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musculoskeletal > Hand Conditions > Flashcards

Hand Conditions Flashcards

1
Q

what is dupuytrens contracture

A

superficial fibromatosis that starts in the hand

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2
Q

age of patients who present with dupuytrens contracture

A

60 yrs

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3
Q

risk factors for dupuytrens contracture

A

DM
alcohol, smoking
genetic predisposition
repetitive trauma

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4
Q

what type are the bands in dupuytrens contracture

A

collagen type 3

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5
Q

pathophysiology of dupuytrens contracture

A

excessive myofibroblast proliferation and altered collagen matrix composition leads to thickened and contracted palmar fascia

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6
Q

clinical presentation of dupuytrens contracture

A

painless, gradual progression
usually starts in the palmar pit

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7
Q

clinical signs of dupuytrens contracture

A

palpate chords
table-top test

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8
Q

conservative management of dupuytrens contracture

A

stretches

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9
Q

surgical management of dupuytrens contracture

A

fasciectomy

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10
Q

what usually causes interphalangeal joint dislocation

A

hyperextension injury

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11
Q

which direction is interphalangeal joint dislocation usually

A

posteriorly

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12
Q

management of interphalangeal joint dislocation

A

closed reduction

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13
Q

what is a boxers fracture

A

Fracture of the 5th metacarpal neck

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14
Q

what usually causes a boxers fracture

A

a clenched fist striking a hard object

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15
Q

management of boxers fracture

A

buddy strap + early mobilisation

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16
Q

what is a bennetts fracutre

A

fracture of the 1st metacarpal base

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17
Q

what usually causes a bennetts fracture

A

forced hyperabduction of the thumb

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18
Q

clinical presentation of bennetts fracture

A

acute pain at the base of the thumb

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19
Q

management of bennetts fracture

A

reduction and fixation with K wires

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20
Q

what is trigger finger

A

inhibition of smooth tendon gliding due to mechanical impingement at the level of the A1 pulley

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21
Q

who presents with trigger finger

A

females, >50. diabetics

22
Q

clinical presentation of trigger finger

A

pain over A1 pulley
sticking of the finger, usually in flexion

23
Q

conservative management of trigger finger

A

resolves spontaneously
splint to prevent flexion

24
Q

what is paronychia

A

infection within the nail fold

25
Q

what is paronychia associated with

A

nail biting

26
Q

name some organisms associated with acute paronychia

A

staph aureus
strep pyogenes

27
Q

what usually causes paronychia

A

candida

28
Q

clinical presentation of paronychia

A

inflammation and redness around the fingertip

29
Q

management of paronychia

A

elevate, antibiotics, incise and drain pus collection

30
Q

management of subungual haematoma

A

trephine

31
Q

what can cause a flexor tendon sheath infection

A

direct penetrating injury, haematogenous spread

32
Q

clinical presentation of flexor tendon sheath infection

A

extremely painful, limited extension

33
Q

kanavels cardinal signs of flexor tendon sheath infection

A
  • Affected finger held in fixed flexion
  • Fusiform swelling over finger
  • Painful to percuss over sheath
  • Painful on passive extension
34
Q

management of flexor tendon sheath infection

A

elevation and high dose antibiotics

35
Q

what commonly causes flexor tendon injuries

A

volar lacerations

36
Q

how are flexor tendon injuries classified

A

by the zone of unjury

37
Q

clinical presentation of flexor tendon injuries

A

loss of active flexion strength or motion of the involved digits

38
Q

investigation of flexor tendon injuries

A

XR and US

39
Q

what is mallet finger

A

an avulsion of the extensor tendon from the distal phalanx resulting in inability to actively extend the DIPJ

40
Q

what causes mallet finger

A

object hitting the top of the thumb

41
Q

clinical presentation of mallet finger

A

tenderness/bruising
no resisted finger extension on examination

42
Q

management of congruent mallet finger

A

mallet splint for 6 weeks

43
Q

management of incongruent mallet finger

A

fixation with K wires or screws

44
Q

management of chronic mallet finger

A

dermatotendonesis

45
Q

condition associated with extensor pollicus longus rupture

A

RA

46
Q

who gets primary raynauds

A

teenagers with no underlying autoimmune disease

47
Q

who gets secondary raynauds

A

older groups with autoimmune diseases

48
Q

clinical presentation of raynauds

A

fingertips change white-blue-red

49
Q

lifestyle management of raynauds

A

smoking cessation
warm gloves
avoid cold exposure

50
Q

first line pharm management of raynauds

A

dihydropyridine calcium channel blockers

musculoskeletal (30 decks)

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