Hand Injuries

Question 1

Why is the nail so important

Answer 1

To preserve the soft tissue and acts as a splint

Question 2

Describe a Boxers fracture

Answer 2

Minimal displacement
No rotation
More distal

Question 3

What is the treatment / management for a Boxer’s fracture

Answer 3

Buddy strap and early mobilisation

Question 4

What do we do if there is an angular deformity

Answer 4

Usually requires surgery as it is very unstable

Question 5

What finger is usually affected by Mallet Finger

Answer 5

Middle finger

Question 6

How does Mallet finger occur

Answer 6

Often basketball

When the finger has been forcibly flexed – either gone through the tendon or possibly a bit of bone has been pulled off

Question 7

What is the management for Mallet finger

Answer 7

A mallet splint for 6 weeks that is to be worn 24/7

Question 8

What is the management/ treatment for a PIP joint dislocation

Answer 8

Pull to reduce (local anaesthetic)

Buddy strap

Question 9

What is the treatment for a PIP joint dislocation that is late in presenting

Answer 9

Fixation / stabilisation

Question 10

What does a Bennett’s fracture involve

Answer 10

The whole of the metacarpal moving away

Question 11

What is the treatment for a Bennett’s fracture

Answer 11

Wires or screws need to be put in

Question 12

Bennett’s fracture is a benign injury. True or False

Answer 12

False

Question 13

How can we test the FDS tendon

Answer 13

Hold other fingers straight and bend the one that you are testing

Question 14

What does the FDS tendon do?

Answer 14

flexor of fingers (primarily at proximal interphalangeal joints)

Question 15

What is the function of the FDP tendon

Answer 15

flex hand and both interphalangeal joints

Question 16

How can the FDP tendon be tested

Answer 16

isolated testing of the FDP is performed by having middle phalanx held in full extension by the examiner;

 - distal phalanx is then actively flexed;
 - test is best performed by maximally extending wrist and MP joints;
       - ie, examiner's holding all finger joints in extension except distal joint;

Question 17

What is the management for an injured flexor tendon

Answer 17

Surgery - need to protext the repair whilst still moving the fingers - splint stop fingers from over extending

Question 18

What are some of the principles of mutilating injuries

Answer 18

Preserve amputated parts on ice 
Early debridement 
Establish bony support 
Establish vascularity 
Repair all tissues 
Establish skin cover 
Prevent / treat infection 
Aggressive mobilisation

Question 19

What is the standard treatment for burns

Answer 19

Respiratory function
Infection prevention
Hydrate
Pain relief

Question 20

What is Eschar

Answer 20

Thick, leathery, inelastic skin which can form after burns

Question 21

What might Eschar require

Answer 21

Surgical release to allow movement