Hand + Finger Injuries

Question 1

3 grades of lig sprains (% tear)

Answer 1

1- 25% tear
2- 25-75% tear
3- Complete

Question 2

Tx of hand lig sprains (for grade 1/2)

Answer 2

1/2 place in splint and ice 20 mins 3 times daily within 5 days start gentle ex

Question 3

What is skiers thumb due to

Answer 3

Injury to UCL due to forced abduction of the 1st MCP

Question 4

how is skierss thumb tx

Answer 4

Grade 1/2 will heal w conservative tx 60% of time

Grade 3 will require surgery + 6 w of immobilization

Question 5

What is a stener lesion

Answer 5

When torn end of UCL folds back on self and is held there by edge of aductor pollicis tendon

Question 6

about how many of skiers thumbs are associated with avulsion fxs

Answer 6

1/2

Question 7

MOI of hand contutions and tx

Answer 7

Blunt force to hand

tx- RICE for 1st 48hrs then ROM exercises in warm water

Question 8

Finger fx tx

Answer 8

Treated w aluminum splint for 3 w and then begin from exercises

Question 9

Boxers fx presentation

Answer 9

Mc fx of hand that occurs at 5th metacarpal

pt will present w swelling and pain, will not be able to make first, localized tenderness

Question 10

Benetts fx presentation + tx

Answer 10

Fx of base of 1st metacarpal

-metacarpal dislocates radially and dorsally leaving small portion of bone that is attached by UCL

tx- immobilize 6w, then rom/strengthening ex

Question 11

What is the pathology of flexor tendonitis

Answer 11

After repeated use the lining of the tendon produces extra lubricating fluid/inflamation
-if that persists the tendon sheath may scar and tendon will not be able to freely move thru sheath (trigger finger)

Question 12

Trigger finger presentation + tx

Answer 12

pt may be able to flex finger yet will have trouble re extending + will eventually just give

tx- rest, splint, cortisone injection eventually

Question 13

Dupuytrens contracture pathology, mc site + age

Answer 13

Contracture of palmar fascia causing progressive flexion of palmar tendons, fixed flex of MCP/PIP jts (usually of 4th/5th digit)

Older males (50-70)

Question 14

What is the m/c tendon alvulsion of the hand and moi + tx

Answer 14

Mallet finger- extensor tendon ripped due to the distal phalyx being jammed in a flexed pos.

tx- splint 2-3 months

Question 15

Jersey finger presentation/ moi

Answer 15

Flexor tendon avulsed; cant flex but can extend distal jt

tx- almost always surgery

Question 16

Presentation of swan neck deformity and moi

Answer 16

Flex of MCP + DIP, extension on PIP

Due to rheumatoid arthritis

Question 17

Presentation of boutonniere defomity + moi

Answer 17

ext of MCP + DIPflexion of PIP

Due to rupture of central tendinous slip of extensor hood

Question 18

Presentation of ulnar drift and why

Answer 18

Ulnar deviation of the digits due to weakening of the capsule and ligamentous structures of the MCP joints.

-Most common cause is rheumatoid arthritis.

Question 19

What is the presentation of claw fingers and why does it occur

Answer 19

MCP hyperextended and PIP/DIP flexed

due to combined palsy of median and ulnar n palsy (lumbricals)

Question 20

Presentation of ape hand deformity and why does it occur

Answer 20

wasting of thenar eminence (thumb lies in line w fingers)

• pt unable to oppose thumb (opens pollicis)
• median nerve palsy

-caused by deep injuries to arm/forarm/wrist

Question 21

Bishop hand deformity presentation and moi/what does it affect

Answer 21

Flex of 4th and 5th dIP and PIP when trying to make fist due to ulnar n palsy (unable to extend full hand)