Hand Injuries

Question 1

Types of bony injury

Answer 1

Fracture
Dislocation
Crush
Amputation

Question 2

Types of Soft tissue injury

Answer 2

Ligaments
Tendons
De-glove injury

Question 3

Functions of metacarpals

Answer 3

5 bones for movement

Question 4

Function of phalanges

Answer 4

14 bones for fine motor movement

Question 5

Ligaments

Answer 5

Hold bones/ joints together

Question 6

Tendons

Answer 6

Attach muscles to bones

Question 7

Types of Acute injuries

Answer 7

Fractures
Dsicolations
Soft tissue injuries
Crush injuries
Amputation

Question 8

Types of bone fractures

Answer 8

Open
Transverse
Greenstick
Comminuted
Segmental
Closed
Spiral
Linear
Impacted

Question 9

What is a fracture and its standard x-ray projections

Answer 9

Fracture:
Partial or complete break in a bone
E.g acute trauma, twisting, trapping/crush

Standard X-ray projections:
Dorsi palmar
Oblique
Lateral view

Question 10

Common acute hand injuries

Answer 10

Punch injury
Trapped in a car door - distal phalanx
Sports injuries - hyper extension of fingers or dislocated 1st MC or phalanx

Question 11

Dislocations

Answer 11

Separation for 2 bones at a joint where they normally meet

Question 12

What is the initial x ray request for dislocation

Answer 12

Review extent of injury
Identify any fractures
Manipulation in theatre
Post manipulation x-ray for surgeon to check for position and fractures
Immobilisation - cast or splint
Follow up imaging via fracture clinic

Question 13

What is a volar plate injury

Answer 13

Soft tissue injury in the fingers
Small piece of ligament
Helps structure the proximal and distal phalanx joints

Question 14

What is a tendon disruption

Answer 14

Type of soft tissue injury
Finger deformity
Inability to extend the distal phalanx

Question 15

Thumb injuries

Answer 15

Ligament injuries - skiers thumb or sprained / avulsion
Fractures - Bennett or Rolando
-small fractured fragment remains intact with trapezium
Dislocations

Question 16

Non acute injury hand x-ray requests

Answer 16

Bone age
Rheumatoid arthritis
Tumours
Marfans
Suspected physical abuse (SPA)

Question 17

Bone age

Answer 17

Determines skeletal age
Children up to 18 years of age
ossifoctaion sites
Imagines compared to standard atlas of bone development
Medial ends of clavicle form 18-22 yrs

Question 18

Bone age Hand x-ray projections

Answer 18

DP hand
Non-dominant hand
Wrist 3rd MC 3rd phalanx aligned

No lateral required

Question 19

Rheumatoid arthritis

Answer 19

Chronic long term condition
Pain, stiffness and swelling in joints
Lining of joints becomes inflamed
Damage to joint tissue
Deformity
Can be in hands wrists feet

Question 20

RM arthritis x-ray projections

Answer 20

DP
Oblique

Question 21

Bone tumours

Answer 21

-osteoid osteoma
-enchondromas
-ganglion cysts

Question 22

Marfans syndrome

Answer 22

For long MC’s metacarpals index
Arachondactyl (spider fingers)
Sometimes a DP hand x-ray can be requested

Question 23

Suspected physical abuse (SPA)

Answer 23

Evidence of child abuse
Hand and wrist bone ossification
Bones are mainly cartilaginous
A fracture is highly indicative of abuse

Question 24

CT

Answer 24

Detailed bony anatomy

Question 25

MRI

Answer 25

SOFT TISSUE

Question 26

Ultrasound

Answer 26

Joint effusions ( fluid/ swelling within the joint)