Forearm Injuries Flashcards
0
Q
Forearm fractures
A
- pretty common
- ulna and radius generally fracture individually
- audible pop or crack
- moderate/severe pain
- swelling
- loss of function
- discoloration
1
Q
Contusion management
A
- price
- rule out fracture
- monitor
- pad/protect
2
Q
Compound forearm fracture
A
- monitor for shock
- cover/keep clean
- call 991
3
Q
Management for fracture
A
- eval
- check pulse
- Ice
- splint
- sling
- refer for X-ray
- long term casting
4
Q
Colles fracture
A
- almost all wrist fractures will be this
- distal end of radius or ulna
- fall on out stretched hand forcing wrist into hyperextension
5
Q
Smith fracture
A
Anterior displacement of distal fragment
6
Q
Signs/symptoms of a colles fracture
A
- forward displacement of radius causing visible deformity (dinner fork deformity)
- ice/splint/refer
- if you think it’s a sprain, and it doesn’t get better refer them
7
Q
Thenar eminence
A
Thumb side
8
Q
Hypothenar eminence
A
Non- thumb side
9
Q
Wrist sprains
A
- most common
- usually fall on hyperextended wrists
- violent flexion or torsion
- multiple incidents may disrupt blood supply and nutrition to carpals
11
Q
Management of wrist sprains
A
- price
- splint
- analgesics for pain
- rehab
- tape
12
Q
Triangular Fibrocartilage Complex Injury (TFCC)
A
- forced hyperextension
- violent twist or torque of wrist
- pain along side ulnar side of wrist, difficulty with wrist extension, possible clicking
- swelling
- refer, immoblize (4 weeks)
13
Q
Tenosynovitis
A
- repetitive wrist acceleration and deceleration
- overuse
- pain with use or passive stretching
- tenderness/swelling
- crepitus
- rest, NSAIDs, immobilization, US
- Increase ROM/strength
14
Q
Tendinitis
A
- overuse
- pain with active use or passive stretching
- RICE, NSAIDs, rest
- heat to promote healing
- ROM/strength
15
Q
Nerve Compression, Entrapment, Palsy
A
- median/ulnar nerve
- overuse/direct trauma
- sharp/burning pain
- claw hand deformity
- refer/decompression may need surgery
16
Q
Bishop/benediction Hand
A
- Ulnar nerve
- thumb, pointer and middle up
- ring/pinky folded down
17
Q
Drop wrist
A
- Radial nerve
- can’t extend hand
18
Q
Claw Hand
A
- Ulnar and Median nerve
- all fingers folded, but spread apart
19
Q
Ape Hand
A
- Median Nerve
- same as claw hand but fingers are together
20
Q
Carpal Tunnel Syndrome
A
- compression of the median nerve due to inflammation of tendons and sheaths of carpal tunnel
- repeated wrist flexion
- tenosynovitis of flexor tendons
21
Q
Signs/Symptoms for Carpal Tunnel
A
- sensory and motor deficits
- tingling, numbness, and paresthesia
- digits 2-4
- thumb weakness
22
Q
Phalen’s Test
A
- carpal tunnel syndrome
- position is held for 1 min
- backs of hands together
- positive test = pain/numbness/tingling
- *Tinel’s sign
23
Q
Management for Carpal Tunnel
A
- conservative treatment
- referral
- rest, immob., NSAIDs
24
Q
de Quervain’s Disease (Hoffman’s disease)
A
- stenosing tenosynovitis in thumb (extensor pollicis brevis & abductor pollicis longus)
- overuse
- aching pain, may radiate into hand or forearm
- positive finkelstein’s test
- weakness during thumb extension and abduction; painful catching and snapping
25
Q
Finkelstein’s Test
A
- athlete makes fist with thumb tucked inside
- wrist is ulnarly deviated
- positive sign is pain
26
Q
Management of de Quervain’s
A
- immobilization
- rest
- ice
- NSAIDs
- US
- Joint mobes to maintain ROM
27
Q
Dislocation of the Lunate
A
- forceful hyperextension
- numbness/paralysis of flexor muscles due to pressure on median nerve
