Wrist and Hand Conditions Flashcards
1
Q
Carpal Tunnel Syndrome:
A
- compression of the median nerve at the carpal tunnel due to inflammation of the flexor tendons and/or median nerve
- Causes:
- repetitive wrist motions or gripping
- pregnancy
- diabetes
- RA
- Must r/o cervical spine dysfunction, TOS, or peripheral nerve entrapment
2
Q
Carpal Tunnel Syndrome: Dx
A
- CLinical findings
- exacerbation of burning/tingling/pins & needles and numbness into med nerve distribution at night
- (+) tinels sign
- phalen’s test
- long term compression = atrophy/weakness of thenar muscles and lat 2 lumbricals & Abductor pollicis brevis
- Electrodiagnostic testing
3
Q
Carpal Tunnel Syndrome: PT
A
Biomechanical Faults
soft tissue techniques
4
Q
De Quervain’s Tenosynovitis:
A
- Inflammation of extensor pollicis brevis and abductor pollicis longus at 1st dorsal compartment
- Results from repetitive microtrauma or complication of swelling during pregnancy
*
5
Q
De Quervain’s Tenosynovitis: Dx
A
- MRI, but usually not necessarry
- Clinical Signs
- p! at anatomical snuff box
- swelling
- decreased grip and pinc strength
- (+) finkelsteins test
6
Q
De Quervain’s Tenosynovitis: PT
A
biomechanical faults
soft tissue techniques
7
Q
Colle’s Fracture:
A
- most common wrist fracture
- from FOOSH
- Immobilized for 5-8 wks
- complication of median nerve compression can occur w/ excessive edema
- characteristic “dinner fork” deformity of wrist and hand results from dorsal or posterior displacement of distal fragment of radius w/ radial shift of wrist and hand
8
Q
Colle’s Fracture: Dx
A
plain film imaging
9
Q
Smith’s Fracture:
A
- similar to colles fx except distal segment of radius dislocates in volar direction
- characteristic “garden spade” deformity
10
Q
Smith’s Fracture: Dx
A
plain film imaging
11
Q
Colles Fracture & Smith’s Fracture: Treatment
A
- early PT intervention that focuses on normalizing flexibility is paramount to functional recovery of wrist and hand
- Biomechanical Faults
- soft tissue mobilization
12
Q
Scaphoid Fracture:
A
- FOOSH in younger person
- most commonly fractured carpal
- complications
- high incidence of avascular necrosis of prox fragment of scaphoid second to poor vascular supply
- imobilized for 4-8 wks
13
Q
Scaphoid Fracture: Dx
A
plain film
14
Q
Scaphoid Fracture: PT
A
- maintanence of flexibility of distal/proximal joints while UE is casted
- later intervention emphasizes strengthening, stretching, and joint soft tissue for full funx
15
Q
Duputren’s Contracture:
A
- observed as banding on palm and digit flexion contractures resulting from contracture of palmar fascia to skin
- affects men > women
- contracture effects:
- MCP and PIP of 4/5th digits non diabetic
- MCP and PIP of 3rd/4th in diabetic
17
Q
Boutonniere’s Deformity
A
- results from rupture of central tendonous slip of extensor hood
- observed deformity is extension of MCP/DIP and flexion of PIP
- Causes:
- trauma, RA w/ degen of central tendon
19
Q
Swan Neck Deformity:
A
- results from contracture of intrinsice ms w/ dorsal sublux of lateral extensor tendons
- observed deformity = flexion of MCP and DIP w. extension of PIP
- Causes
- trauma, RA w/ deg of lat extensor tendons
25
Q
Mallet Finger:
A
- rupture or avulsion of extensor tendon at its insertion into the distal phalanx of digit
- observed deformity = flexion of DIP
- Causes
- trauma, forcing distal phalanx into flex
28
Q
Gamekeeper’s Thumb:
A
- a sprain/rupture of ulnar collateral ligament of MCP in 1st digit
- results in medial instability of thumb
- frequently occurs during fall while skiing when increased forced are placed on thumb through ski pole
- immobilized for 6 wks
