Metacarpals and phalanges

Question 1

what does the volar plate do

Answer 1

normally prevent hyperextension injuries

Question 2

Tuft fractures

Answer 2

these usually result from direct trauma and are often comminuted. They are distal to the insertion of both the flexor and extensor tendons and so rarely create any functional disability

Question 3

Transverse fractures of the proximal phalanx

Answer 3

usually unstable due to the pull of interossei and the central slip in opposite directions

Question 4

spiral and oblique fractures of the phalanges

Answer 4

shorten due to muscle forces crossing the joint

it is vital to detect any rotational element to fracture fragments

Question 5

How are condylar fractures

Answer 5

axial loading

all condylar fractures need surgical opinion

Question 6

Mallet finger

Answer 6

closed rupture of the terminal conjoined extensor tendon or an avulsion of a bony fragment from the base of the distal phalanx at the attachment of the distal conjoined extensor tendon

Question 7

Volar plate avulsion

Answer 7

Rupture of the volar plate at the base of the phalanx with or without an associated bony fracture.`

through forced extension at the PIP or DIP

Question 8

flexor digitorum profundus (FDP) tendon is avulsed - how is it different to an avulsion fracture?

Answer 8

There is a bone fragment pulled down to the middle phalanx base

Question 9

skiers thumb / gamekeepers thumb happens how?

Answer 9

Forced abduction of the thumb.

Question 10

Stener lesion after skiers thumb injury

Answer 10

Associated displacement of the ulnar collateral ligament proximal and superficial to the adductor pollicis aponeurosis

Question 11

Indicatrions to operate on boxers fracture

Answer 11

severe angulation, unstable rotational deformity and significant comminution.

Question 12

What to do if 2nd and 3rd metacarpal fractures are angulated

Answer 12

need precise reduction. 10 to 15 degrees should be ocrrected

Question 13

Bennetts fracture

Answer 13

oblique intra-articular fracture of the base of the first metacarpal,

intraarticular is what differentiates it to pseudo bennett

needs surgical pinning

Question 14

Rolandos fractrure

Answer 14

similar to Bennetts but with assocaited comminution

Question 15

What should be reported on in every case

Answer 15

Intra-articular involvement
The extent of the articular surface area involved
The rotational element of fracture