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MSK AM > Orthopaedic problems of the hand > Flashcards

Orthopaedic problems of the hand Flashcards

1
Q

Who is dupuytrens seen in?

A

Males > females

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2
Q

What is Dupuytrens associated with?

A 
DM
Alcohol
Tobacco
Alcohol
HIV
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3
Q

What is the pathology of Dupuytrens?

A

Palmar aponeurosis thickens and contracts

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4
Q

Whatvare the clinical features of Dupuytrens?

A

Usually not painful
Loss of finger extension
Functional problems

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5
Q

What is the treatment of Dupuytrens?

A 
Non op- observe, radiotherapy
Operative- partial fasciectomy
Dermo-fasciectomy
Arthrodesis
Amputation
Percutaneous needle fasciotomy
Collagenase
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6
Q

What is the pathology of trigger finger?

A

Swelling of tendon catches on pulley

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7
Q

Who is trigger finger seen in?

A

Women > men

40-60 year olds

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8
Q

What is trigger finger associated with?

A

RA
DM
Gout

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9
Q

What are the clinical features of trigger finger?

A

Clicking sensation with movement of digit
Lump in palm under pulley
May have to use other hand to unlock

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10
Q

What is critical for diagnosis of trigger finger?

A

Palpable lump in palm over A1 pulley

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11
Q

What is the treatment of trigger finger?

A

Non op- splint age, steroid injection

Op- percutaneous release, open surgery

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12
Q

Who is De Quervain’s syndrome seen in?

A

Females, 50-60

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13
Q

What is de Quervain’s syndrome?

A

Thickening of localised segment of tendon running through fibrous-psseus tunnel at distal radius

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14
Q

What ar the clinical features of de Quervain’s syndrome?

A

Several weeks of pain localised to side of wrist and aggravated by thumb movement
Localised swelling and tenderness
Lump- feels like bone

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15
Q

How is de Quervain’s diagnosed?

A

Examination of thumb

Finklestein’s test

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16
Q

What is the treatment of de Quervain’s?

A

Non op- splints, steroid injection

Surgical decompression

17
Q

Who are ganglia seen in?

A

Females 20-40

18
Q

What are ganglia in the wrist associated with?

A

Recurrent injury

19
Q

What are the clinical features of a ganglion?

A

Lump- firm, non tender, smooth, occasionally lobulated, never fixed to skin but can be fixed to underlying tissue

20
Q

What is the treatment of a ganglion?

A

Non op- aspiration, “family bible”

Op- excision

21
Q

What are the clinical features of OA of base of thumb?

A 
Pain
Stiffness
Swelling
Deformity
Loss of function
22
Q

Who is OA of the base of thumb seen in?

A

1 in 3 woemn

23
Q

What are the non op treatments of OA?

A

Lifestyle
NSAIDs
Splints
Steroid injections

24
Q

What are the operative treatment of OA of base of thumb?

A

Trapeziectomy
Fusion
Replacement

MSK AM (37 decks)

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