day eleven: extensor tendon injuries

Question 1

three muscules of the extensor tendon digits?

Answer 1

EDC
EDM
EI

Question 2

two muscles of the thumb?

Answer 2

Extensor pollicus longus

extensor pollicus brevis

Question 3

three actions of the EDC:

Answer 3

extends the MCP joint of the medial 4 digits

• (w/ lumbricals) extends the IP joints
• weakly extends the wrist

Question 4

Insertion of the EDC:

Answer 4

base of the middle phalanx of the extensor zone 3

Question 5

the central slip:

Answer 5

the insertion of the EDC at the base of the middle phalax of the extensor zone 3

Question 6

three things combine at the central slip

Answer 6

both interossei
the lumbricals
EDC proximal to ins

Question 7

ligamentous structures in the dorsal finger present in what shape?

Answer 7

triangular ligaments

Question 8

there are ______ extensor zones for the ______

Answer 8

eight

finger zones

Question 9

there are ______ extensor zones for the _______

Answer 9

five

thumb zones

Question 10

list four treatment goals for an extensor tendon injury

Answer 10

prevent tendon rupture
restore PROM and AROM
encourage tendon glidng
prevent flexion contractures

Question 11

mallet finger occurs in what zones?

Answer 11

one and two

Question 12

mallet finger def?

Answer 12

a lesion of the terminal extensor tendon

Question 13

what injury is most common in the extensor tendon?

Answer 13

mallet finger

Question 14

how doe mallet finger look?

Answer 14

dip flexion

pip hyperextension

Question 15

goal of the mallet finger treatment?

Answer 15

30 degrees of flexion at PIP and 10 degrees hyperextension at DIP if lateral band is torn

Question 16

when could you have unrestricted use for mallet finger?

Answer 16

12 weeks

Question 17

so it takes how many weeks to heal for mallet finger?

Answer 17

12 weeks

Question 18

when is a splint removed for mallet finger?

Answer 18

6-8 weeks

Question 19

bountonnierre deformity

Answer 19

occurs after rupture of the central slip or triangular ligament (zones f3 and 4)

Question 20

boutonnier deformity occurs in what zones?

Answer 20

3 and 4

Question 21

boutonniere deformity looks like?

Answer 21

dip hyperextension

pip flexion

Question 22

what would you do at 10-12 weeks with boutonieres deformity

Answer 22

gentle strengthening for full fist

continue to wear the splint between exercises at night

Question 23

difference between mallet finger and boutonniere for treatment goals?

Answer 23

mallet you’re unrestricted w/o splint at 12 weeks

boutinnerre you still wear in between exercises and at night

Question 24

what injury happens in zone 5

Answer 24

sagittal band

Question 25

where is the sagittal band found

Answer 25

zone 5

Question 26

a zone 5 sagittal band rupture is a

Answer 26

laceration at the level of the MCPs

Question 27

treatment for zone 5 sagittal band injury

Answer 27

dynamic splinting

Question 28

differences between zone 1-2 treatment 3-4 tx and 5-6 tx

Answer 28

1-2: mallet: 12 w unrestricted
3-4: boutinnerre; still have splint half time
5-6: dynamic splinting

Question 29

one additional thing in zone 5-8 injuries:

Answer 29

juncturae tendinum

Question 30

what is one thing you have to remember with juncturae tendinum

Answer 30

when making a splint you have to include the ulnar side if includes anything else put the index finger

Question 31

with early motion method what splints would you use when?

Answer 31

dynamic splint in the morning

immobilization splint at night

Question 32

what type of splint would you use with juncturae tendinum

Answer 32

immobilization splint

Question 33

when would relative motion splinting be used?

Answer 33

with patient with two ore more intact long extensor finger tendons

Question 34

what degrees are used with relative motion splinting?

Answer 34

15 degrees more extension

Question 35

what degrees would you put the wrist in ?

Answer 35

20-25 degrees

Question 36

relative motion protocol

Answer 36

6 weeks splint discontinued

activity encouraged the entire time

Question 37

list four complications of extensor tendon injury

Answer 37

infection
tendon rupture
tendon adhesion
joint stiffness