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Orthopedics > 2- Wrist/Hand > Flashcards

2- Wrist/Hand Flashcards

1
Q

What is the most commonly fractured carpal bone?

A

scaphoid

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2
Q

A jersey finger consists of a rupture of the ________ tendon resulting in immediate loss of flexion at the DIP joints.

A

flexor digitorum profundus

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3
Q

What is the mechanism of injury for a jersey finger?

A

occurs when flexed DIP is forcefully hyperextended

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4
Q

If you ask a patient to “make a fist” and they are unable to flex their ring finger what diagnosis does this clue you in on?

A

jersey finger

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5
Q

What is the treatment for jersey finger?

A
  • place in aluminum splint in slight flexion
  • refer to hand specialist for surgery

ALWAYS REQUIRES SURGERY MOST WITHIN 7-10 DAYS

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6
Q

A mallet finger is a rupture of the insertion of the ____ tendon at the base of distal phalanx.

A

extensor

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7
Q

What is the most common tendon injury of the finger?

A

mallet finger

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8
Q

What is the mechanism of injury for a mallet finger?

A

direct blow to tip of finger causing forceful flexion of DIP

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9
Q

If you see a DIP joint held in flexion with associated pain and swelling what diagnosis is this?

A

mallet finger

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10
Q

What is the treatment for mallet finger?

A

splint in full extension or slight hyperextension for 6-8 weeks

do not take splint off or else time restarts

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11
Q

In boutonniere deformity the PIP is ______ and the DIP is ______ .

A 
PIP = flexed 
DIP = hyperextended
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12
Q

What is the treatment for boutonniere deformity OR swan-neck deformity?

A

splint in extension for 6 weeks + hand follow up

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13
Q

This is defined as a disruption of extensor tendon at DIP in addition to injury to central slip resulting in DIP flexion with PIP hyperextension

A

Swan-neck deformity

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14
Q

In swan-neck deformity the PIP is ______ and the DIP is ______ .

A 
PIP = hyperextended
DIP = flexion
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15
Q

A UCL injury of the hand also goes by these 2 names

A

Gamekeeper’s thumb OR Skier’s thumb

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16
Q

What is the mechanism of injury of an ULC tear?

A

forced abduction and extension of thumb

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17
Q

Pain and/or laxity with _____ stress is consistent with a UCL injury of the hand.

A

valgus

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18
Q

What is the treatment management for a UCL injury of the thumb?

A
  • RICE/NSAIDs
  • thumb spica splint
  • refer to hand surgeon
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19
Q

What is the most common fracture site in the upper extremity?

A

distal radius fracture

Colles’ fracture most common

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20
Q

Wrist pain after a fall on outstretched hand is consistent with what fracture?

A

Colles’

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21
Q

Wrist pain after a fall on flexed hand is consistent with what fracture?

A

Smith

22
Q

in a colles’ fracture the distal radius fragment is tilted _____ .

A

dorsally

23
Q

in a smith’s fracture the distal radius fragment is tilted _____ .

A

volar (palmar)

24
Q

What is the difference in management for a distal radius fracture it is non-displaced or displaced?

A
  • non-displaced = sugar tong splint + pain management

- displaced = closed reduction or ORIF

25
Q

Tenderness to palpation of the snuff box is consistent with what fracture?

A

scaphoid fracture

26
Q

What part of the scaphoid is more at risk for avascular necrosis?

A

proximal

27
Q

What is the treatment for a scaphoid fracture if there is no radiographic fracture but positive clinical findings?

A

treat as fracture

28
Q

What is the treatment for a non-displaced scaphoid fracture?

A

immobilize in thumb spica splint and repeat radiographs every 2 weeks

29
Q

What is the treatment for a displaced scaphoid fracture?

A

surgery

30
Q

What is the duration of immobilization if the scaphoid fracture is located in the following areas:

a. distal pole
b. waist
c. proximal third

A

a. 4-6 weeks
b. 10-12 weeks
c. 12-20 weeks

31
Q

A Bennet’s fracture is a fracture of the _____ metacarpal?

A

first

32
Q

What is the treatment for a first metacarpal fracture?

A
  • thumb spica splint

- refer to hand surgeon for surgery

33
Q

What is the most common metacarpal fracture?

A

fifth metacarpal fracture

34
Q

Deformity, swelling, and tenderness to the dorsum hand and loss of knuckle prominence is consistent with this diagnosis.

A

fifth metacarpal fracture

35
Q

What is the treatment for a fifth metacarpal fracture?

A
  • ulnar gutter splint

- refer to hand surgeon

36
Q

You normally have ____ degrees of angulation of the metacarpals.

A

15 degrees

37
Q

What is the “10,20,30,40” rule for a metacarpal fracture?

A
  • first metacarpal can tolerate 10 degrees = 25
  • second metacarpal = 20 degrees = 35
  • third metacarpal = 30 degrees = 45
  • fourth metacarpal = 30 degrees = 45

(15 degrees is normal SO ADD 15 degrees to 10,20,30,30)

38
Q

Phalanx fractures are usually caused by this mechanism.

A

crush injuries

39
Q

distal phalanx fracture are referred to as a what?

A

Tuft fracture

40
Q

This is defined as blood trapped under fingernail after injury.

A

subungual hematoma

41
Q

if hematoma involves > ___% of nail bed, fractures are more likely.

A

> 50%

42
Q

What is the treatment for a subungual hematoma?

A

trephination

d/n need to give antibiotics unless diabetics

43
Q

What is the most common type of finger dislocation?

A

dorsal

44
Q

What is the first thing you should do if you suspect a finger dislocation?

a get plain films

b. do a digital block
c. reduction
d. splint

A

a. get plain films

45
Q

In a LUNATE dislocation, the _____ stays in place but the _____ is displaced

A
  • capitate stays in place

- lunate is displaced

46
Q

In a PERILUNATE dislocation, the _____ stays in place but the _____ is displaced

A
  • lunate stays in place

- capitate is displaced

47
Q

A lunate and a perilunate dislocation is associated with what nerve injury?

A

median nerve injury

48
Q

A volar/palmar swelling with palpable mass is consistent with:

lunate OR perilunate dislocations?

A

lunate dislocation

49
Q

A dorsal swelling with palpable mass is consistent with:

lunate OR perilunate dislocations?

A

perilunate dislocation

50
Q

lunate and perilunate dislocations are best assessed on what films?

A

lateral films

51
Q

What is the treatment for a lunate OR perilunate dislocation?

A
  • immediate reduction followed by sugar tong splint

- referral for surgical repair

Orthopedics (5 decks)

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