Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MI1 > Hand Injuries > Flashcards

Hand Injuries Flashcards

1
Q

What are the 5 major retaining structures of the IP joints?

A
  • Volar plate
  • True collaterals
  • Accessory collaterals
  • Central slip (part of extensor hood mechanism)
  • FDS/FDP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the function of the central slip?

A

Holds the extensor mechanism on the dorsal side, including the lateral bands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the function of the volar plate?

A

Limits extension at the IP joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Where do the volar plates occur?

A

At all of the IP joints, another version of them at the MCP joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the common mechanism of injury for the volar plate?

A

Ball on the end of the finger, commonly results in dorsal dislocation/subluxation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do you test for a volar plate injury?

A
  • Palpation of volar plate
  • Passive extension of IP
  • Anterior glide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How are VP injuries graded?

A

Grade 1: Sprain/stable
Grade 2: Instability, often bone flake
Grade 3: More than 30% volar lip disruption (#) subluxation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is oedema in VP injuries managed?

A

Coban tape

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How are grade I VP injuries managed?

A
  • Buddy taping 3-4/52
  • Isolated tendon exercises
  • Beware of loaded extension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How are grade II VP injuries managed?

A
  • Extension block splint in 30-60 degrees for 3-4/52
  • Then buddy taping
  • Active exercises & strength
  • Avoid loaded extension 6-8/52
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How are grade III VP injuries managed?

A
  • > 40% articular surface then ORIF

- <40% then gutter splint 3/52 then manage as grade II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some of the complications of VP injuries?

A
  • Swan neck deformity

- Flexion contracture (VP heals in shortened position)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some of the causes of swan neck deformity?

A
  • Dorsal dislocation PIP
  • Imbalance from mallet injury, tight oblique retinacular ligament
  • RA changes MCP/PIPs
  • Develops over time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the function of the accessory and true collaterals?

A
  • TCL: Stability in flexion

- ACL: Stability in extension (with VP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How are the collaterals tested?

A
  • TCL: In 30 degrees flexion

- ACL: At 0 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How are collateral ligament injuries managed?

A

No deformity: Buddy tape 4-6/52, graded exercises

Presence of 
- VP involvement
- Ligament interposition post reduction
- Large avulsed fracture
indicates need for ORIF and/or splintage
17
Q

What are some of the complications of collateral ligament injuries?

A
  • Valgus/varus deformity
  • Scissoring of fingers
  • Unable to make a fist
  • Need to clarify bony status
  • ST tightness
18
Q

Where does the central slip attach?

A

Dorsal aspect of the PIP

19
Q

What happens if the central slip is ruptured? (E.g. dorsal dislocation)

A

Lateral bands are able to slip forward

20
Q

How do you test for a central slip?

A

Palpate dorsal PIP: Boggy and tender

Elson’s test:

  • Wrist & MCPs flexed
  • Patient extends against resistance at MP
  • +ve if PIP flexes or weakness
21
Q

Why is a central slip a NTBM injury?

A

Because they don’t have a great capacity to heal on their own

22
Q

What is the surgical treatment for a central slip?

A
  • Tendon repair
  • K-wire 3/52 then splints
  • Mobilise
  • Scar management vital to outcome
  • DIP free to flex to keep lateral bands from tightening
  • No passive PIP flexion for 8-12/52
23
Q

What is the conservative treatment for a central slip?

A
  • Splint PIP in extension 6-8/52, DIP free

- Graded mobilisation

24
Q

What are the complications of a central slip?

A
  • Linked with volar PIP dislocation, forced flexion injury, laceration, fracture
  • Boutonniere deformity (PIP flexed, DIP extended)
25
Q

What does Finkelstein’s test assess for and how is it performed?

A
  • DeQuervain’s Tenosynovitis

- Thumb inside fist, ulnar deviation

26
Q

What is the management for DeQuervain’s Tenosynovitis?

A
  • Rest/ice
  • Splintage
  • Anti-inflamms
  • U/S, STM, neural stretches
  • Graded exercises
27
Q

What is the mechanism of injury for game keeper’s (skier’s) thumb?

A
  • Hyperextension & abduction

- Collateral ligament disruption +/- volar plate injury and fracture

28
Q

How do you test for skier’s thumb?

A
  • Flexion, extension, opposition ROM

- Test MCPs and collaterals with radial directed stress

29
Q

What grips does skier’s thumb affect?

A

Key grip
Pen grip
Power grip

30
Q

What is the mechanism of injury for CMC OA?

A
  • Wear & tear
  • Reduced opposition/abduction
  • Reduced grip strength
31
Q

What is the management for CMC OA?

A
  • Anti inflammatories
  • Splintage
  • ROM exercises
  • Graded strengthening exercises
  • Chronic: Arthrodesis/arthroplasty
32
Q

What causes a mallet finger?

A

Distal extensor tendon rupture

33
Q

What is the mechanism for FDP avulsion injuries?

A

Forced DIP hyperextension when FDP on maximal contraction

34
Q

What is the timeline for FDP avulsion management?

A

7 days DIP arthrodesis/graft

MI1 (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions