hand conditions Flashcards
epidemiology dupuytrens
fascia of hand becomes thickened and tight leading to shortening of soft tissues and restricted movement
males more
sex linked
almost exclusively white races
risk factors- diabetes, alcohol, tobacco, HIV, epilepsy
presentation dupuytrens
early onset
bilateral
family history
not painful
loss of finger extension
hand in pocket problem
hard to grip things
dupuytrens managment
radiotherapy
partial fasciectomy- excise thickened bands. most common. wounds take 2-3 weeks to heal
dermofasciectomy
athrodesis
amputation if unmanageable
percutaneous needle fasciotomy- higher recurrence, can be repeated, return to normal activity 2-3 days
dupuytrens managment
radiotherapy
partial fasciectomy- excise thickened bands. most common. wounds take 2-3 weeks to heal
dermofasciectomy
athrodesis
amputation if unmanageable
percutaneous needle fasciotomy- higher recurrence, can be repeated, return to normal activity 2-3 days
trigger finger epidemiology
women more
40-60s
ring most, then thumb, middle
repetitive use of hand
associated with RA, DM, gout
diagnosis trigger finger
thickening of tendon within sheath
pain in palm
difficulty moving affected finger
clicking with movement of finger
worse in morning
lump in palm over A1 pulley (most common affected)
can lock
management of trigger finger
rest and analgesia
steroid injections
splintage
percutaneous release
open surgery release
de quervains tenosynovitis
swelling and inflammation in tendon sheaths
abductor pollicis longus and extensor pollicis brevis affected
due to repetitive strain - new baby lifiting
de quervains tenosynovitis diagnosis
pain several weeks localised to radial side of wrist
aggravated by movement of thumb
de quervains tenosynovitis test
finkelsteins test thumb inside fingers, adducted . pain on radial side
resisted thumb extension
