Facts from Questions Flashcards
management of acute injuries of sagittal bands?
in normal people can be treated with extension splinting
in professional athletes, acute open repair
indication for collagen conduits:
small (<4cm) defects in small diameter, simple sensory nerves
- for most everything more complex, choose autograft (sural or MABC)
proper collateral ligament of the digits:
restraint to varus/valgus with joint in flexion
accessory collateral ligament of the digits:
restraint to varus/valgus with joint in extension
sural artery pedicle is to the:
gastrocnemius - both medial and lateral heads.
85% of the time there isa single vascular supply
what causes swan neck deformity?
chronic volar plate ruptures
utility of basal joint injections for OA?
no difference between cortisone, hyaluronan, and saline
indications for a Darrach procedure?
only in low demand elderly patients
DRUJ arthritis/instabilty
best treatment for heavy laborers with DRUJ OA and TFCC insufficiency?
TFCC reconstruction and ulnar hemiresection arthroplasty
most common causes of radial tunel syndrome:
- fibrous adhesions between brachialis and BR
- the leash of henry (radial recurrent vessels)
- fibrous edge of ECRB
- arcade of frohse (supinator arch)
- fibrous distal edge of supinator
best tendon transfers for PIN palsy:
FCR to the common digital extensors
PL to the EPL
Leri-Weill Dyschondrosteosis:
- bilateral Madelung deformities
- SHOX gene mutation
SHOX gene mutation is:
Leri-Weill dyschondrosteosis
treatment of volar PIP dislocations
reduction and extension splinting for 6 weeks
- frequently with central slip injuries, and if not splinted can lead to boutonniere deformities
Merkels skin receptor
- light touch
- pressure
- 2-point discrimination
Pacinian corpuscles
- stretching of skin
Meisner’s corpuscles
- rapid response to light touch
detection of fanconi anemia?
- CBC
- peripheral blood smear
- DNA breakage analysis
Apert’s syndrome
facial dysmorphism and complex syndactyly of hands
- FGFR2 mutant
FGFR2 mtuation causes
Apert’s syndrome
SHH mutations cause:
radial longitudinal deficiencies
best flap for defects of the dorsal thumb?
first dorsal metacarpal artery flap (Kite flap/FDMA)
outcomes after pisiformectomy?
no deficiency in grip strength, power, or wrist motion
after carpal tunnel release, grip and pinch strength should return to normal by:
3 months
island volar advancement flaps to the thumb tip can be used for defects up to size:
3.5cm
How long does it take split thickness skin graft to re-epithelialize
2-3 weeks
Primary pathologic cell in Giant Cell Tumor of Tendon Sheath:
lipid laden foam cell
- disordered cellular lipid metabolism
Role of TGF-b in Dupuytren contracture
TGF-b encourages differentiation of myofibroblasts (from fibroblasts) which are the contractile cell type in Dupuytren’s
Apical ectodermal ridge
controls longitudinal forearm growth
- express Homeobox proteins
Wnt signalling in limb development
controls volar/dorsal differentiation
Role of Sonic Hedgehog Protein in limb development
controls radio-ulnar differentiation
- ulnar forearm and ulnar 4 digits
Principal function of the sagittal bands?
extension of the MP joint
Recurrence rates of giant cell tumor of tendon sheath
4-44%
- worse with extensive bone involvement, spread to tendons or joint capsule
- can consider radiation for extensive disease
Most common Martin Gruber anastomosis
type 1 - motor median to ulnar, innervating median intrinsics
Which ligament’s humeral origin is at the axis of rotation of the elbow
lateral ulnar collateral
- it is isometric and maintains static tension throughout elbow ROM
Lipoma arborescens
tumor with frondlike projections
histo wtih mature lipocytes
suprapatellar or in the elbow
replacemnt of the synovial lining with pathologic lipocytes
Lack of thumb development would typically be caused by:
SHH concentration abnormally in the anterior region of the ZPA.
- typically concentrated in the posterior region of the ZPA which corresponds to the ulna and ulnar 4 digits differentiation
- if concentrated whre the thumb wil ldevelop, will fuck up the thumb
