Hand Conditions Flashcards
what is dupuytrens contracture
superficial fibromatosis that starts in the hand
age of patients who present with dupuytrens contracture
60 yrs
risk factors for dupuytrens contracture
DM
alcohol, smoking
genetic predisposition
repetitive trauma
what type are the bands in dupuytrens contracture
collagen type 3
pathophysiology of dupuytrens contracture
excessive myofibroblast proliferation and altered collagen matrix composition leads to thickened and contracted palmar fascia
clinical presentation of dupuytrens contracture
painless, gradual progression
usually starts in the palmar pit
clinical signs of dupuytrens contracture
palpate chords
table-top test
conservative management of dupuytrens contracture
stretches
surgical management of dupuytrens contracture
fasciectomy
what usually causes interphalangeal joint dislocation
hyperextension injury
which direction is interphalangeal joint dislocation usually
posteriorly
management of interphalangeal joint dislocation
closed reduction
what is a boxers fracture
Fracture of the 5th metacarpal neck
what usually causes a boxers fracture
a clenched fist striking a hard object
management of boxers fracture
buddy strap + early mobilisation
what is a bennetts fracutre
fracture of the 1st metacarpal base
what usually causes a bennetts fracture
forced hyperabduction of the thumb
clinical presentation of bennetts fracture
acute pain at the base of the thumb
management of bennetts fracture
reduction and fixation with K wires
what is trigger finger
inhibition of smooth tendon gliding due to mechanical impingement at the level of the A1 pulley
who presents with trigger finger
females, >50. diabetics
clinical presentation of trigger finger
pain over A1 pulley
sticking of the finger, usually in flexion
conservative management of trigger finger
resolves spontaneously
splint to prevent flexion
what is paronychia
infection within the nail fold
what is paronychia associated with
nail biting
name some organisms associated with acute paronychia
staph aureus
strep pyogenes
what usually causes paronychia
candida
clinical presentation of paronychia
inflammation and redness around the fingertip
management of paronychia
elevate, antibiotics, incise and drain pus collection
management of subungual haematoma
trephine
what can cause a flexor tendon sheath infection
direct penetrating injury, haematogenous spread
clinical presentation of flexor tendon sheath infection
extremely painful, limited extension
kanavels cardinal signs of flexor tendon sheath infection
- Affected finger held in fixed flexion
- Fusiform swelling over finger
- Painful to percuss over sheath
- Painful on passive extension
management of flexor tendon sheath infection
elevation and high dose antibiotics
what commonly causes flexor tendon injuries
volar lacerations
how are flexor tendon injuries classified
by the zone of unjury
clinical presentation of flexor tendon injuries
loss of active flexion strength or motion of the involved digits
investigation of flexor tendon injuries
XR and US
what is mallet finger
an avulsion of the extensor tendon from the distal phalanx resulting in inability to actively extend the DIPJ
what causes mallet finger
object hitting the top of the thumb
clinical presentation of mallet finger
tenderness/bruising
no resisted finger extension on examination
management of congruent mallet finger
mallet splint for 6 weeks
management of incongruent mallet finger
fixation with K wires or screws
management of chronic mallet finger
dermatotendonesis
condition associated with extensor pollicus longus rupture
RA
who gets primary raynauds
teenagers with no underlying autoimmune disease
who gets secondary raynauds
older groups with autoimmune diseases
clinical presentation of raynauds
fingertips change white-blue-red
lifestyle management of raynauds
smoking cessation
warm gloves
avoid cold exposure
first line pharm management of raynauds
dihydropyridine calcium channel blockers
