Orthopaedic Problems Of The Hand Flashcards
Who’s more likely to get Duputrens? Male or female?
Age 15-64 males are more likely to get 8:1
Over 76s M:F 2:1
Name some risk factors for dupuytrens?
Diabetes, alcohol, tobacco, HIV, epilepsy, family history
Presentation of dupuytrens
Painful lump in palm, becomes not painful,
Loss of passive and active finger extension,
Functional problems- cant put hand in pocket, gripping things, washing face
Non-operative treatment of Dupuytrens disease?
Observe, radiotherapy
Operative treatment of dupuytrens?
Partial fasciectomy, dermo-fasciectomy, arthrodesis, amputation, percutaneous needle fasciotomy, collagenase
Pathology of trigger finger
Thickening in sheath creates a pulley and swellings in tendons get caught on the pulley
Risk factors of trigger finger?
Female, 40-60s, Local trauma, RA, DM, Gout
Presentation of trigger finger?
Clicking sensation with movement of digit,
Lump in palm under pulley,
Clicking may progress to locking
Examination of trigger finger?
Palpable lump in palm over A1 pulley
Nor operative treatment of trigger finger?
Splintage, steroid
Operative treatment of trigger finger?
Percutaneous release,
Open surgery
Presentation of De Quervain’s Syndrome?
Several weeks pain localised to radial side of wrist,
Aggravated by movement of the thumb,
Localised swelling,
Localised tenderness over tunnel
Risk factors of De Quervain’s Syndrome?
Female, 50-60s, Postpartum, Lactating females, Activities with frequent thumb abduction and ulnar deviation
Investigations for De Quervain’s Syndrome?
Finklestein’s test,
Resisted thumb extension
non-operative treatment of De Quervain’s Syndrome?
Splints, steroid injection