MSK 3 with pictures Flashcards
What is the most frequently injured portion of the hand?
Fingertips
What is nail trephination and what disorder is it useful for?
Putting a hole in the nail plate to allow instant relief to the pts b/c it releases all the pressure and blood; useful for subungual hematomas
Why is a ring block not suggested for laceration repair?
b/c of the possibility of cutting off blood supply
What are the names of the 2 adhesives that can be used instead of stitches in lac repair?
Indermil and Histoacryl
What area are simple lacerations confined to?
Nail bed (do not extend into peripheral soft tissue)
What are 5 steps to repairing a complex stellate lac?
1) Need to remove nail plate 2) Any free tissue should be put back in place 3)Suture nail bed w/small, absorbable sutures 4) Suture nail plate back 5) Trephination of the nail
What image do you always want to order with complex stellate lac and why?
X-ray b/c likely to find a fx underneath (most likely dealing with open fx and will want to put on abx)
What do you do before suturing a displaced fx?
Reduce them (if needed)
What is mallet finger and what finger is most commonly affected?
An injury to the extensor digitorum tendon at the DIP usually caused by trauma to the distal phalanx; middle finger most common
What is the etiology of mallet finger?
Axial loading of finger; causes sudden forced flexion of distal phalanx→ flexion damages the extensor tendon
What are the 4 findings on clinical presentation/PE of mallet finger?
(1) unable to extend distal phalanx after trauma (2) pain over DIP (3) swelling (4) ecchymosis
What is the tx of mallet finger?
Splinting in full extension or hyperextension for 6-8 weeks 24/7 (or tx has to restart)
What ruptures in rugger-jersey finger and which finger is most commonly affected?
The flexor digitorum profundus; ring finger (75%)
Why does rugger-jersey finger need to be fixed promptly?
b/c if not fixed promptly, pt can be left with FDP finger where they won’t be able to flex that finger again
What is the etiology of rugger-jersey finger?
Forced hyperextension
What are the 3 findings on clinical presentation/PE of rugger-jersey finger?
(1) acute pain (2) swelling volar aspect of DIP (palmar side) (3) inability to flex the distal phalanx
What is the tx in almost all cases of rugger-jersey finger?
surgery
What are ganglions and what do they contain?
Fluid filled swelling overlying a joint or tendon sheath; contain mucinous or gelatinous fluid
Where are flexor tendon ganglions usually located? Where are joint ganglions usually located?
Flexor tendon: usually on palms and fingers joint: usually on dorsal wrist
What are 2 etiologies of ganglions?
(1) degeneration of periarticular structures like synovial lining (2) repetitive movements
What are 4 possible findings on clinical presentation/PE of ganglions?
(1) obvious swelling (2) without swelling, just joint pain (3) cyst typically smooth, firm, rounded and rubbery (4) sometimes tender
What are the 3 tx options of ganglions?
(1) observation (2) needle aspiration w/18 G needle w/3 cc syringe (3) surgical removal for recurrent cysts
What is the location of a mucous cyst?
Usually at the DIP on the dorsal surface
What disorder are mucous cysts usually associated with?
osteoarthritis













