Hand Injuries Flashcards
When taking a history of trauma important to ask
Type-crush,sharp,burn Any protective items(could there be fabric driven into the wound) Timing of injury Degloving Estimate of level of energy
When examining important to look at
wound nails deformity swelling point of tenderness movement neurological
Tight swelling and a cash injury. What is the most likely diagnosis?
Compartment syndrome
How do you describe a wound?
Where how long how deep clean/dirty skin loss obvious structures in wound-bone,tendon,foreign bodies, dirt/grit
What are fingertip injuries?
Subungual haematoma
if pressure causing pain-trephine
nail may eventually fall off
How would you treat level 1 and 2 injury to the finger
dressing only
How would you treat a level 3 injury to the finger
repair nail bed and stabilise bone
When healing in the hand it is better to completely immobilise the hand T/F
False- Callus formation will be better if there is movement at the fracture site
What is boxers fracture
Minimal displacement
no rotation
more distal
“buddy strap” early mobilisation
What is Mallet finger
tips forced into flexion whilst the extensor tendon has been pulling
Should x-ray to know if there is a bone fragment
What is the management for Mallet finger
Mallet splint for 6/52 24/7
Occ fix large displaced avulsion fragment-wire
dermatotenodesis in chronic cases
What is the Tx for PIPjt dislocation
Pull to reduce, buddy strap
these injuries are stiff for a long time
What is the problem of delayed presentation of PIPjt dislocation
impossible to reduce
may require fusion
What is a Bennett fracture
A fracture at the base of the shaft of the thumb
Which zone in the hand is known as no mans land for tendon injuries?
Zone 2 (where the two tendons are running in the sheath)
