Hand Problems

Question 1

what causes dupuytrens contracture?

Answer 1

> epilepsy
> diabetes
> alcohol
> tobacco
> HIV

Question 2

true or false

dupuytrens contractures occurs more frequently and earlier in men

Answer 2

true

Question 3

true or false

dupuytrens contracture is autosomal recessive

Answer 3

false

Question 4

describe the presentation of dupuytrens contracture

Answer 4

> bilateral
nonpainful
affecting gripping movements
loss of finger extension actively and passively

Question 5

what management options are there for dupuytrens contracture?

Answer 5

> observation
> radiotherapy
> dermofasciectomy (radical)
> collagenase
> percutaneous needle fasciotomy
> partial fasciectomy

Question 6

what is trigger finger?

Answer 6

2 tendons run in a sheath and there is a thickening of this sheath creating a pulley that catches

Question 7

what is the epidemiology of trigger finger?

Answer 7

> F>M

> 40-60

Question 8

what finger does trigger finger affect commonly?

Answer 8

ring finger

Question 9

what associations with trigger finger are there?

Answer 9

> gout
rheumatoid arthritis
diabetes mellitus

Question 10

how does trigger finger present?

Answer 10

> may lock
clicking sensation with digit movement
lump in palm under pulley

Question 11

how is trigger finger managed?

Answer 11

> open surgery
percutaneous release
splints
steroids

Question 12

what is De Quervains syndrome?

Answer 12

thickening of localised segment of fibro-osseous tunnel at distal radius

Question 13

in what groups is de quervains syndrome most common?

Answer 13

> women
50-60yrs
postpartum and lactating women

Question 14

what is seen in the history of De Quervains syndrome?

Answer 14

> weeks of pain on the radial side of the wrist
aggravated by thumb movement
localised swelling

Question 15

what is seen on examination of De Quervains syndrome?

Answer 15

> resisted thumb extension

> finlesteins test: pain on adduction and flexion of the thumb

Question 16

what treatment is there for De Quervains syndrome?

Answer 16

> splints
steroid injections
decompression surgery

Question 17

are dorsal or volar ganglion more common?

Answer 17

dorsal

Question 18

what are ganglions associated with?

Answer 18

> women

> recurrent injury

Question 19

how does a ganglion present?

Answer 19

> firm
> non-tender
> changes is size
> smooth
> occasionally lobulated
> not fixed to underlying tissue
> never fixed to skin

Question 20

what is the management of ganglion?

Answer 20

> operative: excision

> non-operative: aspiration, reassurance and observation

Question 21

how does osteoarthritis of the base of the thumb present?

Answer 21

> stiffness
> pain
> swelling
> deformity
> loss of function

Question 22

what management is there for osteoarthritis of the base of the thumb?

Answer 22

> life style modification
> NSAIDs
> splint
> steroid injection
> replacement
> fusion
> TRAPEZIECTOMY