Hand Flashcards
What kind of details would we need to know about the injury?
Crush, sharp, burn?
Gloves/protective items?
Timing exact for injury
What kind of energy level is the injury?
What does degloving injury mean?
A degloving injury is a traumatic injury that results in the top layers of skin and tissue being torn away from the underlying muscle, connective tissue or bone
How does fingertip injuries present?
Subungual haematoma
Pressure pain –> trephine method (release pain)
How to classify nail/nailbed injuries?
Describe anatomy of finger tip
When might the V to Y procedure be performed?
When patient particularly need sensation at finger tip
What to consider when facing a hand fracture?
Which bones?
Joint involvement?
Deformity/Rotation?
Stability (index and little are more likely to be unstable)
What are boxers fractures and how are they managed?
Minor displacement in distal fingers
Use ‘buddy strap’, but require early mobilisation to get back to full function
What is a test for rotational fractures in the digits?
What is mallet finger? What are the two subtypes and how to manage each?
- Soft-tissue mallet
Tendon involvement
Make sure joint aligned, put on splint for 8 weeks - Avulsion fracture
Splint for 6 weeks
Is PIP joint dislocation a condition that requires immediate presentation and acute management?
Yes
Pull to reduce, buddy strap
Delayed presentation might be impossible to reduce and may require fusion
What is Bennett’s fracture? and How to treat it?
The Bennett fracture is the most common fracture involving the base of the thumb. This fracture refers to an intraarticular fracture that separates the palmar ulnar aspect of the first metacarpal base from the remaining first metacarpal
What are the principles of managing mutilating injuries?
What is the standard burn treatment?
What are procedures of specific treatment for the hand?
What are muscous cysts and how to manage them?
How do ganglions present and how to mange them?
Mx:
If benign, neglect
Compress with heavy book/Aspiration/excision (depends on position of ganglions)
What is trigger finger and how does it present?
Related to swelling of tendon sheath of finger tendon
How to manage trigger finger?
What does carpal tunnel consist of?
What is carpal tunnel syndrome and what are causes of it?
Reduced space in carpal tunnel
How does carpal tunnel syndrome present?
What are examination and investigations for carpel tunnel syndrome?
How to manage carpal tunnel syndrome?
How does DeQuervain’s tenosynovitis present and how to manage?
Spontaneous
Painful
Swollen/red around base of thumb
Finklestein’s test
Mx:
NSAIDS
Splint Rest
Steroid injection
Surgical decompression
What is Dupuytrens contracture of the hand and how does it present?
Thickening and contracture of subdermal fascia leading to fixed flexion deformity of fingers
Painless/gradual progression
Usually starts as palmar pit/nodule
What are potential causes and exminations?
How to manage Dupuytren’s?
What is paronychia and how to manage?
Infection with nail fold, risk is nail biting
May result in pus collection
Mx:
What is flexor tendon sheath infection and how to observe/identify it?
