21. Soft tissue and tendon injuries of the hand. Septic hand.

Question 1

What happens if there is damage to the tendons of the hand?

Answer 1

Injury to these ligaments leads to abnormal motion between the two rows of carpal bones and to wrist instability.

Question 2

What is scapholunate dissociation?

Answer 2

most common and significant ligamentous disruption of the wrist. Imaging:
• Terry Thomas sign - widening of the scapholunate space. Treatment:
• Scaphoid can be reduced with an audible and palpable click → spica cast for 8 weeks
• If it cant be reduced then ORIF

Question 3

What is Lunotriquetral dissociation?

Answer 3

Acute lunotriquetral dissociation with minimal deformity may be treated with a short arm cast or splint for 6 to 8 weeks. Closed reduction with pinning of the lunate to the triquetrum may be necessary to maintain reduction.

Question 4

What is Ulnocarpal dissociation?

Answer 4

Avulsion or rupture of the TFCC from the ulnar styloid results in a loss of support for the ulnar wrist
Clinical evaluation reveals dorsal prominence of the distal ulna and volar displacement of the ulnar carpal bones Treatment

Question 5

Jersey finger

Answer 5

4th digit
Primary tendon repair

Question 6

Mallet finger

Answer 6

Ball on external fingertip
Extension splinting for 6 – 8 weeks / K-wire

Question 7

No Man’s land

Answer 7

Flexor tendon in flexor sheath

Question 8

Septic hand

Answer 8

Open debridement and antibiotics