Hand wrist MSK

Question 1

1st extensor compartment

Answer 1

APL, EPB

Question 2

boxers fracture

Answer 2

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.

Question 3

UCL injury

Answer 3

UCL of MCP of thumb due to excess radial deviation, laxity and pain with thumb abduction, immobilize with splint, refer if steners lesion

Question 4

Stener’s lesion

Answer 4

trapping of adductor aponeurosis in MCP joint due to severe UCL tear that opens up access to the joint, ortho referral

Question 5

Jersey finger

Answer 5

FDP or FDS avulsion , treatment ortho referral

Question 6

Scaphoid fx proximal 1/3 requires

Answer 6

surgery consult – if within distal 2/3 then thumb spica is appropriate
A proximal 3rd scaphoid fracture should be immobilized for about 5 months.

Question 7

2nd extensor compartment

Answer 7

ECRL, ECRB

Question 8

3rd extensor compartment

Answer 8

EPL

Question 9

4th extensor compartment

Answer 9

ED, EIP

Question 10

5th extensor compartment

Answer 10

EDM

Question 11

6th extensor compartment

Answer 11

ECU

Question 12

Listers tubercle

Answer 12

between 2nd and 3rd compartment

Question 13

snapping wrist syndrome

Answer 13

snapping ECU tendon

Question 14

Drummer’s wrsit

Answer 14

inflammation of 3rd extensor compartment (EPL)

Question 15

Vaughn Jackson syndrome

Answer 15

inflammation of 5th compartment tendon (EDM)

Question 16

Radial border of snuff box

Answer 16

APL, EPB

Question 17

Medial/ulnar border of snuff box

Answer 17

EPL

Question 18

Colles Fracture

Answer 18

distal radius fragment is DORSALLY displaced

Question 19

Smith Fracture

Answer 19

distal radius fragment is volarly displaced (Sweater VEST)

Question 20

Base/floor of snuff box

Answer 20

scaphoid

Question 21

Refer to surgery for scaphoid fracture if what two thingsq

Answer 21

If proximal 1/3 fracture or if fracture is displaced

Question 22

Most common type of scaphoid fracture

Answer 22

waist fracture (middle), there is proximal pole and distal pole and the waist is in the middle

Question 23

Mallet finger tx

Answer 23

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)

Question 24

Gamekeepers thumb

Answer 24

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.

Question 25

Monteggia fx mechanism

Answer 25

FOOSH with pronation, fx of proximal 1/3 ulna and radial head dilslocation, causes injury of PIN

Question 26

Intersecion syndrome

Answer 26

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

Question 27

Glucocerebroside accumulates in the reticuloendothelial cells of the spleen, liver and bone marrow i

Answer 27

n Gaucher’s disease.

Question 28

Dupuytren’s contracture is what inheritance

Answer 28

AD

Question 29

oblique fracture-subluxation at the base of the thumb metacarpal (fell with thumb in abducted position)

Answer 29

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.