Hand Deformity

Question 1

Drop- Wrist Deformity

Answer 1

➢ Paralyzed extensor of wrist due to radial nerve palsy.

Question 1

Ape Hand Deformity

Answer 1

-Wastign of the thenar eminence of the hand as a result of MEDIAN NERVE PALSY and thumb falls back in line with the finger as a result of pull of extensor muscles
- Pt is unable to flex or oppose the thumb

Question 2

Bishops hand or Benediction

Answer 2

Wasting of Hypothenar muscles of the hand, interossei muscles, & 2 medial lumbricals muscles due to
ULNAR nerve palsy.
➢ Hyperextension of MCP joint and flexion of IP joint.

Question 3

Claw fingers

Answer 3

➢ Intrinsic minus hand, caused by combination of median & ulnar nerve.
➢ Results from the loss of intrinsic muscle action and the overaction of the extrinsic extensor muscles on the
proximal phalanx of the fingers.
➢ MCP joints are hyperextended, and PIP and DIP joints are flexed.

Question 4

Dupuytren Contracture

Answer 4

➢ Contracture of palmar fascia, fixed flexion deformity of MCP & PIP.
➢ Usually seen in ring or little finger.
➢ Affects men more than women.

Question 5

Mallet Finger

Answer 5

➢ Due to rupture or avulsion of the extensor tendon at distal phalanx of finger, distal phalanx rest in flexed
position.

Question 6

Boutonniere Deformity

Answer 6

➢ Extension of MCP and DIP joint and flexion of PIP joint (primary deformity).
➢ This deformity is the results of a rupture of the central tendinous slip of the extensor hood and is most
common after trauma or in RA.

Question 7

Swan neck deformity

Answer 7

➢ Extension of PIP, flexion of MCP & DIP due to contracture of intrinsic ma or tearing of Volar plate (common
in RA)

Question 8

Trigger Finger

Answer 8

➢ Also known as tenovaginitis stenosans.
➢ Results of a thickening of the flexor tendon sheath (Notta’s nodule), which causes sticking of the tendon
when the patient attempts to flex the finger.
➢ A low-grade inflammation of the proximal fold of flexor tendon leads to swelling and constriction in digital
flexor tendon. When patient attempts to flex the finger, the tendon sticks, and the finger “let’s go,” often
with a snap.
➢ As condition worsens, eventually finger will flex but not let go, and it will have to passively extended until
finally a fixed flexion deformity occurs.
➢ Usually occurs in 3rd or 4th finger.
➢ Most often associated with RA and tends to be worse in the morning.

Question 9

De Quervians Tenosynovitis

Answer 9

➢ Inflammation of Extensor Pollicis Brevis (EPB) & Abductor Pollicis Longus (APL) tendons at 1st dorsal
compartment. (Common in pregnancy).
➢ Pain at anatomical snuffbox, swelling, decreased grip & pinch strength.
➢ Positive Finkelstein’s test.

Question 10

CTS (carpal tunnel syndrom)

Answer 10

➢ Compression of median nerve, common in pregnancy, diabetes & RA. burning, tingling, pins n needles &
numbness at night.
➢ Positive tinel’s sign.

Question 11

Colles Fracture

Answer 11

➢ Dorsal displacement of distal fragment of radius with radial shift of wrist and hand results in dinner fork
deformity.

Question 12

Smiths fracture

Answer 12

➢ Distal fragment of radius dislocates in a Volar direction result in Garden spade deformity.