Ch 4 - MSK: Hand Flashcards
Describe the Flexion ROM of the digits.
– MCP: 90°
– PIP: 90°
– DIP: 90°
– Thumb: MCP 50°, IP 90°
Describe the Extension ROM of the digits.
– MCP: 30°
– PIP: 0°
– DIP: 0 to 10°
– Thumb: MCP 0°, IP 20°
Describe the Abduction ROM of the digits.
– Finger: 20°
– Thumb: 70
Describe the Adduction ROM of the digits.
– Finger: 0°
– Thumb: 0°
Describe the muscles and innervation of Finger flexion.
– FDP ■Digits 2 and 3 ■ Digits 4 and 5 – FDS – Lumbricals ■ 1st and 2nd ■ 3rd and 4th – Dorsal and palmar interossei – FDM
Describe the muscles and innervation of Finger extension.
– EDC
– EIP
– EDM
Describe the muscles and innervation of Finger abduction.
– 4–Dorsal interossei
– ADM
Describe the muscles and innervation of Finger adduction.
3-Palmar interossei
Describe the muscles and innervation of thumb flexion.
– FPB
– FPL
– Opponens pollicis
– Adductor pollicis
Describe the muscles and innervation of thumb extension.
– EPL
– EPB
– APL
Describe the muscles and innervation of thumb abduction.
– APL
– APB
Describe the muscles and innervation of thumb adduction.
– Adductor pollicis
Describe the muscles and innervation of thumb opposition to 5th digit.
– Opponens pollicis
– FPB, superficial head
– APB
– Opponens digiti minimi
What is the MOI of collateral ligaments of MCP and PIP?
Valgus or varus stress with the finger in an extended position
What is the MOI of volar plate of MCP and PIP?
Hyperextension with dorsal dislocation, which is usually reducible
What imaging is needed to assess collateral ligament or volar plate injuries (fingers)?
AP and lateral views to r/o fx, ensure proper reduction and congruency of the joint
Who typically gets gamekeeper’s thumb?
Skiers
Basketball players
Ball-handling athletes
What is the MOI of gamekeepers’ thumb?
Forceful radial deviation of the proximal phalanx at the MCP joint
What is a Stener’s lesion?
Complex tears l/t entrapment of the adductor aponeurosis in the MCP joint and impair healing
What indicates instability on radiographs in gamekeeper’s thumb?
Radial deviation >40° in extension and >20° in flexion
What is the treatment of gamekeeper’s thumb?
- Short arm cast with thumb spica splint
* Stener’s lesion with failure to heal may need surgical treatment
What is a jersey finger?
Complete or incomplete injury to the flexor tendon (superficialis and/or profundus)
What is the classic MOI of a jersey finger?
A player’s finger gets caught in the jersey of another when attempting to grab him
Which digit is typically involved in a jersey finger?
4th digit
What is the clinical presentation of a jersey finger?
Patient unable to actively flex the DIP joint
Describe testing of FDP.
Flex the DIP while the PIP joint is held in extension
FDS action eliminated with PIP in extension
Describe testing of FDS.
Hold the DIP of the noninvolved digits in extension and flex the unrestrained digit
What is the MOI of a mallet finger?
Sudden passive flexion of the DIP joint when the finger is extended, causing a rupture of the extensor tendon
What can occur with a mallet finger injury?
Avulsion fracture of the distal phalanx
What is the conservative treatment of a mallet finger?
Splinting of the DIP in extension for 6 to 8 weeks with a stack splint or custom-made splint
What should be done after 6 weeks of conservative treatment of a mallet finger?
Gentle active flexion with night splinting should be done for 2 to 4 weeks
When is surgery indicated for mallet finger?
Poor healing
Avulsed fragment involves >1/3 of the joint
