hand and wrist Flashcards
scaphoid
most commonly injured carpal…if fractured, can result in bone necrosis
split into 2, one portion doesn’t recieve blood supply
necrotic bone is removed and graft made from iliac crest
can be undetected on xray until 2 weeks later (new bone growth)
lunate
most commonly DISLOCATED carpal, 2nd most fractured
triquetrum
3rd most fractured carpal
pisiform
sesamoid bone
innervation of the hand
past the elbow, radial nerve branches into 2
superficial branch = dorsal hand skin
deep branch = wrist extensors
de quervain’s tenosynovitis
extensor pollicis longus, extensor pollicis brevis, abductor pollicis longus tendons
- tendons w/in the sheath, becomes inflamed w rep tendon mvmnt
thumb use w ulnar dev, i.e. frisbee
finkelstein’s test
boutonniere deformity
proximal jt is flexed while distal jt is extended
MOI = blunt trauma to dorsal PIP jt…rapid, forceful flexion against resistance
cannot extend…not passive
damage to CENTRAL SLIP of extensor tendon on dorsal aspect
there are also lateral slips, attach to metacarpals
mallet finger
distal jt is bent/flexed
MOI = object hits finger while it’s straight, axial load
EXTENSOR TENDON tears from attachment on DIP, assoc w avulsion fracture
- lateral band damage
- can have assoc avulsion fracture
CAN passive extend, but NOT active bcs no tendon attachment
- can’t push nail up, resisted extension
split so finger never flexes or resets healing
jersey finger
MOI = forceful extension i.e. caught in jersey
injury to flexor digitorum profundus tendon
pain, swelling, popping
cannot resist FLEXION, also cannot flex
finger is fully straight when passively flexed, whereas other fingers have angle
carpal tunnel syndrome
median nerve, first 3 and 1/2 of 4th digit
over use injury, main assoc w office jobs rather than sports
flexor tendons pass thru carpal tunnel in one sheath
- roof is retinaculum holds tendons tgt
phalen’s test
tinel tap test at WRIST for median nerve
what is in the carpal tunnel
tendons, vessels, median nerve
held tgt by retinaculum roof
cyclist’s palsy
ulnar nerve injury from overuse
- nerve lies b/w hook of hamate and pisiform
MOI = biking w compression on ulnar nerve
swelling, pain that subsides when dec pressure
- resolves w rest
bowler’s thumb
neurological condition impacting ulnar digital sensory nerve
- med aspect of thumb
- superficial nerve
compression causes neuroma/denseness around thumb
numb, tingle, pain medial thumb
colles fracture
distal radius fracture, 1.5 inches away from distal end
S/S = pain/swell, dinner fork deformity (dorsal displacement)
can involve both or one bones
distal posterior interosseous nerve syndrome
superficial branch of radial nerve
compression combined w hyperextension
- WEIGHTBEARING i.e. gymnastics
nerve compressed b/w muscles
galeazzi fracture
fracture of distal third of radius w dislocation of distal radioulnar joint
more proximal than colles
MOI = FOOSH
smith’s fracture
reverse dinner fork/garden spade
- distal segment moves towards palmar aspect
MOI = FOOSH, falling on dorsal hand that’s flexed
gymnast wrist
widening of growth plates at distal radius
overuse, bcs of compressive forces
landing on hands in gymnastics
boxer’s fracture
fracture of the 4th or 5th metacarpal
TFCC
triangular fibrocartilage complex
on ulnar aspect of hand
- can be injured akin to a meniscus
skier’s thumb
stretch/tear of UCL of the THUMB
i.e. extension plus fall
