Hand Flashcards
What are the indications for repantation.
Contraindications to replant
Treatment of replant patient in ER.
What is your approach to replant?
What is your post op replant care?
What is approach to failing replant?
What’s your approach to major limb replant?
ICU, Blood
Perfusate.
Warn Anesthesia, K+, lactate, myoglobin
Fasciotomies.
Replant complications?
Replant Outcomes?
Differential for bone tumors?
What are the stabilizing ligaments of the thumb?
What position would you fix your thumb arthrodesis?
What would you also assess?
What are the diagnostic criteria of RA?
What is the Nalebuff Rhume classification?
Non op, passive corr, flxed, salvage
What is the approach to RA?
What are the indications and principles of tendon transfers?
An RA patient is referred for inability to flex thumb.
What is your reconstructive plan?
A patient has extensor tendon ruptures.
What is your algorthim.
Side to side for closest, EIP or FDS.
All 4: FDS 3 and 4 to power 2 EDC.
What are the options for EPL TT?
What is the Nailbuff Thumb classification?
How would you manage a Type 1 and Type 3 Nailbuff thumb deformity?
What angle would you fuse the MCP?
What is the algorthim for ear coverage?
What are the tendon excursions?
What is your post op protocol for TT?
6 retrain
8 strength
12 foll
What’s the difference between a high and pin palsy?
What are the radial nerve TT?
What are the signs of ulnar nerve palsy?
What is the BOUVIER maneuver?
A patient has a high ulnar nerve palasy 3 years ago.
What do you need to reconstruct for high and low ulnar nerve palsies?
D45 ETS D3
FCR–> FCU
What are the tendon transfers for low and high ulnar nerve palsy?
How would you do your key pinch reconstruction?
ECRB + TG- Palmar to adductor, dorsal to tendons, NV strs.
FDS - fascia used as pulley - weakens power grip.
1st DI - APL accessory slip +TG
What are the muscles innervated by the median nerve?
What do you need to reconstruct in median nerve palsey?
Low - opponens
AIN - FPL/ FDP2
High - all
What movement is thumb opposition?
What are the options? And prerequsites?
Flexion, abducion, pronation (FAP)
May not be fully compromised if dual innervation to FPB. Dont do opponens then.
Describe a EIP/ Burkhalter transfer, what is the position of tension?
When can you not use FDS?
Describe and FDS/ Bunnell transfer.
Wrist in neutral, max palmer abduction.
High Median or ulnar.
Review the median nerve TT.
What nerve transfers could be used in low/high median nerve palsy.
Sensory?
What are the CP changes in hand, wrist, forearm.
What are the requirements for surgical innervation in a TP patient?
How would you eval?
Options:
Elbow: Central delt +TG, Biceps
Wrist: BR –> ECRL
Pinch–> BR or Moberg(Static) to DR -+ IP fusion
Digits extension: EDC/EPL tenodesis, Fowler static wrist tenodesis
flexion: 2s2 fdp, ECRL
Intrinsic: any opponens, static claw correction.
You get a referal for a patient with corkscrew collaterals.
WHat is your differential.
What is your management if its Buerger’s?
What are the ligaments of the wrist.
Extrinsic and intrinsic.
RSC, RSL, L&S RU, UL, UTq
DRC (RL, RTq)
Intrinsic: SL (DSL stronger dorsal), LTq. (TV) stronger volar
Volar:+ PisoHam
Dorsal: + Dorsal Intercarpal lig
What are the components of the TFCC.
What is the blood supply to the scapoid?
Clinical signs of scapoid #?
What is your initial management of a scapohid fracture?
What are the indicaitons?
What is a humpback deformity?
Describe your OR for scaphoid #.
RF for scaphoid non union.
What are the SNAC stages and treatment?
How to reduce a Perilunate injury?
What is your algortim for Kienbocks?
How would you test for TFCC pathology?
What are the functions?
What would you see on XR?
Ins
Pal: Ulnar wrist, Fovea, Druj Stab, Impaction
Clicking with Pro/sup
Stabilize, Cushion, P/S
What are the treatment options for TFCC?
What are the DRUJ stabilizers?
What are causes of instability?
What would you see on exam? Inv? Tx?
What are the concepts of nerve transfer.
What are the common nerve transfers?
What are the contents of the triangular space, interval and quadrangular space?
What is the course of the median nerve?
What is the course of the ulnar nerve? Where does the dorsal branch separate?
What are the sites of compression of the ulnar nerve?
What is the course of the radial nerve?
What is the boundaries of the radial tunnel. How do you differentiate Epicondylitis vs PIN?
Sites of RC compression
- Bands at RC
- ECRB tendinous origin
- Recurrent radial - leash of Henry
- Proximal/ Distal Supinator
Review the Seddon and Sunderland Classification.
What are the factors of nerve recovery?
How will you do a local flap ear repair?
