Common disorders of the hand and wrist Flashcards
What is a colles fracture
A extra-articular fracture of the distal radial metaphysis with dorsal angulation
Most common type of distal radial fracture commonly seen in osteoporosis
Dinner fork deformity
Smiths fracture
Fracture of the distal radius with palmar angulation of the distal fracture fragment
Leads to garden spade deformity
Common deformities seen in advanced rheumatoid arthritis
Swan neck deformity
Boutonnière deformity
Swan neck deformity
Tissues on the volar aspect of the proximal PIPJ joint become lax
the PIPJ hyperextends and MCPJ and DIPJ are flexed
Boutenniere deformity
MCPJ and DIPJ are hyperextended and the PIPJ is flexed
Heberdens nodes
classic sign of osteoarthritis and affect the DIPJ of the fingers. They typically develop in middle age, are more common in women than men and tend to run in families, suggesting a genetic predisposition.
Carpal tunnel syndrome
Compression of the median nerve as it passes through the carpal tunnel from the forearm into the hand
Causes of carpal tunnel syndrom
TRAMP
T-trauma R- rheumatoid arthritis A- acromegaly M- Myxoedema P- pregnancy
Dupuytren’s contracture
Common condition in which there is localised thickening and contracture for the palmar aponeurosis leading to flexion deformity
Which nerve is commonly injured in mid shaft humeral fracture
Radial because it runs in the radial groove on the posterior surface of the shaft of the humerus
Will the patient be able to extend their elbow in injury to he radial nerve
Yes. Extension of the elbow will either be normal or only mildly compromised. The nerve supply to the long and lateral heads of triceps is given off prior to the radial nerve entering the spiral groove. The nerve supply to the medial head of triceps is given off in the spiral groove, but this is generally proximal to the fracture and thus is unaffected. Anconeus is paralysed but this has only a minor role in elbow extension.
In what position will the patients wrist and fingers be in radial nerve injury
The wrist and fingers will be flexed. Injury to the radial nerve in the radial groove will result in paralysis of brachioradialis and all extensor muscles of the wrist and fingers. This injury results in “wrist drop” and inability to actively extend the fingers. The wrist and fingers are flexed when the forearm is pronated because of unopposed flexor muscles and gravity.
Sensory impairment in radial nerve injury
Superficial branch of the radial nerve
When is the median nerve commonly damaged
Supracondylar fracture of the humerus
What is hand of benediction
When the patient attempts to make a fist the ring and little fingers will flex into the palm normally however the index ad middle fingers remain fully extended
