Disorders of the Hand and Wrist Flashcards
What is a ganglion cyst?
Benign, fluid filled cyst forms as a herniation of the synovium of the wrist joint, or from the tendon sheath
What are the symptoms of a ganglion cyst?
Usually painless mass. Can be quite firm. Often fluctuates in size.
What is the treatment of a ganglion cyst?
- Aspiration and injection of corticosteroid can be performed but high chance of reoccurrence
- Surgical excision still has 20 % reoccurrence
Where is the pain located for a scaphoid fracture?
the anatomical snuff box
how do scaphoid fractures usually occur?
- young male
- high energy fall on outstretched hand
- radial sided wrist pain
- treatment not sought early
what do you have to keep in mind about a scaphoid fracture on X-ray?
they usually don’t show!
if high suspicion–> re-xray in 2 weeks
How do you treat scaphoid fractures?
- thumb spica cast for non-displaced fx (12 weeks)
- open reduction internal fixation for acute fx
- bone graft for displaced or non-vascular frx
Describe how a triquetral avulsion fracture may occur:
Usually fall on outstretched hand of low to moderate intensity
Where will the pain be for a triquetral avulsion fracture? what is the treatment?
over the dorsum of the wrist in the midline position
Treatment is cast or splint for 3 weeks if having a lot of pain
How does a “hook of the hamate” fracture normally occur?
Usually caused by forceful blow while holding bat, golf club, tennis racket
Can occur with high energy fall to ulnar side of hand
What will the pain symptom be that accompanies a HOH fx?
What is the treatment?
pain with grasp
treatment = excision
What are the three post-traumatic reasons for wrist arthritis?
Scaphoid non-union
Old Scapholunate ligament injury
Malunion or intra-articular Distal Radius Fractures
What is a mucous cyst?
- Benign cyst usually arising from the distal interphalangeal joint (DIP)
- Often associated with an arthritic joint
- Many times causes ridging or deformity of nail
What is the treatment for a mucous cyst?
a pressure wrap or surgical excision (but there is a high recurrence rate)
What is a retinacular cyst? What is the treatment?
Benign ganglion cyst arising from the flexor tendon sheath
Treatment is aspiration with corticosteroid injection or surgical excision
What is a Giant Cell Tumor of the Tendon Sheath? How do you treat it?
Aggressive, locally growing benign tumor of the tendon sheath
Painless
Surgical excision before too large
What is a mallet finger? how is a mallet finger normally caused?
Definition: Loss of continuity of the extensor tendon to the Distal Phalanx.
Cause: Forceful hyper-flexion of the DIP