Hand/UE Disorders & Injuries Flashcards
Dupuytrens Disease
Disease of fascia of palm/digits where fascia becomes thick/contracted - develops cords/bands that extend into digits: Results in flex deformities of involved digits
*Surgical release required
Tx for Dupuytrens Disease
Wound care - dressing changes; Edema control - elevation; Extension splint - initially at all times; A/PROM and progress to strengthening; Scar mngt; Purposeful grip/release task
Skiers Thumb/Gamekeepers thumb
Rupture of ulnar collateral lig of MCP joint of thumb - most common is fall w ski pole in hand
TS for Skiers Thumb/Gamekeepers thumb
Thumb splint 4-6mo, AROM/Pinch strengthening for 6mo, Focus on ADL that req opposition/pinch strength, post-op tx: thumb splint for 6wx then AROM. PROM can begin at 8wk, strengthening at 10
Complex Regional Pain Syndrome (CRPS) {2 types}
Type I: formerly known as reflex sympathetic dystrophy (RSD); Type II: formerly known as causalgia
Vasomotor dysfx as a result of an abnormal reflex; Can be localized or spread
CRPS symptoms
Severe pain, edema, discoloration, osteoporosis, sudomotor changes, temp changes, trophic changes and vasomotor instability
Tx for CRPS
Modalities to decrease pain, edema mngt, AROM, ADL to encourage pain-free use, stress loading (wt bear/joint distraction activities like scrubbing/carrying), splinting to prevent contractures/enable ability, encourage self mngt, interventions to avoid/caution: PROM. pass stretch, joint mob, dynamic splinting/casting
Intraarticular vs Extraarticular fracture
Intra-articular fractures involve a joint space and are significantly more serious because they are associated with a much greater incidence of long-term complications; Extraarticulars do not extend into the joint
Closed vs Open fracture
An open fracture is an injury that not only damages the bone but will break the skin; Closed does not break skin
Dorsal vs Volar Displacement Fracture
A Colles’ fx: of the distal radius in the forearm w dorsal (posterior) and radial displacement - Sometimes referred to as a “dinner fork” or “bayonet”; Smiths fx: of the distal radius w volar displacement
A fracture with an offset of 2mm+ in any plane or 2mmm offset involving the articular surface is considered displaced.
Complete vs Incomplete Fracture
A complete fracture means that the fracture line goes completely across the bone — through the cortex
Simple vs Comminuted Fracture
A simple fracture is one where there are only 2 major bone fragments and one fracture line. A comminuted fracture is one where there are multiple bone fragments and multiple fracture lines.
Transverse Fracture
Fracture line is perpendicular to the long axis of the bone, caused by force in the direction of the fracture
Spiral Fracture
Fracture line is twisted and the fracture line is a twisting fracture caused by a twisting injury such as a break in your leg that happens when your foot is planted but your leg keeps turning
Oblique/Diagonal Fracture
Fracture line is on the diagonal and usually caused by force applied in the same direction as the long axis of the bone
