Forearm, wrist & hands

Question 1

Carpal tunnel syndrome- Eti

Answer 1

Most common compressive neuropathy, 40-60 YO, Female>male

Question 2

Carpal tunnel syndrome- Sx

Answer 2

Bothersome during sleep, muscle weakness at thenar eminence, Pain, numbness & parasthesias in distribution of median nerve

Question 3

Carpal tunnel syndrome- Dx

Answer 3

Tinel, Phalen, Median nerve compression test

Question 4

Carpal tunnel syndrome- Tx

Answer 4

Splinting, cortisone, surgical tx

Question 5

Dupuytren contracture- Eti

Answer 5

White males over 50, DM, alcohol, tobacco, trauma, repetitive use

Question 6

Dupuytren contracture- Sx

Answer 6

Hyperplasia of palmar fascia, nodular or cord like thickening, most commonly 4th & 5th digit.

Question 7

Dupuytren contracture- Dx

Answer 7

Clinical

Question 8

Dupuytren contracture- Tx

Answer 8

Injection or surgical intervention

Question 9

De Quervain tenosynovitis- Eti

Answer 9

Entrapment of tendons leading to thumb. Peritendonitis without inflammation. Common in mothers with infants

Question 10

De Quervain tenosynovitis- Sx

Answer 10

Tenderness over first extensor compartment. Finklestein Test positive

Question 11

De Quervain tenosynovitis- Tx

Answer 11

Spinting, steroids, surgical release

Question 12

Colles Fracture- Eti

Answer 12

Distal radius fracture caused by FOOSH- dorsiflexion

Question 13

Colles Fracture- Sx

Answer 13

Dinner fork deformity, pain swelling and tenderness on distal forearm

Question 14

Colles Fracture- Tx

Answer 14

Reduction and casting

Question 15

Smith Fracture- Eti

Answer 15

Dorsally angulated fracture of distal radius, displaced volarly

Question 16

Smith Fracture- Sx

Answer 16

Garden spade deformity. Volar angulation of distal radius

Question 17

Smith Fracture- Tx

Answer 17

Reduction and casting

Question 18

Navicular fracture- Eti

Answer 18

Most common carpal bone break, FOOSH, At risk of developing avascular necrosis

Question 19

Navicular fracture- sx

Answer 19

Pain in anatomical snuffbox- radiating to radial aspect of wrist

Question 20

Navicular fracture- Tx

Answer 20

Splint to surgery depending on pt and severity

Question 21

Boxer fracture- Eti

Answer 21

Direct blow of hand striking a solid object- common in young males punching things

Question 22

Boxer fracture- Sx

Answer 22

5th metacarpal neck fracture + postive PMH

Question 23

Boxer fracture- Tx

Answer 23

Splint. Reduction if significant angulation

Question 24

Bennett Fracture- Eti

Answer 24

Dislocation of thumb basal joint with displacement of metacarpal articular surface

Question 25

Bennett Fracture- Sx

Answer 25

Thumb displaced proximally, radially and into adduction

Question 26

Bennett Fracture- Tx

Answer 26

Reduction & fixation with pins

Question 27

Ganglion cyst- Eti

Answer 27

Most common benign tumor of hand or wrist- not nerve related. Joint leakage due to weakness in joint capsule.

Question 28

Ganglion cyst- Sx

Answer 28

Common at dorsal wrist & palmar aspect of radial wrist. Painless, mobile, transinllumiation growth. Gel like consistency

Question 29

Ganglion cyst- Tx

Answer 29

Aspiration. Recurrance is common.

Question 30

Paronychia- Eti

Answer 30

Most common infection of the hand. Infection to seal of nail fold. S. aureus most common

Question 31

Paronychia- Sx

Answer 31

Local pain, tenderness, erythema and pus where nail plate meets fold

Question 32

Felon- Eti

Answer 32

Closed space infection of compartment- commonly thumb or index. Hx of penetration, splint or paronychia

Question 33

Felon- Sx

Answer 33

Pain, abscess, erythema and swelling

Question 34

Tuft Fracture- Eti

Answer 34

Fracture of distal phalanx, commonly due to crushing injury. May affect nailbed

Question 35

Tuft fracture- Sx

Answer 35

Hx & injury at distal phalanx