgery
“Stener Lesion.”
54
The idea is the overuse / repetitive trauma causes scarring in the flexor tendon sheath.
Trigger Finger
55

8. MSK (27 decks)

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