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NMSKI > Hand Fractures > Flashcards

Hand Fractures Flashcards

1
Q

hand fractures

A

Scaphoid Fracture
Carpal Dislocations
Metacarpal Fractures
Phalangeal Fractures

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2
Q

cause of scaphoid fracture

A

Fall on outstretched hand

violent hyperextension

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3
Q

location of scaphoid fractures

A

Distal & proximal pole
Waist / tubercle
Most common site of fracture is the waist (80% )

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4
Q

most common site of scaphoid fracture

A

With waist and proximal 1/3 fractures the blood supply of the scaphoid is disrupted.
Increased risk of tendency of non- union and AVN (5-15%)

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5
Q

types of scaphoid fractures

A

stable/undisplaced

unstable/displaced

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6
Q

most of blood supply for scaphoid

A

form branch of radial artery

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7
Q

clinical signs of scaphoid fracture

A

tenderness and swelling of snuff box
pain w/ pinch grip
may not be present

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8
Q

methods of diagnosing scaphoid fracture

A

Bone scan
CT
MRI
Re-xray

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9
Q

management of scaphoid non or minimally displaced fracture

A

Thumb spica cast
Wrist in neutral position
+ Sling

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10
Q

management of displaced scaphoid fracture

A 
ORIF 
Herbert compression screw
Kirschner (K) wires
Non-union may require bone grafting 
Thumb Spica Cast 2 - 3 months
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11
Q

complications of scaphoid fracture

A 
AVN 
Non-union
Advanced OA
Carpal Instability 
Post-op damage sensory Branch Radial Nerve
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12
Q

cause of carpal dislocations

A

Fall outstretched hand
High energy injuries
Relatively uncommon

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13
Q

different types of carpal dislocations

A

Perilunate dislocation
Scapholunate dislocation
+ More

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14
Q

how is perilunate dislocation

A

Easily missed - need lateral X-Ray

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15
Q

management and complications of perilunate dislocation

A 
Accurate reduction MUA
POP  x 4/52
If unstable – ORIF (K-wire)
Complication – 
Median Nerve palsy 
AVN 
OA
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16
Q

most common type of carpal instability

A

scapho-lunate dislocation

17
Q

cause of scapholunate dislocation

A

similar to scaphoid fracture, except hand may be in ulnar deviation
+/- fracture radial styloid

18
Q

signs and symptoms of scapholunate dislocation

A

Pain/swelling on dorsal/radial side of wrist

“Clicking” sensation with wrist movement

19
Q

3 types of metacarpal fracture

A

Neck
Oblique: rotation deformity
Transverse comminuted
- stable/unstable

20
Q

management of stable metacarpal fracture

A

Buddy Strapping

21
Q

management of unstable metacarpal fracture

A

ORIF (wire/plate)

22
Q

management of metacarpal or phalangeal fracture

A 
Strapping ‘buddy tape’
Splint / POP 
Functional position of 
MCP 70-900 flexion  
PIP + DIP’s extended  
Thumb abducted
Difficult reduction - ORIF
23
Q

boxer’s fracture cause

A

Fracture to Neck of Metacarpal (4th and 5th most common)

Usually caused by direct blow to immovable object

24
Q

management of non-displaced boxers fracture

A

If small amount of angulation

Immobilise (Ulnar Gutter Cast)

25
Q

management of displaced boxer’s fracture

A

If significant angulation
Rare
Percutaneous K-wiring

26
Q

where does the bennett fracture extend to

A

in 1st metacarpal

Fracture extends into 1st CMCJ

27
Q

causes of bennett’s fracture

A

Punching injury

28
Q

what makes bennett’s fracture unstable

A

Proximal segment trapezium
Oblique
Muscle pull

29
Q

treatment of bennett’s fracture

A

Rx - POP / ORIF (pin/wire)
Thumb spica
Vulnerable to non-union

30
Q

multiple metacarpals fracture treatment

A

ORIF
K wiring
+ Cast

31
Q

mechanism of injury of phalangeal fracture

A

Twisting force fall on hand

Rotation deformity common

32
Q

what should be monitored with a phalangeal fracture

A

bone tendon integrity

33
Q

management of stable phalangeal fracture

A

buddy strap / finger splint

34
Q

management of unstable phalangeal fracture

A

ORIF

35
Q

finger exercises to improve joint mobility

A 
isolated exercise stabilising proximal joint and move distal joint
hook fist 
straight fist 
full fist
DIP flexion
PIP flexion

NMSKI (38 decks)

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