Exam 3 Hand Ortho Emergencies Flashcards
Metacarpal Fxrs found in what areas? (4)
1) Head
2) Neck
3) Shaft
4) Base
Metacarpal Fxrs U caused by what motion?
Direct blow
Smashed
Boxer’s Fxr is?
Caused by?
Fxr of 5th metacarpal
Punching
Boxer’s Fxr presentation? (3)
Always assess for what?
Significant swelling
Point tender
ROM preserved
Human bite
Boxer’s Fxr tx? (3)
If no angulation = ulnar-gutter splint, refer to ortho
If angulation > 35° = reduction
If a/w bite = vigorous wound care, ABX
Bennett’s Fxr is?
Tx?
Fxr of thumb metacarpal base
Disrupts carpometacarpal joint at volar base
Reduction + internal fixation
Gamekeeper’s Thumb is?
Mechanism of Injury?
Presentation?
Tear in ulnar collateral ligament (UCL) of the MCP joint of the thumb
Ski pole, MVA
Point tender @ base of thumb
UCL > 40° angle
Complete rupture = difficulty pinching
Gamekeeper’s Thumb tx?
Thumb Spica splint
Hand Ortho
PIP/DIP dislocations U involve?
Mechanism of Injury?
Tx?
Ligament rupture
P fxr
Hyperextension or lateral force
Splint
Hand Ortho
Reduction of MCP/PIP/DIP in fingers 2-5?
Longitudinal traction
w/ Hyperext for dorsal dislocation
w/ Hyperflex for volar dislocation
Tuft Fxr is?
Tx?
Crush injury to fingertip
Splint
Refer
Subungual Hematoma result of?
Tx?
Crushed fingertip
(bleeding under nail)
Evac w/ 18g needle or electrocautery
Dress/splint
Subtotal Amputation result of?
Tx?
Crushed fingertip
Clean/Irrigate/Refer
Laceration and Nail bed need repair
Tetanus, ABX, pain meds
Complete tip amputation tx?
Tetanus
ABX
Pain meds
Compartment Syndrome is?
↑ pressure w/i osteofascial compartment causes ↓ perfusion ->
causes necrosis, limb loss, renal fail
Forearm compartments? (4)
1) Superficial volar (flexor)
2) Deep volar (flex digi profundus, flex pollicis long, pronator quad mm/tendons)
3) Dorsal (extensor)
4) Mobile wad of Henry (barchioradialis, ext carpi rad brev/long mm/tendons)
Hand compartments? (10 total/5 categories)
1) Dorsal interossei x 4
2) Volar interossei x 3
3) Add pollicis
4) Thenar
5) Hypothenar
Compartment Syndrome presentation? (6)
Pain OOP Pain w/ passive stretch Parasthesia Paralysis Pulselessness Swollen, hard shiny skin
Compartment Syndrome caused by?
Fxr Crush Injection Infection Drugs
High Pressure Injection injury is?
High pressure device (paint/grease guns) inject substance into hand
Type of substance important
High Pressure Injection injury presentation?
Tx?
Initial findings scant
URGENT referral to ortho
Hospitalize
Prompt decompress/debridement/irrigation
Long recovery
