Conditions of the Hand Flashcards
Who gets dupuytren’s
M> F 8:1 15-64
M>F 2:1 75+
Autosomal dominant
Associations - Diabetes, alcohol, tobacco, HIV, epilepsy
Pathology of Dupuytren’s
Shortening and thickening at palmar fascia
Finger contracture
Loss of extension
Functional effects of dupuytrens
Not painful
Loss of extension - active or passive
Grippling things
Washing face
Dupuytren’s treatment
Non operative : Observe, radiotherapy
Operative: Partial or dermo fasciectomy, arthrodesis, amputation, percutaneous needle fasciotomy, collagenase
Trigger Finger who?
F > M 40s-60s Ring > thumb > finger Repetitive use of hand Local trauma Associations - RA, DM, gout
Pathology of trigger finger?
Swelling in tendon catches on pulley
Trigger finger diangosis
Patient history Clicking sensation with movement of digit Lump in palm under pulley Use other hand to unlock Clicking --> locking
Trigger finger treatment/
Non operative - splint age, steroid
Operative - percutaneous release, open surgery
De Quervain’s Syndrome
Tendons of APL and EPB, swollen, hot, tender, red
Pain on radial side wrist aggravated by movement of thumb
Finkelstein’s test
Treatment splints, steroid injection or decompression
Who get ganglion?
F > M 2:1
20-40 years peak
Dorsal > volar 3:1
Recurrent injury to wrist
Pathology of ganglion
Myxoid degeneration from joint synovia
Arise from capsule, sheath or ligament
Diagnosis of ganglion
Present with lump\ Firm non tender Change in size Smooth Not fixed to underlying tissues Never fixed to skin
Treatment of ganglion
Non-operative: reassure and observe, aspiration
Operative: excision including the root
OA of base of thumb symptoms
Pain, stiffness Swelling Deformity Loss of function Pain pinching
X-ray of OA base of thumb
Decreased joint space, subchondral sclerosis and cysts, osteophytes