- refer for reduction
28
Q
Kienbock’s Disease
A
- loss of blood supply to lunate bone from osteonecrosis
- decreased grip strength
- immob/NSAIDs
29
Q
Scaphoid Fracture
A
- falling on an outstretched hand
- compression of the scaphoid between the radius and second row of carpal bones
- poor blood supply so it doesn’t heal
- severe pain in the anatomical snuff box
- pain with radial flexion
30
Q
Management of Scaphoid Fracture
A
- referral
- immobilization 6 weeks or longer
- rehab
- unstable fractures may require internal fixation
31
Q
Hamate Fracture
A
- falling/contact with equipment
- wrist pain/weakness
- point tenderness
- pull of muscle attachment may cause non-union
- cast wrist/thumb
32
Q
Wrist Ganglion
A
- synovial cyst (herniation of joint capsule or synovial sheath)
- area of swelling
- pain that increases with use
- aspiration/chemical cauterization, pressure pad, surgical removal
33
Q
Trigger Finger
A
- overuse resulting in tenosynovitis
- inflammation of extensor tendons or wrist, fingers and thumb
- snapping sensation that is palpable, audible and painful
- painful
- nodule may be felt within tendon sheath
34
Q
Extensor Tendon Avulsion (Mallet Finger
A
- blow to the tip of finger
- pain at DIP
- unable to extend distal end of finger (stuck at 30 degrees)
- RICE/splint 6-8 weeks
35
Q
Boutonniere Deformity
A
- inability to extend DIP
- swelling and point tenderness
- splint 6-8 weeks
- *called a button hole
36
Q
Jersey Finger
A
- Rupture of flexor digitorum profundnus tendon from insertion on distal phalanx
- usually ring finger
- DIP cannot be flexed, finger remains extended
- must be surgically repaired
- rehab of 12 weeks
37
Q
Dupuytren’s Contracture
A
- nodules develop in palmer aponeurosis, limiting finger extension
- most common in 4th or 5th digits
- nodules must be removed to restore normal hand function
38
Q
Gamekeeper’s Thumb
A
- sprain of UCL of MCP joint of the thumb
- forceful abduction of the proximal phalanx
- pain over UCL
- instability
- immediate referral
- thumb splint for 3 weeks
39
Q
Sprains of Interphalangeal Joints
A
- axial loading and or various/valgus stress
- pain/swelling/point tenderness
- paraffin/ROM
40
Q
PIP Dorsal Dislocation
A
- hyperextension
- obvious deformity
- reduce?
41
Q
PIP Palmar Dislocation
A
- twisting motion while digit is semi flexed
42
Q
MCP Dislocation
A
- twisting or shearing force
43
Q
Metacarpal Fracture
A
- direct axial force or compressive force
- 5th metacarpal (boxer’s fracture)
- splint/refer
44
Q
Bennett’s Fracture
A
- carpometacarpal joint of the thumb as a result of an axial and abduction force
- deformity
- loss of function
45
Q
Distal Phalangeal Fracture
A
- crushing force
- pain and swelling
- drain subungual hematoma if present
46
Q
Middle Phalangeal Fracture
A
- direct trauma or twisting motion
- pain/swelling/ over middle phalanx
- possible deformity
- buddy tape if no deformity
- immob if deformity 3-4 weeks, additional splint for 9-10 weeks
47
Q
Proximal Phalangeal Fracture
A
- spiral or angular force
- pain/swelling
- immobilization of the wrist in slight extension
48
Q
PIP Fractures and Dislocation
A
- axial load on a partially flexed finger
- pain, swelling, tenderness
- small bone fragment - buddy taping
- large bone fragment - splint at 30-60 degrees
49
Q
Fingernail deformities
A
- changes in normal appearance can be indicative of different diseases
- scaling or ridging = psoriasis
- ridging and poor development = nutritional deficiencies
- yellowing = heart/congenital diseases
- spooning/depression = iron deficiency
