Hand Extension Injuries

Question 1

Indication for immediate I&D

Answer 1

Fight bite to MCP joint

Question 2

Tendon repair indications

Answer 2

Laceration more than 50% tendon width in all zones

Question 3

Fixation of bony avulsion indication

Answer 3

Bony mallet finger with P3 volar subluxation

Question 4

Complications

Answer 4

1. Adhesion formation
2. Tendon rupture
3. Swan neck deformity
4. Boutonniere deformity (DIP hyperextension)

Question 5

4 Nail bed injuries

Answer 5

1. Subungual hematoma
2. Nail bed laceration
3. Nail bed avulsion
4. Fingertip injuries*

Question 6

Nail bed injury assoc. w/ distal phalanx #

Answer 6

Avulsion injuries

Question 7

Complications of avulsion injuries

Answer 7

Hook nail

Split nail
- scarring of matrix following injury to nail bed

Question 8

Goal of treatment for fingertip amputation

Answer 8

1. Sensate tip
2. Durable tip
3. Bone support for nail growth

Question 9

Epineurium

Answer 9

Outer sheath covering around nerve

Question 10

Fascicles

Answer 10

Nerve fiber (axons) bundles

Question 11

What surrounds each fascicle

Answer 11

Perineurium

Question 12

Dermatome

Answer 12

Area of skin supplied by a single spinal root

Question 13

Myotome

Answer 13

Muscle unit supplied by a single spinal root

Question 14

Seddon’s classification of nerve injuries

Answer 14

1. Neurapraxia
2. Axonotmesis
3. Neurotmesis

Question 15

Neurapraxia

Answer 15

Temporary paralysis of a nerve caused by lack of blood flow or by pressure on the affected nerve with no loss of structural continuity

Question 16

Axonotmesis

Answer 16

Neural tube intact, but axons are disrupted, nerves are likely to recover

Question 17

Neurotmesis

Answer 17

The neural tube is severed

injuries are likely permanent without repair