Hand Injuries Flashcards
What does ABCDS when interpreting X-rays?
Alignment. Bone. Cartilage. Distribution of any changes. Soft tissues.
State one thing to look for when analysing bone on X-rays.
Mineralization, osteopenia. New bone formation - osteophytes. Joint spaces. Erosions. Fractures.
State one thing to look for when analysing cartilage on X-rays.
Joint spaces. Calcifications.
State the most common type of carpal fracture.
Scaphoid fracture.
Define a scaphoid fracture.
A scaphoid fracture is a break in one of the small bones on the thumb side of the wrist.
State the 2 types of scaphoid fractures.
Non-displaced fracture - bone fragments line up correctly. Displaced fracture - bone fragments out of position.
State a cause of a scaphoid fracture.
Fall onto an outstretched hand. Sports activities increase risk.
State a symptom of a scaphoid fracture.
Swelling, pain near anatomic snuffbox. Pain worse when you move thumb/wrist.
State a test used to assess a scaphoid fracture.
MRI - learn more about the bones and soft tissue in the wrist. CT - reveals fracture of the scaphoid/whether bones displaced. X rays - provides image of dense structures e.g. bone (determine fracture and whether broken pieces displaced).
State a treatment of a scaphoid fracture.
Fracture near the thumb (doctor may place forearm/hand in a cast/splint. Fracture near the forearm - fracture treated with a cast.
State other fractures in the hand.
Lunate fracture (in wrist). Tuft fracture (distal phalanx). Spiral fracture. Boxer’s fracture. Thumb fracture. Shier’s thumb.
Define a lunate fracture.
Carpal bone in the wrist.
Define a tuft fracture.
Fracture of the distal phalanx.
State a cause of a tuft fracture.
Crush injury (e.g. finger in a door).
State a feature of a tuft fracture.
Haetoma (collection of blood) under the nail bed.
Define a spiral fracture.
Fracture of the phalanges/metacarpal bone - leads to rotation and shortening.
Define a boxer’s fracture.
Transversal metacarpal fracture of the neck and common in 5th metacarpal.
Whereabouts is the thumb fracture most located?
At the base.
State how a thumb fracture can be distinguished.
2 part Bennett fracture.
3 part Rolando fracture.
Comminuted fracture.
Define a shier’s thumb.
Ligament damage of the ulnar collateral ligament MCP - thumb joint.
State a feature of Shier’s thumb.
Rupture of the ulnar collateral ligament may be associated with an avulsion fragment - bone fracture where fragments of bone tears away from the main mass of bone (due to physical trauma).
What is Stener’s lesion?
Type of traumatic injury to the thumb.
When the aponeurosis of the adductor pollicis muscle becomes intersposed between a ruptured ulnar collateral ligament (UCL) and site of insertion (base of proximal phalanx), it’s known as…
Stener’s lesion.
Give an example of a dislocation to the joints.
Proximal interphalangeal joint dislocation. Metocarpophalangeal joint (MCP) dislocation (between metacarpal bones and proximal phalanges of fingers).
State one tendon injury.
Mallet injury. Flexor digitorum profundus.
Define a mallet injury.
An avulsion (fragment of the bone tears away) of the extensor tendon on the distal phalanx - prevents active extension.
What is the flexor digitorum profundus?
Muscle in the forearm that flexes fingers.
State a symptom of a flexor digitorum profundus rupture.
Muscle fans out into 4 tendons to palmar base of distal phalanx (affects whether fingers can make a fist).
