Chapter 24

Question 1

Special Tests:

Answer 1

• Finkelstein’s test
• Phalen’s test
• Tinel’s Sign
• valgus/varus and glide stress tests for wrist
• lunotriquetral ballotment test
• circualtory and neurological evaluation
• allen’s test

Question 2

Specific Injuries: Carpal Tunnel Syndrome - Management

Answer 2

• rest
• Immobilization
• possible surgery or corticosteroid

Question 3

Specific Injuries: Carpal Tunnel Syndrome - Signs and Symptoms

Answer 3

• compression of median nerve —> results in both sensory and motor deficits
• sensory changes could result in tingling, numbness and paresthesia in the arc of the median nerve innervation over the thumb
• index and middle fingers and three thenar muscles
• weakness in thumb movement

Question 4

Specific Injuries: Colle’s Fracture

Answer 4

• most common forearm fracture
• involve lower end of radius

Question 5

Specific Injuries: deQuervain’s Syndrome - Management

Answer 5

• immobilization
• rest
• cryotherapy
• US and ice massage
• joint mobilization

Question 6

Specific Injuries: deQuervain’s Syndrome - Signs and Symptoms

Answer 6

• primary symptom is an aching pain
• movement sof wrist tend to increase pain
• +’ve finkelstein’s test
• point tenderness and weakness during thumb extension and abduction
• may be painful snapping and catching of the tendons during movement

Question 7

Specific Injuries: Forearm Splints - Management

Answer 7

• care is symptomatic
• increase strength of forearm through resistance exercise
• rest and cryotherapy
• supportive wrap during activity
  can sustain acute or chronic compartment syndrome

Question 8

Specific Injuries: Forearm Splints - Signs and Symptoms

Answer 8

• dull ache between extensor muscles which cross the back of the forearm
• may be weakness and extreme pain during muscle contraction
• palpation reveals irritation of interosseous membrane and surrounding tissue
• cause is uncertain
• contraction causes minute tears in areas of interosseous membrane

Question 9

Specific Injuries: Madelung Deformity

Answer 9

• developmental abnormality of the wrist
• anatomical changes int eh radius, ulna and carpal bones, leading to palmar and ulnar wrist subluxation
• more common in females and usually present bilaterally
• becomes evident btwn 6-13 yrs old

Question 10

Specific Injuries: Madelung Deformity - Management

Answer 10

• modalities
• tape wrist or wear commercial brace to prevent end Rom of wrist extension
• typically corrected surgically in patients with chronic pain and disability

Question 11

Specific Injuries: Madelung Deformity - Signs and Symptoms

Answer 11

• can result in wrist pain and loss of forearm rotation, leading to decreased function of wrist and hand
• may be palmar subluxation with prominence of radial and ulnar styloid processes

Question 12

Specific Injuries: TFCC Injury - Management

Answer 12

• refer to physician
• if not properly managed, permanent loss of motion and disability can occur
• wrist should be immobilized for 4 weeks
• surgery if conservative fails

Question 13

Specific Injuries: TFCC Injury - Signs and Symptoms

Answer 13

• common for the patient not to immediately report injury
• pain along ulnar side of wrist
• extension is difficult and painful on ulnar side
• clicking sound or a catching sensation when moving wrist
• considerable swelling around wrist