Hand wrist MSK Flashcards
1st extensor compartment
APL, EPB
boxers fracture
fx of head of 5th metacarpal
Boxer’s fracture must be buddy taped to prevent malrotation. The MCP joint should be flexed to 90 degrees.
UCL injury
UCL of MCP of thumb due to excess radial deviation, laxity and pain with thumb abduction, immobilize with splint, refer if steners lesion
Stener’s lesion
trapping of adductor aponeurosis in MCP joint due to severe UCL tear that opens up access to the joint, ortho referral
Jersey finger
FDP or FDS avulsion , treatment ortho referral
Scaphoid fx proximal 1/3 requires
surgery consult – if within distal 2/3 then thumb spica is appropriate
A proximal 3rd scaphoid fracture should be immobilized for about 5 months.
2nd extensor compartment
ECRL, ECRB
3rd extensor compartment
EPL
4th extensor compartment
ED, EIP
5th extensor compartment
EDM
6th extensor compartment
ECU
Listers tubercle
between 2nd and 3rd compartment
snapping wrist syndrome
snapping ECU tendon
Drummer’s wrsit
inflammation of 3rd extensor compartment (EPL)
Vaughn Jackson syndrome
inflammation of 5th compartment tendon (EDM)
Radial border of snuff box
APL, EPB
Medial/ulnar border of snuff box
EPL
Colles Fracture
distal radius fragment is DORSALLY displaced
Smith Fracture
distal radius fragment is volarly displaced (Sweater VEST)
Base/floor of snuff box
scaphoid
Refer to surgery for scaphoid fracture if what two thingsq
If proximal 1/3 fracture or if fracture is displaced
Most common type of scaphoid fracture
waist fracture (middle), there is proximal pole and distal pole and the waist is in the middle
Mallet finger tx
can be treated conservatively with splinting in DIP in extension 6-8 wks, surgical repair if poor healing or if avulsed fragment is greater than 1/3 of the joint (jersey finger on the other hand is always a surgical referral)
Gamekeepers thumb
Gamekeeper’s thumb is an injury to the ulnar collateral ligament of the thumb-MCP joint resulting in joint instability. Usually, the mechanism of injury is a forced radial deviation of the thumb or from a ski pole injury.
Terminology. Skier’s thumb refers to acute injury due to trauma, from hyperabduction of the thumb as it is caught by the ski pole strap. Gamekeeper’s thumb refers to chronic non-traumatic overuse injury (stress and repetitive trauma) that gradually injure the ulnar collateral ligament.
Monteggia fx mechanism
FOOSH with pronation, fx of proximal 1/3 ulna and radial head dilslocation, causes injury of PIN
Intersecion syndrome
Intersection syndrome is an inflammatory condition that occurs at the crossing point of the 1st dorsal compartment (APL and EPB ) and the 2nd dorsal compartment (ECRL, ECRB).
Diagnosis is made clinically with pain over the dorsoradial forearm (5 cm from wrist joint) made worse with resisted wrist extension and thumb extension.
Treatment is conservative with rest, wrist splinting and steroid injections.
seen in rowers
Glucocerebroside accumulates in the reticuloendothelial cells of the spleen, liver and bone marrow i
n Gaucher’s disease.
Dupuytren’s contracture is what inheritance
AD
oblique fracture-subluxation at the base of the thumb metacarpal (fell with thumb in abducted position)
Bennet’s fx
A Bennet’s is an intrarticular fracture of the 1st metacarpal that extends into the CMC. This fracture typically results from a fist fight.
