2/20/16 Hand Tendons Flashcards
Benefit of early motion protocols after tendon repair
decreased adhesions
Jersey finger: types and time to repair
Type 1: retraction of the FDP tendon to the palm
Type 2: retraction of the FDP tendon to the PIP joint
Type 3: avulsion of the bone
Type 4: type 3 lesions with the additiona of avulsion of the FDP from the fracture fragment
Type 1, 2: within 7 days
Type 3: 2-3 months
Type 4: Urgent
muscles of the anterior forearm compartment
Superficial: FCU, FCR, Pronator teres, palmaris longus
Intermediate: FDS
Deep: FDP, pronator quadratus, FPL
muscle of the posterior forearm compartment
superficial: brachioradialis, ECRB, ECRL, EDC, EDM, ECU, anconeus
Deep: supinator, APL, EPL/EPB, EIP
injury that causes a Boutonnière deformity
injury to the central tendon and injury or attenuation of the triangular ligament
Indications for flexor tenolysis
minimal soft-tissue edema, minimal scarring, and full or near-full passive range of motion.
Swan neck deformity
The swan-neck deformity occurs when the lateral bands sublux dorsal to the PIP joint rotation of axis. This is prevented by the transverse retinacular ligament, which acts to prevent dorsal migration of the lateral bands at the PIP joint.
Boutonniere deformity
injury to central slip or attenuation of the triangular ligament which causes the lateral bands to sublux volar
Lumbrical plus
paradoxical extension of the a finger when attempting to flex.
- due to FDP disruption distal to the lumbricals
Elson test for central slip disruption
tests the extensor mechanism of the finger. PIP if central slip is injured, the DIP can be actively extended.
when to get studies after closed brachial plexus injuries
3 weeks - EMG, CT or MRI Myelogram
14 weeks - EMG and electromyography
When to do surgery after closed nerve injury?
if there is no clincial or electrical evidence of recovery on EMG. after 12-18 months, motor recovery is unlikely
