Hand Injuries Flashcards
What do the metacarpals do?
They’re the 5 bones for movement
What do the phalanges do?
They’re the 14 bones for fine motor movement
How many phalanges do we have?
14
How many metacarpals do we have?
5
What do ligaments do?
They hold bones/joints together
What do tendons do?
They attach muscles to bones
What do bony injuries include?
(4)
Fracture
Dislocation
Crush
Amputation
What do soft tissue injuries involve?
(3)
Ligaments
Tendons
De-glove injury
What are the 2 types of injury to the hand, fingers and thumb?
Bony injury
Soft tissue injury
What are the types of acute injuries?
(3)
Fractures/breaks
Dislocations
Soft tissue injuries
What can fractures/breaks be?
(3)
Avulsion fracture
Crush injuries
Amputation
What can dislocations be?
(2)
Partial
Complete
What can soft tissue injuries be?
(3)
Injury to ligaments
Injury to tendons
Foreign bodies, such as glass or stone
What are the types of bone fractures?
(9)
Open
Closed
Transverse
Sigmental
Green stick
Spiral
Linear
Comminuted
Impacted
What is a fracture?
A partial or complete break in a bone, e.g. due to acute trauma, twisting, trapping/crush
What are the standard x-ray projections for a fracture?
(3)
Dorsi-palmar (DP)
Oblique
Lateral view
What are common ways that people get acute hand injuries?
(3)
Punch injury
Trapped in car door
Sports injuries
Which bone can be affected by trapping your hand in a car door?
Distal phalanx
Which bones can be affected by sports injuries?
(3)
Hyper extension of the thumb
Dislocated 1st metacarpal or phalanx
Hyper extension of the fingers or phalanx
What are dislocations?
The separation of 2 bones at a joint where they normally meet
What is the most common way that people dislocate their hand?
Punch injury
What projection views should be done for a hand dislocation?
(3)
DP
Oblique
Lateral
Why is a lateral hand view done for a dislocation?
For degree of volar angulation
What does volar angulation mean?
Towards the palm
What are the stages of treatment for a hand dislocation?
(5)
Initial x-ray request to review the extent of injury
Theatre (during manipulation)
Post manipulation x-ray for the surgeon to check for position and to visualise any fractures
Immobilisation, e.g. cast, splint
Follow-up imaging via fracture clinic
What are the soft tissue injuries that you can get in the fingers?
(2)
Volar plate injuries
Tendon disruption
What is a volar plate?
A small piece of ligament
What does the volar plate do?
It helps to structure the proximal and distal phalanx joints
What’s an example of tendon disruption?
What does it do?
Mallet finger deformity
Inability to extend the distal phalanx Hyper extension
What are examples of injuries we can get in the thumb?
(2)
Ligament injuries
Fractures
Dislocations
What are examples of ligament injuries in the thumb?
(2)
Sprained thumb
Skiers thumb
What are examples of fractures that could happen in the thumb?
Bennett or Rolando
What does a thumb fracture look like?
The small fractured fragment remains in tact with the trapezium
What are examples of reasons for non-acute injury hand x-ray requests?
(5)
To check for:
Bone age
Rheumatoid arthritis
Tumours
Marfans
Suspected physical abuse (SPA)
What does bone age mean?
Determining the skeletal age
Why is it important for x-rays to determine bone age?
Those images are compared to a standard atlas of bone development
What are the features of x-raying a hand to reveal the bone age?
(4)
DP hand projection
Non-dominant hand
Wrist, 3rd metacarpal and 3rd finger aligned
No lateral requires
What is rheumatoid arthritis?
A chronic long term condition where there’s pain, stiffness and swelling in the joints
What can rheumatoid arthritis cause?
(3)
The lining of the joint to become inflamed
Damage to joint tissue
Deformity
Where can rheumatoid arthritis happen?
(3)
Hands
Wrist
Feet
What projections are done when x-raying for rheumatoid arthritis?
(2)
DP
Oblique
What are examples of bone tumours in the hand?
(3)
Osteoid osteoma
Enchondromas
Ganglion cysts
What is marfans syndrome?
When someone has long metacarpals (spider fingers)
What x-ray projection can be done on a hand with marfans syndrome?
DP
Why would a hand x-ray be done if there’s suspected child abuse?
(3)
To check for evidence of child abuse
To check the hand and wrist bone ossification
A fracture is highly indicative of abuse
What type of body part does CT reveal?
More detailed bony anatomy
What type of body part does MRI reveal?
Soft tissue
What type of body part does ultrasound reveal?
Joint effusions (fluid/swelling within the joint)
