Hand Problems Flashcards
This Deck Covers:
- Dupuytren’s
- Trigger Finger
- De-Quervain’s Tenovaginitis
- Ganglia
- Base of Thumb OA
Who gets Dupuytren’s Disease?
Mostly Men (8M>1F), men present younger too.
White people
Explain the genetic component of Dupuytren’s Disease?
Autosomal dominant with variable penetrance
What conditions are associated with Dupuytren’s?
Diabetes Alcohol Tobacco HIV Epilepsy
Describe the pathology behind Dupuytren’s?
Myofibroblasts make collagen which forms hard nodules along the palmar tendons of the fingers, pulling the finger into flexion
How does Dupuytren’s Present?
First hard nodules under palmar skin
Then the fingers become permanently flexed (lose passive/active extension)
Its not painful but they do get functional issues like problems washing their face or gripping things
Which fingers are effected by Dupuytren’s?
Mostly Ring Finger
Followed by Pinkie & Middle
How do we treat Dupuytren’s?
Radiotherapy
Fasciectomy
Percutaneous needle fasciotomy (Early)
What are the pros/cons of the major treatments for Dupuytren’s?
Partial Fasciectomy followed by physio
Percutaneous Needle Fasciotomy is good cos it recovers within 2/3days rather than weeks, has high recurrence but can be repeated
Who gets Trigger Finger and which fingers does it affect?
F>M in 40-60s
Affects Ring > Thumb > Middle
What is Trigger Finger?
Swollen flexor tendon catches the sheath it passes through making it difficult to flex
What conditions are associated with trigger finger?
RA
Diabetes
Gout
How does Trigger Finger present?
Clicking sensation on movement of the digit than can progress to “locking”
They may need the other hand to unlock the digit
May be a palpable lump under the sheath in the palm
How can we treat Trigger Finger?
Splintage
Steroid Injection
Operatively:
- Percutaneous release or open surgery
Define De-quervain’s Tenovaginitis?
Non-inflammatory thickening of the EPB & APL tendons along with their sheaths that causes:
- radial wrist pain aggravated by thumb movement
- +/- a localised swelling