H A N D + W R I S T Flashcards
give the common wrist fractures
colles’
smith’s
scaphoid
what is the moi of colles’ fracture
FOOSH
describe the pathology of colles’ fracture
- transverse distal radial fracture, extra articular
2. dorsal displacement and angulation
what Lx are required in suspected wrist fracture
XR - pa, lateral, oblique of wrist
describe management of wrist fracture
closed reductio and cast application
ORIF if remains unstable following reduction
describe scaphoid fracture and its presentation
carpal fracture
Tenderness over anatomical snuffbox
Pain on movement of wrist
Pain on longitudinal compression of the thumb
lx and management of scaphoid fracture
XR
Repeat XR in 7 – 10 days if inconclusive
CT/MRI
Cast for 6/52 if undisplaced and distal
Operative management if unstable or # of proximal pole
what is carpal tunnel syndrome
Compression of the median nerve within the carpal tunnel leads to paraesthesia of the lateral 3 and a half digits
Thenar wasting may also be apparent
risk factors for carpal tunnel
F>M, pregnancy, obesity, DM, hypothyroidism, multiple myeloma, particular occupations
management for carpal tunnel syndrome
Conservative – splint
Medical – steroid injections
Surgical – carpal tunnel release surgery. LA, ELECTIVE
what is duputreyn’s contracture
Thickening of palmar fascia leads to contracture and fixed flexion of the fingers (ring and little usually)
rx for duputreyn’s contracture
alcohol, smoking, DM, FHx, epilepsy
describe management of dupuytren’s
fasciectomy
needle fasciotomy
what is trigger finger
Stenosing flexor tenosynovitis
Finger or thumb lock in flexion
Associated with DM, RA and amyloidosis
management of trigger finger
Conservative (splint)
Medical – steroid injections
Surgical – percutaneous trigger release
