Common Hand & Wrist Problems Flashcards
What is the rhyme to remember the carpal bones?
She licks toms pisiform because her capitate was too tight
What carpal bone is below the thumb?
trapezIUM is below the thUMB
What is a Colles’ fracture?
fracture of the radius in the wrist,
with a characteristic backward displacement of the hand: dinner fork,
FOOSH
What is a Smith’s fractures
Fracture of the distal radius.
direct blow to dorsal forearm or falling onto flexed wrists
Outline Rheumatoid arthritis
long-term autoimmune disorder, inflam of synovial membrane = swollen, tender, warm, stiffness limits movement, increased stiffness early in morning
Describe osteoarthritis
progressive disorder of joints = gradual loss of cartilage = devel of bony spurs and cysts at margins of joints
How does a scaphoid fracture present
Most common type of carpal bone fracture.
Usually present with pain at base of thumb accompanied by swelling in same area
Describe a 5th metacarpal (Boxer’s) fracture
Classically, fracture occurs transversely across neck of bone, after pt strikes an object with a closed fist
What is De Quervain’s tenosynovitis?
Inflam of fluid-filled sheath/tunnel that surround 2 tendons that control movement of the thumb = pain radial side of wrist, spasms, tenderness, occasional burning sensation in hand, and swelling over thumb side of wrist, difficulty gripping
What is finkelsteins test?
used to diagnose De Quervain’s tenosynovitis = grasps thumb and ulnar deviates hand sharply, sharp pain occurs along the distal radius = de Quervain’s tenosynovitis is likely
Discuss carpal tunnel syndrome
Compression of median nerve within the carpal tunnel by thickened ligaments and tendon sheaths = numbness, tingling, pain- worse in the mornings, can use split and corticosteroid injections
What happens due to compression of the ulnar nerve in Guyon’s canal
Feeling of pins and needles in ring and little fingers before progressing to a loss of sensation and/or impaired motor function of the intrinsic muscles.
Commonly seen in regular cyclists due to prolonged pressure of Guyon’s canal against bicycle handlebars.
What is dupuytrens contracture?
fixed forward curvature of one or more fingers,
caused by development of fibrosis of palmar fascia = PIPJ contracture >30 degrees
Describe reflex sympathetic dystrophy
characterised by severe pain and sensitivity, swelling, and changes in the skin
Outline ulnar claw
Ulnar nerve lesion = partial/complete = denervation of medial 2 lumbricals = unopposed extension = hyper-extension of MCP joint of little finger and ring finger + Flexion IP joints of little finger and ring finger
Interossei paralysed = no abduction, no adduction
