Hand conditions Flashcards
dupuytrens contracture common fingers
ring and little fingers
what type of deformity is there in dupuytrens contracture
fixed flexion deformity
generally, what is the pathophysiology of dupuytrens contracture
palmar thickening
proliferation of myofibroblasts causes
dupuytrens contracture
which group of people are most likely to get dupuytrans contracture (age and sex)
males >60
what 2 conditions predispose someone to getting dupuytrens contracture
diabetes
alcoholic cirrhosis
what type of collagen is produced in dupuytrens contracture
type 3 (normally type 1)
what is peyronies disease
dupuytrens contracture in the penis
where can dupuytrenscontratcure also occur (as weel as the hands)
penis
plantar foot
what is dupuytrens contracture in the palmar foot called
ledderhose disease
dupuytrens contracture investigation and explanation
hueston table top test
try to put hand flat on table, if >30 degrees = needs surgery
likelihood of dupuytrens contracture recurrence
likely
tigger finger common fingers
middle and ring fingers
inflammation of flexor tendon digit causing nodular enlargement
trigger finger
why is nodular enlargement significant in trigger finger
catches on A1 pulley in metacarpal neck on flexion = can get stuck there
what 2 things is dequervains tenosynovitis associated with
pregnancy
rheumatoid arthritis
aetiology of dequervains tenosynovitis
repetitive strain
presentation of dequervains tenosynovitis
pain over radial styloid process
red, hot, swollen tendon
investigation for dequervains tenosynovitis
finklesteins test
finklesteins test description
make a fist with thumb inside, move wrist in ulnar direction, if painful = positive test
dequervains tenosynovitis treatment (4)
splint, rest, NSAIDs
physio
steroid injection
surgery - for decompression
infection in nail fold in kids that bite nails
paronychia
subungal haematoma
collection of blood under nail
subungal haematoma treatment (2)
nothing
trephine if painful
what happens if you do nothing to a subungal haematoma
will eventually fall off
what is a staved finger clinically known as
mallet finger
which tendon is affected when you sprain your finger (think about it)
extensor tendon
aetiology of mallet finger
sports injury eg ball
mallet finger is a staved finger!
treatment of mallet (staved) finger
splint for 4 weeks
any carpal dislocation treatment
complication of no treatment
emergency surgery
osteoarthritis
treatment of finger dislocation (2)
local anaesthetic and reduce dislocation
then splint to neighbouring finger asap
arthritis type involving MCP and carpals
rheumatoid arthritis
arthritis type involving PIP, DIP, base of thumb
osteoarthritis
where do ganglion cysts occur
synovial joints eg knee (bakers cyst), wrist
what are ganglion cysts filled with
mucous/synovial fluid
fluid filled cyst at DIP joint
transiluminate
well defined
firm
ganglion cyst
ganglion cyst treatment (3)
leave alone
needle aspirate excision if painful
if you leave a ganglion cyst alone, what is likely to happen
recurrence
flexor tendon sheath infection presentation
v v painful, hot and swollen
down arm to index finger
treatment of flexor tendon sheath infection
surgery to wash out tendon
compression of median nerve
carpal tunnel syndrome
aetiology of carpal tunnel syndrome (3)
hand injury
pregnancy
rheumatoid arthritis
bilateral carpal tunnel syndrome aetiology
rheumatoid arthritis
why is pregnancy a risk factor for carpal tunnel syndrome
increased fluid retention = pressure in carpal tunnel
early presentation of carpal tunnel syndrome
pins and needles
late presentation of carpal tunnel syndrome (2)
weakness in thenar (thumb) muscles
numbness in digits 1-3 and lateral half of 4
2 investigations for carpal tunnel syndrome
tinnels test
phalens test
what is tinnels test
for carpal tunnel syndrome
tap wrist for 30 seconds and will feel pins and needles
carpal tunnel syndrome treatment
steroid injection
surgery - for carpal tunnel decompression
most likely group of people for carpal tunnel syndrome (age and sex)
females >30
compression of ulnar nerve behind the medial epicondyle at the elbow
cubital tunnel syndrome
which nerve do you hit when you hit your ‘funny bone’
ulnar nerve
most likely group of people for cubital tunnel syndrome (age and sex)
males >60
aetiology of cubital tunnel syndrome (2)
tight band of fasica on roof of cubital tunnel
tight intermuscular septum
= ulnar nerve compression
early presentation of cubital tunnel syndrome
pins and needles
late presentation of cubital tunnel syndrome
paraesthesia in ulnar 1.5 fingers
weakness of 1st dorsal interosseous and adductor pollicis muscles (thumb muscles)
treatment of cubital tunnel syndrome
surgery for nerve decompression
