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Ortho AM > Hand Problems > Flashcards

Hand Problems Flashcards

1
Q

What is the most common carpal fracture?

A

Scaphoid

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2
Q

What is the most common location for scaphoid fracture?

A

Waist of scaphoid

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3
Q

What is the presentation of scaphoid fracture?

A

Fall onto outstretched hand
Localised pain
Tenderness in anatomical snuffbox

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4
Q

What investigations are done for suspected fractured scaphoid?

A

XR- specifically ask for scaphoid

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5
Q

What is the management of scaphoid fracture?

A

Cast immobilisation 6-8 weeks

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6
Q

What are the complications of scaphoid fracture?

A

Non unon

Avascular necrosis

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7
Q

What is there a risk of avascular necrosis in scaphoid fracture?

A

Blood supply to distal scaphoid closely associated with the waist of scaphoid

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8
Q

What is a boxer’s fracture?

A

Fracture of 5th metacarpal

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9
Q

What is th presentation of a boxer’s fracture?

A

Pain

Depressed knuckle

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10
Q

What is the management of a Boxer’s fracture?

A

<70 degrees= buddy taping, or tensor bandage/splint

>70 degrees= reduction and splint

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11
Q

What is Dupytrens?

A

Thickening and contracture of palmar aponeurosis due to change in type of collagen produced

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12
Q

What are the strong risk factors for Dupytrens?

A

Men
>40
FH
DM

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13
Q

What are the weak risk factors for Dypytrens?

A

Alcohol
Tobacco
HIV
Epilepsy

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14
Q

What is the early presentation of Dypytrens?

A

Palmar nodules and cords

Skin changes

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15
Q

What is the progression of Dypytrens?

A

Functional al difficulties
Contracture- classically ring finger first, and pinkie
Loss of finger extension, active or passive

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16
Q

What are the management options for Dupytrens?

A

Non operative
Operative
Percutaneous needle fasciotomy

17
Q

What are the non operative management options for Dupytrens?

A

Steroid injection
Collagenase fasciotomy
Radiotherapy

18
Q

What are the operative management options for Dupytrens?

A

Partial fasciotomy- common, 50% recurrence at 5 years

Dermo-fasciotomy= more radical, intensive physiol

19
Q

What is trigger finger?

A

Digital flexor tendinitis at A1 pulley

20
Q

What are the risk factors for trigger finger?

A 
Women
40-60yo
RA
DM
Gout
21
Q

What is the presentation of trigger finger?

A

Palpable ndule at base of digit- most often ring finger or thumb
Painful popping sensation with movement
Need to “unlock” tinder

22
Q

What is the management of trigger finger?

A

Non op- splint, NSAIDs, steroid injection

Operative- percutaneous release, open surgery

23
Q

What is DeQuervain’s?

A

Inflammation and thickening of tendon sheath/tendon at distal radius

24
Q

What i the presentation of DeQuervain’s?

A

Pain, tenderness and swelling at radial side of wrist, aggravated by movement
Palpable nodule
Positive Finkelstein’s test

25
Q

What is FInklestein’s test?

A

Thumb clasped in palm, and ulnar deviation

PAin= +

26
Q

What is done to diagnose De Quervain’s?

A

Characteristic history
+ Finkestein’s
US if necessary

27
Q

What are the management options for DeQuervain’s?

A
  1. NSAIDs, rest and splint
  2. Steroid injection
  3. surgical decompression
28
Q

What is the presentation of OA of base of thumb?

A

Pain, stiffness and swelling
Deformity- squared off or Z thumb
Loss of function

29
Q

What causes squared off thumb and Z thumb?

A

Attenuation of ligaments and subluxation of joints

30
Q

What investigations are done for OA of base of thumb?

A 
XR
-Loss of joint space
-osteophytes
-sclerosis
-subchondral cysts
Bilat= check for haemachromatosis
31
Q

What is the management of OA base of thumb?

A 
Lifestyle
NSAIDs
Splinting
Steroid injection
Operative
32
Q

What are the operative management options for OA base of thumb?

A

Trapeziectomy= gold standard but last resort
Fusion
Replacement

33
Q

What is carpal tunnel syndrome?

A

Compression of median nerve in carpal tunnel

34
Q

What re the risk factors for carpal tunnel?

A 
Female 
>30
High BMI
DM
RA
fractured write/carpal bones
Thyroid pathology
35
Q

What is the presentation of carpal tunnel?

A 
Numbness, paraestoesia with night time worsening of thumb and radial 2.5 digits 
Weakness and wasting of thenar muscles
Clumsiness
Aching of arm
\+ Tinel's and Phalen's
36
Q

How is carpal tunnel diagnosed?

What is the management of carpal tunnel?

A

Dx=Characteristic history, Nerve conduction studies
Splint and steroids
Steroid injection
Surgical decompression

Ortho AM (23 decks)

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