Orthopaedic problems of the hand Flashcards
Is dupuytrens more common in males or females?
Males
What are some risk factors associated with Dupuytrens?
Alcohol Tobacco Diabetes HIV Epilepsy
What are the main pathological features of Dupuytren’s?
Growth factors
Excessive collagen production by myofibroblasts
What are some treatment options for Dups?
Fasciectomy
Needle fasciotomy
Collagenase
What is a benefit of fasciectomy for dups?
Less chance of contracture coming back
What does collagenase do?
Dissolves collagen in the band to straighten finger
What are some drawbacks of collagenase for dups?
Can cause flexor tendon ruptures
Expensive
What is trigger finger?
Tendon swells and catches on thickenings in the tendon sheath (pulleys)
How is trigger finger diagnosed?
Patient describes pain around the distal palmar crease
Clicking sensation when tendon flexes
Palpable lump in hand over a1 pulley
Palpable triggering when you extend the finger
How is trigger finger treated?
Splinting to rest swollen tendon
Steroid injection to decrease swelling
Percutaneous release
What is De Quervain’s syndrome?
Thickening segment in first distal extensor compartment
How may DeQuervain’s present?
Several weeks of pain in radial side of wrist
Pain aggravated by movement of thumb
Localised tenderness over tunnel
May have swelling
What is Finklesteins test?
Close thumb into palm and turn wrist towards ulnar
Causes pain in DeQuervain’s patients
What are some non-operative solutions for DeQuervains?
Night time splinting
Steroid injections into sheath
What is an operative solution for DeQuervains?
Open compartments and decompress
