Upper Extremity II Flashcards
What region in the hand leads to the worst outcomes with flexor tendon injury?
location of laceration and position of finger will determine the tendons are cut; fingers are the worst location for injury, the palm is the best
Contrast the actions of the flexor digitorum profundus and superificialis.
profundus extends all the way to the distal phalange to assist flexor, which the superficialis only extends to the middle and proximal phalanges
How are tendons repaired?
multiple sutures are attached longitudinally and a final stitch joins the tendon ends together (40N of strength is required to allow early active motion
How are tendons repaired?
multiple sutures are attached longitudinally and a final stitch joins the tendon ends together (40N of strength is required to allow early active motion)
How can a extensor tendon become injured (most commonly)?
direct trauma (ie. mallet, boutonniere) or via inflammatory arthritis
Describe the clinical presentation and treatment of a mallet fracture.
disruption of the terminal extensor tendon leads to the inability to extend the distal phalanx at DIP
can include bone or only the soft tissue, treated with extension splint or surgical repair (assess that distal joint is properly aligned)
Describe the clinical presentation of a boutonniere fracture.
rupture of a central slip insertion on the proximal phalanx (swan-neck deformity like) causes attenuation of triangular ligament resulting in deformity
PIP remains flexed, DIP remains extended
Which joints does osteoarthritis most commonly affect?
degenerative arthritis most commonly affects DIP joints and thumb CMC joint
post-traumatic arthritis affects the wrist and PIP joints
Which joints does osteoarthritis most commonly affect?
degenerative arthritis most commonly affects DIP joints and thumb CMC joint
post-traumatic arthritis affects the wrist and PIP joints
What evidence of osteoarthritis would you find on X-ray?
joint space narrowing, subchondral sclerosis, bone spurs, subluxation
What is Parsonage-Turner syndrome?
autoimmune like-damage to the brachial plexus that leads to tenderness over the shoulder and numbness/tingling in the arm
sudden onset pain can also occur
What is Parsonage-Turner syndrome?
autoimmune like-damage to the brachial plexus that leads to tenderness over the shoulder and numbness/tingling in the arm
sudden onset pain can also occur
In carpal tunnel the median nerve is compressed below which structure?
the transverse carpal ligament, also includes FPL, FDP, FDS
In carpal tunnel the median nerve is compressed below which structure?
the transverse carpal ligament, also includes FPL, FDP, FDS
How are braces best used in treatment of carpal tunnel?
used to position wrist with least amount of compressive, helping with best blood flow during sleeping
not shown to produce lasting effects
