day eleven: extensor tendon injuries Flashcards
three muscules of the extensor tendon digits?
EDC
EDM
EI
two muscles of the thumb?
Extensor pollicus longus
extensor pollicus brevis
three actions of the EDC:
extends the MCP joint of the medial 4 digits
- (w/ lumbricals) extends the IP joints
- weakly extends the wrist
Insertion of the EDC:
base of the middle phalanx of the extensor zone 3
the central slip:
the insertion of the EDC at the base of the middle phalax of the extensor zone 3
three things combine at the central slip
both interossei
the lumbricals
EDC proximal to ins
ligamentous structures in the dorsal finger present in what shape?
triangular ligaments
there are ______ extensor zones for the ______
eight
finger zones
there are ______ extensor zones for the _______
five
thumb zones
list four treatment goals for an extensor tendon injury
prevent tendon rupture
restore PROM and AROM
encourage tendon glidng
prevent flexion contractures
mallet finger occurs in what zones?
one and two
mallet finger def?
a lesion of the terminal extensor tendon
what injury is most common in the extensor tendon?
mallet finger
how doe mallet finger look?
dip flexion
pip hyperextension
goal of the mallet finger treatment?
30 degrees of flexion at PIP and 10 degrees hyperextension at DIP if lateral band is torn
when could you have unrestricted use for mallet finger?
12 weeks
so it takes how many weeks to heal for mallet finger?
12 weeks
when is a splint removed for mallet finger?
6-8 weeks
bountonnierre deformity
occurs after rupture of the central slip or triangular ligament (zones f3 and 4)
boutonnier deformity occurs in what zones?
3 and 4
boutonniere deformity looks like?
dip hyperextension
pip flexion
what would you do at 10-12 weeks with boutonieres deformity
gentle strengthening for full fist
continue to wear the splint between exercises at night
difference between mallet finger and boutonniere for treatment goals?
mallet you’re unrestricted w/o splint at 12 weeks
boutinnerre you still wear in between exercises and at night
what injury happens in zone 5
sagittal band
where is the sagittal band found
zone 5
a zone 5 sagittal band rupture is a
laceration at the level of the MCPs
treatment for zone 5 sagittal band injury
dynamic splinting
differences between zone 1-2 treatment 3-4 tx and 5-6 tx
1-2: mallet: 12 w unrestricted
3-4: boutinnerre; still have splint half time
5-6: dynamic splinting
one additional thing in zone 5-8 injuries:
juncturae tendinum
what is one thing you have to remember with juncturae tendinum
when making a splint you have to include the ulnar side if includes anything else put the index finger
with early motion method what splints would you use when?
dynamic splint in the morning
immobilization splint at night
what type of splint would you use with juncturae tendinum
immobilization splint
when would relative motion splinting be used?
with patient with two ore more intact long extensor finger tendons
what degrees are used with relative motion splinting?
15 degrees more extension
what degrees would you put the wrist in ?
20-25 degrees
relative motion protocol
6 weeks splint discontinued
activity encouraged the entire time
list four complications of extensor tendon injury
infection
tendon rupture
tendon adhesion
joint stiffness
