Orthopaedic Problems Of The Hand Flashcards

1
Q

Who’s more likely to get Duputrens? Male or female?

A

Age 15-64 males are more likely to get 8:1

Over 76s M:F 2:1

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2
Q

Name some risk factors for dupuytrens?

A

Diabetes, alcohol, tobacco, HIV, epilepsy, family history

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3
Q

Presentation of dupuytrens

A

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

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4
Q

Non-operative treatment of Dupuytrens disease?

A

Observe, radiotherapy

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5
Q

Operative treatment of dupuytrens?

A

Partial fasciectomy, dermo-fasciectomy, arthrodesis, amputation, percutaneous needle fasciotomy, collagenase

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6
Q

Pathology of trigger finger

A

Thickening in sheath creates a pulley and swellings in tendons get caught on the pulley

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7
Q

Risk factors of trigger finger?

A
Female, 
40-60s, 
Local trauma,
RA,
DM,
Gout
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8
Q

Presentation of trigger finger?

A

Clicking sensation with movement of digit,
Lump in palm under pulley,
Clicking may progress to locking

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9
Q

Examination of trigger finger?

A

Palpable lump in palm over A1 pulley

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10
Q

Nor operative treatment of trigger finger?

A

Splintage, steroid

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11
Q

Operative treatment of trigger finger?

A

Percutaneous release,

Open surgery

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12
Q

Presentation of De Quervain’s Syndrome?

A

Several weeks pain localised to radial side of wrist,
Aggravated by movement of the thumb,
Localised swelling,
Localised tenderness over tunnel

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13
Q

Risk factors of De Quervain’s Syndrome?

A
Female, 
50-60s,
Postpartum,
Lactating females, 
Activities with frequent thumb abduction and ulnar deviation
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14
Q

Investigations for De Quervain’s Syndrome?

A

Finklestein’s test,

Resisted thumb extension

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15
Q

non-operative treatment of De Quervain’s Syndrome?

A

Splints, steroid injection

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16
Q

Operative treatment of De Quervain’s syndrome?

A

Decompression

17
Q

What is a ganglion?

A

A myxoid degeneration from joint synovial which arises from joint capsule, tendon sheath or ligament

18
Q

What is a ganglion lump appear like?

A

Firm,
Non-tender,
Smooth,
Not fixed to skin

19
Q

Non operative treatment of ganglion?

A

Reassure and observe,

Aspiration

20
Q

Operative treatment of ganglion?

A

Excision

21
Q

Presentation of OA base of thumb?

A

Pain, stiffness, swelling, deformity, loss of function

22
Q

Non-operative treatment of OA base of thumb?

A

Life style modifications, NSAIDs, splint, steroid injection

23
Q

Operative treatment methods of OA base of thumb?

A

Trapeziectomy, fusion, replacement