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MSK > Orthopaedic Problems on the Hand > Flashcards

Orthopaedic Problems on the Hand Flashcards

1
Q

Which gender is more prevalent of dupytrens disease and when does this occur?

A

M > F

occurs earlier in males

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2
Q

Genetics of dupytrens disease

A

autosomal dominant - variable penetrance

sporadic 30% of cases

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3
Q

Associations of dupytrens contracture

A 
Diabetic 
alcohol 
tobacco 
HIV
epilepsy
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4
Q

What is dupytren’s diathesis?

A

A more aggressive dupytrens

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5
Q

Features of dupytrens diathesis

A

Early onset disease
Bilateral disease
FH
Ectopic disease

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6
Q

Pathology of dupytrens

A

myofibroblast

  • intracellular contractile elements
  • regulated by growth factors
  • production of collagen
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7
Q

Presentation of dupytrens

A 
Not painful usually
Loss of finger extension (active or passive)
Hand in pocket
gripping things problems
curse of the macrrimmonds
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8
Q

treatment of dupytrens

A 
observe
radiotherapy
partial fasciectomy
dermo-fasiectomy
arthrodesis
amputation 
percutanoues needle fasciotomy 
collagenase
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9
Q

What is trigger finger?

A

A condition in which tendons of the hand become swollen and inflamed and “catch” in the pulley it runs through in the tendon sheath

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10
Q

Who gets trigger finger?

A

W > M

40-60s

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11
Q

Which finger are mostly affected in trigger finger?

A

Ring > thumb > middle

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12
Q

Associations of trigger finger

A 
repetitive use of the hand
local trauma
RA
DM
Gout
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13
Q

Presentation of trigger finger

A

Clicking sensation of movement of digit
Lump on palm under pully
may have to use the other hand to ‘unlock’
‘clicking’ may progress to ‘locking’

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14
Q

Treatment of trigger finger

A

splintage
Steriod
percutaneous release
open surgery

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15
Q

What is De Quervians syndrome?

A

Painful inflammation of the tendons of your wrist and lower thumb - the sheath of containing the extensor pollicus brevis and abductor pollicus longus tendons are inflamed

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16
Q

Presentation of De Quervians syndrome

A

Several weeks pain localised to the radial side of the wrist
Tenderness over radial styloid process
Aggravated pain by movement of the thumb
Abduction of thumb against resistance is painful
localised swelling
localised tenderness over tunnel

17
Q

Who gets de Quervians syndrome?

A

F > M

30-50s y/o

18
Q

assosiations of de quervians syndrome

A

post partum
lactating females
activities with frequent thumb abduction and ulnar deviation
washerwomans sprain

19
Q

Pathology of de quervians syndrome

A

1st dorsal extensor compartment
fibro-osseous tunnel at distal radius
30% 1st compartment divided by septum

20
Q

investigations of de quervians syndrome

A

examine thumb joints
Friklesteins tests
resistricted thumb extension

21
Q

Treatment of de quervian syndrome

A

non operative = splints, steroid injections, analgesia

Operative decompression

22
Q

What is a ganglia?

A

A myxoid degeneration from joint synovia

23
Q

Where can ganglions arise from?

A

joint capsule
tendon sheath
ligament

24
Q

Who gets ganglias?

A

F > M
20 - 40 y/o
dorsal > volar

25
Q

What can a ganglia be associated with?

A

Recurrent injury around the wrist

26
Q

Presentation of a ganglia

A 
lump 
firm 
non tender
change in size
smooth 
occasionally lobulated 
not normally fixed to any underlying tissues
never fixed to the skin
27
Q

treatment of ganglia

A

reassure and observe
aspiration
excision; including the ‘root’

28
Q

Presentation of OA of the thumb

A 
pain 
stiffness
swelling
deformity
loss of function 
pain opening jars/pinching
29
Q

Pathology of OA of the thumb

A

dorsal sublaxation
metacarpal adduction
MCPJ extension

30
Q

Treatment of OA of the thumb

A 
Life style modifications
NSAIDs
splint
steroid injections
operative
- trapeziectomy 
- fusion 
- replacement
31
Q

What is the gold standard operative treatment for OA of the thumb?

A

Trapeziectomy

32
Q

What drug treatment can dupytrens contracture be a S/E for?

A

Phenytoin treatment

33
Q

What is friklestones test used for and how does it work?

A

De Quervians tenosynovitis
Pull thumb in ulnar deviation and longitudinal traction. This action (if have the condition) causes pain over the radial styloid process and along the length of the extensor pollicus brevis and abductor pollicus longus

34
Q

What is a common cause of bilateral carpal tunnel syndrome?

A

Rheumatoid arthritis

MSK (25 decks)

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