Ch 4 - MSK: Hand

Question 1

Describe the Flexion ROM of the digits.

Answer 1

– MCP: 90°
– PIP: 90°
– DIP: 90°
– Thumb: MCP 50°, IP 90°

Question 2

Describe the Extension ROM of the digits.

Answer 2

– MCP: 30°
– PIP: 0°
– DIP: 0 to 10°
– Thumb: MCP 0°, IP 20°

Question 3

Describe the Abduction ROM of the digits.

Answer 3

– Finger: 20°

– Thumb: 70

Question 4

Describe the Adduction ROM of the digits.

Answer 4

– Finger: 0°

– Thumb: 0°

Question 5

Describe the muscles and innervation of Finger flexion.

Answer 5

– FDP
■Digits 2 and 3
■ Digits 4 and 5 
– FDS
– Lumbricals
■ 1st and 2nd
■ 3rd and 4th
 – Dorsal and palmar interossei
 – FDM

Question 6

Describe the muscles and innervation of Finger extension.

Answer 6

– EDC
– EIP
– EDM

Question 7

Describe the muscles and innervation of Finger abduction.

Answer 7

– 4–Dorsal interossei

– ADM

Question 8

Describe the muscles and innervation of Finger adduction.

Answer 8

3-Palmar interossei

Question 9

Describe the muscles and innervation of thumb flexion.

Answer 9

– FPB
– FPL
– Opponens pollicis
– Adductor pollicis

Question 10

Describe the muscles and innervation of thumb extension.

Answer 10

– EPL
– EPB
– APL

Question 11

Describe the muscles and innervation of thumb abduction.

Answer 11

– APL

– APB

Question 12

Describe the muscles and innervation of thumb adduction.

Answer 12

– Adductor pollicis

Question 13

Describe the muscles and innervation of thumb opposition to 5th digit.

Answer 13

– Opponens pollicis
– FPB, superficial head
– APB
– Opponens digiti minimi

Question 14

What is the MOI of collateral ligaments of MCP and PIP?

Answer 14

Valgus or varus stress with the finger in an extended position

Question 15

What is the MOI of volar plate of MCP and PIP?

Answer 15

Hyperextension with dorsal dislocation, which is usually reducible

Question 16

What imaging is needed to assess collateral ligament or volar plate injuries (fingers)?

Answer 16

AP and lateral views to r/o fx, ensure proper reduction and congruency of the joint

Question 17

Who typically gets gamekeeper’s thumb?

Answer 17

Skiers
Basketball players
Ball-handling athletes

Question 18

What is the MOI of gamekeepers’ thumb?

Answer 18

Forceful radial deviation of the proximal phalanx at the MCP joint

Question 19

What is a Stener’s lesion?

Answer 19

Complex tears l/t entrapment of the adductor aponeurosis in the MCP joint and impair healing

Question 20

What indicates instability on radiographs in gamekeeper’s thumb?

Answer 20

Radial deviation >40° in extension and >20° in flexion

Question 21

What is the treatment of gamekeeper’s thumb?

Answer 21

• Short arm cast with thumb spica splint

* Stener’s lesion with failure to heal may need surgical treatment

Question 22

What is a jersey finger?

Answer 22

Complete or incomplete injury to the flexor tendon (superficialis and/or profundus)

Question 23

What is the classic MOI of a jersey finger?

Answer 23

A player’s finger gets caught in the jersey of another when attempting to grab him

Question 24

Which digit is typically involved in a jersey finger?

Answer 24

4th digit

Question 25

What is the clinical presentation of a jersey finger?

Answer 25

Patient unable to actively flex the DIP joint

Question 26

Describe testing of FDP.

Answer 26

Flex the DIP while the PIP joint is held in extension | FDS action eliminated with PIP in extension

Question 27

Describe testing of FDS.

Answer 27

Hold the DIP of the noninvolved digits in extension and flex the unrestrained digit

Question 28

What is the MOI of a mallet finger?

Answer 28

Sudden passive flexion of the DIP joint when the finger is extended, causing a rupture of the extensor tendon

Question 29

What can occur with a mallet finger injury?

Answer 29

Avulsion fracture of the distal phalanx

Question 30

What is the conservative treatment of a mallet finger?

Answer 30

Splinting of the DIP in extension for 6 to 8 weeks with a stack splint or custom-made splint

Question 31

What should be done after 6 weeks of conservative treatment of a mallet finger?

Answer 31

Gentle active flexion with night splinting should be done for 2 to 4 weeks

Question 32

When is surgery indicated for mallet finger?

Answer 32

Poor healing | Avulsed fragment involves >1/3 of the joint