Module 3 Hand Deformities

Question 1

Ape Hand Deformity

Answer 1

Wasting of the thenar eminence of the hand as a result of a median nerve palsy, and the thumb falls back in line with the fingers as a result of the pull of the extensor muscles. Pt. is unable to oppose or flex thumb.

Question 2

Bishop’s Hand or Benediction Hand Deformity (Duchene’s Sign)

Answer 2

Wasting of the hypothenar muscles of the hand, the interossei muscles, and the two medial lumbrical muscles occurs because of ulnar nerve palsy. There is hyperextension of the MTP joint and flexion of IP joints.

Question 3

Andre-Thomas Sign

Answer 3

If the wrist flexes with MTP extensions when the extrinsic extensors contract.

Question 4

Boutonniere Deformity

Answer 4

Extension of the MTP and distal IP joints and flexion of the proximal IP joint are seen with this deformity.

Question 5

Boutonniere deformity is a result of

Answer 5

rupture of the central tendinous slip of the extensor hood and is most common after trauma or RA

Question 6

Carpal (Carpometacarpal) Bossing

Answer 6

overgrowth of hard bone on the posterior aspect of the hand where the index and/or middle fingers meet the trapezoid and capitate bone

Question 7

What does carpal Bossing indicate?

Answer 7

Arithritis and can be seen on xray

Question 8

Claw Fingers

Answer 8

Results from loss of intrinsic muscle action and the overaction of the extrinsic extensor muscles on the proximal phalanx of the fingers. The MCP joints are hyper extended, and the proximal and distal IP joints are flexed.

Question 9

Intrinsic Minus Hand

Answer 9

intrinsic function is lost and is caused by combined medians and ulnar nerve palsy.

Question 10

Masse’s sign

Answer 10

flattening of the dorsal transverse metatarsal arch and the hand appear flat from the result of hypothenar muscle paralysis

Question 11

Dinner Fork Deformity

Answer 11

malunion distal radial fracture (Colles fracture) with the distal radial fragment angulated posteriorly

Question 12

Drop-wrist Deformity

Answer 12

extensor muscles of the wrist are paralyzed as a result of radial nerve palsy

Question 13

Dupuytren Contracture/Disease

Answer 13

progressive disease of genetic origin results of the palmar fascia. Normally seen in ring or little finger. Most common in men from 50-70

Question 14

Extensor Plus Deformity

Answer 14

Caused by adhesions or shortening of the extensor communis tendon proximal to metacarpophalangeal joint.

Question 15

Mallet Finger

Answer 15

result of a rupture or avulsion of the extensor tendon where it inserts into the distal phalanx of the finger. The distal phalanx rests in a flexed position

Question 16

Myelopathy Hand

Answer 16

dysfunction of the hand caused by cervical spinal cord pathology in conjunction with cervical spondylosis

Question 17

Pitres-Testus Sign

Answer 17

It is evident when the pt. is asked to shape the hand in the form of a cone and can’t do so bc of loss of hypothenar muscles due to ulnar nerve neuropathy

Question 18

Polydactyly

Answer 18

a congenital anomaly characterized by the presence of more than the normal number of fingers or toes

Question 19

Triphalangism

Answer 19

there are three phalanges instead of the normal two as would be seen in the thumb

Question 20

Prominent Ulnar Head

Answer 20

indicates DRUJ pathology of ulnar side carpal patho or TFCC

Question 21

Shoulder sign of the thumb

Answer 21

Subluxation of the CMC joint of the thumb may occur in arthritis

Question 22

Swan neck deformity

Answer 22

result of contracture of the intrinsic muscles or tearing of the volar plate and is often seen in pt. with RA or following trauma

Question 23

Syndactyly

Answer 23

a congenital condition in which some fingers are wholly or partially united, joined, or webbed

Question 24

Trigger finger

Answer 24

result of thickening of the flexor tendon sheath, which causes sticking of the tendon when the pt. attempts to flex the finger

Question 25

Ulnar Drift

Answer 25

results ulnar deviation of the digits bc of weakening of the capsuloligamentous structures of the MCP joints and the accompanying bowstring effect of the extensor communis tendons

Question 26

Ulanar Variance

Answer 26

the ulna is more distal than the radius

Question 27

Zigzag Deformity of the Thumb

Answer 27

the thumb is flexed at the CMP joint and hyperextended at the MCP joint