Hand Flashcards
In which conditions is pollicization indicated?
Blauth 3b and above or traumatic injuries with unstable CMC.
What does the index MP become after pollicization?
Thumb CMC.
What does the index PIP become after pollicization?
Thumb MCP.
What does the index DIP become after pollicization?
Thumb IP.
What function does the extensor digitorum communis serve after pollicization?
Function of the abductor pollicis longus.
What structure attaches to the radial lateral band to perform the function of the abductor pollicis brevis?
Dorsal interosseous.
Fill in the blank: Pollicization is indicated in traumatic injuries where the CMC is not _______.
[stable].
True or False: The flexor digitorum profundus serves the function of the flexor pollicis longus after pollicization.
True.
What are the three joints that need to be replaced during pollicization?
- CMC
- MCP
- IP
What is the acronym LOAF used to describe?
Intrinsic muscles innervated by the median nerve
LOAF stands for: Lumbricals to index and long, Opponens pollicis, Abductor pollicis brevis, Flexor pollicis brevis (superficial head).
List the sites of compression for the ulnar nerve.
- Between the heads of the flexor carpi ulnaris
- Arcade of Struthers
- Osborne’s ligament
- Anconeus epitrochlearis
- Guyon’s canal
These sites are common areas where the ulnar nerve can become compressed and lead to symptoms.
What are the common sites of compression for the median nerve?
- Supracondylar process
- Ligament of Struthers
- Lacertus fibrosis
- Between the heads of the pronator teres
- Leading edge of the FDS aponeurosis
- Carpal tunnel
These are common anatomical locations where median nerve compression occurs.
True or False: The ligament of Struthers is a canal from the medial triceps to the intermuscular septum.
False
The ligament of Struthers is a fibrous band, not a canal, and it connects the supracondylar process to the medial epicondyle.
What is best treatment for a patient with fibrillations and no MUPs on EMG?
Open carpal tunnel release with campus transfer- transferring palmaris longis tendon with strip of palmaris aponeurosis to insertion of abductor pollicis breves to improve thumb opposition
Surgical release alone would not improve opposition when MUPs absent
What is the space of parona
Located in distal forearm, deep to FDP tendons and superficial to pronator quadratus- how infection can spread between thenar and hypothenar spaces
Vaughn Jackson syndrome
In untreated rheumatoid arthritis, attritional rupture of extensor tendons over ulnar head
Wartenberg syndrome
Cheiralgia paresthetica, compressive neuropathy of superficial radial sensory nerve at the wrist, typically 9cm proximal to radial styloid
Madelungs deformity
Congenital deformity, due to deficiency of ulnar volar distal radial physis
Can present with symptoms of ulnar impaction syndrome and ulnar/volar displacement of carpus
Kienbock’s disease
Vascular necrosis of the lunate
Preiser disease
Vascular necrosis of the scaphoid
What points of compression for radial tunnel syndrome?
Arcade of froshe(proximal aponeurotic edge of superficial head of supinator), ECRB, leash of henry(radial recurrent vessels), fibrous bands anterior to radiocapitellar joint, between two heads of supinator muscle
What is the most common malignant bony tumor of the hand
Chondrosarcoma
Ulnar forearm flap is innervated by what?
Medial antebrachial cutaneous nerve
Radial forearm flap is innervated by what?
Lateral antebrachial cutaneous nerve
Primary mechanism by which vascularized bone graft aids in healing?
Osteogenesis
When do you see osteoconduction
Calcium hydroxyapatite and cortical bone grafts
Creeping substitution
What type of products cause osteoinduction
Cancellous bone grafts and BMP
Growth factors stimulate stem cells to become osteoblasts and form bone
What does negative Allen’s test mean?
Patient does not have dual blood flow to the hand
What is parsonage turner syndrome
Brachial neuritis, can be preceded by viral illness
Two phases: first- shoulder pain as presenting symptom, second- flaccid paralysis
Any nerve within brachial plexus can be affected
What is camptodactyly
Flexion contracture at PIP joint
MC small and ring fingers
MC in infancy or adolescence
Can be treated with passive stretching and splinting but may require FDS tenotomy or FDS transfer to radial lateral band if full active PIP extension can be achieved with MCP flexion
How do you test the proper and accessory portions of the ulnar collateral ligament of the thumb
Thumb in 30 deg flexion for proper ligament and full extension for the accessory ligament
Where do dorsal ganglions most commonly come from?
Scapholunate joint
Where do volar ganglion cysts most commonly originate?
Radioscaphoid or STT joints
What muscles are most affected in forearm compartment syndrome?
FDP, FPL are in deep volar compartment
