Wrist Flashcards
Outstretched hand Transverse frac @ radius 1inch prox to RadioCarp joint Dorsal displacement + angulation -Dinner fork deformity Distal radius #
Colles
Fall BACK onto palm
Fall with wrists flexed
Volar displacement
Distal radius #
Smith (reverse colles)
RadioCarpal dislocation
Distal radius #
Barton’s
RadioUlnar joint dislocation + ulnar #
Outstretched hand, FORCED pronation
Monteggia
RadioUlnar joint dislocation + radial #
Outstretched hand, rotational force
Galleazzi
Fistfight – flexed metacarpal
1st carpometacarpal joint
Triangular fragment @ metacarpal ulnar base
Bennet
Outstretched hand
- fracture not initially seen
- after casting THEN fracture seen..
Pain @ snuffbox – poss AVN necrosis
Scaphoid fracture
Outstretched hand
Tender radial head,
impaired elbow movement (inc sup and pron)
sharp lateral elbow pain
Radial head fracture
Painful wrist
Pain @ resisted thumb ABduction
pain @ radial wrist @ FINKelstein
What’s dx? And finkelstein? Which tendons?
De Quervain’s tenosynovitis – finkelstein to diagnose
Pain @:
Flex thumb THEN
Ulnar deviate and flex wrist
Extensor pollicis brevis
Adductor pollicis longus
Kanavel’s sign:
FIXED flexion,
Fusiform swelling,
Pain @ passive extension
Infective flexor tenosynovitis
AB’s, RICE, debridement
AR Bone harder denser
Cant differentiate between cortex and medulla @ x-ray #marblebone
Osteopetrosis
Poor collagen formation -> shit osteoid
Translucent, multiple fractures
Blue sclera
Osteogenesis imperfecta
VitD def -> osteoid ossify fail = Small, F2T
LARGE head,
CW deformity –
thick costochonJunc; Transverse(Harrison’s) sulcus in chest=pull of diaphragm
Bowing femur+tibia,
Rickets osteomalacia
1 in 10million @young males
Long bone DIAPHYSIS = small round tumour
Onion skin appearance
Aggressive
Ewing
Long bone METAPHYSIS
Assoc with Pagets, Radiation, Retinoblastoma
Osteosarcoma
2 in 1 million @>40yr
Liposarcoma
Tumour with loads of histiocytes
Most common in adults
Undifferentiated pleomorphic sarcoma i.e. cell origin unknown
Malignant Fibrous Histiocytoma
Trapped flexor tendon
Digit Locked in flexion
Have to passively release it
Associated with diabetes rheumatoid gout
Stenosing Tino synovitis
A.k.a. trigger finger
Flexor tendon sheath thickened and narrowed
Analgesias/steds
Patient has diabetes/cirrhosis/phenytoin user
Patients got flexion contracture of the fingers
(mainly RING)
Nodular thickening of palmer fascia
What test?
Dupuytrens contracture
Proliferative fibroplasis of Palmer and digital fascia
Assoc with Peyeonie/Ledderhose
Hueston table top test
What fractures are compartment syndrome associated with?
Supracondylar and tibial shaft
Pain and swelling
Large radiolucent and head of numerous extending to subchondral plate
SOAP bubble on X-ray
Can present as path fract
Giant cell tumour
