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Sports Medicine > Wrist / Hand > Flashcards

Wrist / Hand Flashcards

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1
Q

what dorsal compartment is the ECU located within?

A

6th dorsal compartment

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2
Q

where does the ECU insert?

A

fifth MC base

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3
Q

with what two resisted motions will you test for subluxation of the ECU at the wrist?

A

resisted extension / ulnar deviation

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4
Q

what are the two general treatments for ECU tendinopathy?

A

extension splint and occupational therapy

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5
Q

what is the name for an open Salter Harris 1 distal phalangeal fracture?

A

Seymour fracture

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6
Q

t/f open fractures through the nailbed require urgent surgical debridement in the operating room

A

true

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7
Q

what is the typical treatment for displaced distal phalangeal shaft fracture?

A

surgical pinning

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8
Q

a patient sustains mallet finger injury with > 30% joint involvement. what is the next step?

A

surgical referral to consider restoration of joint congruity

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9
Q

a patient sustains a mallet finger injury with volar avulsion of the distal phalanx. what is the next step in treatment other than splinting?

A

surgical referral

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10
Q

t/f most patients with mallet finger injury will have some degree of extensor lag even with full compliance

A

true

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11
Q

what condition is characterized by traumatic avulsion of the FDP from the distal phalanx?

A

jersey finger

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12
Q

inability to flex the DIP joint is most indicative of what injury?

A

Jersey finger

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13
Q

what is the most specific physical exam finding for jersey finger?

A

loss of active DIP joint flexion

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14
Q

a patient experiences a jersey finger injury with bony avulsion. where is the most likely place in the flexor compartment that the tendon will retract to?

A

PIP joint at the level of the FDS tendon

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15
Q

if a patient experiences jersey finger with tendon retraction to the palm, what is the timeline for surgery?

A

7-10 days surgery should be performed

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16
Q

what is the most common dislocation pattern of the PIP (direction of dislocation of middle to proximal phalanx?)

A

dorsal dislocation of the middle phalanx

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17
Q

how long should a typical dorsal dislocation PIP injury be immobilized after reduction?

A

3 weeks

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18
Q

what soft tissue structure is almost always disrupted in a volar disclocation of the PIP joint?

A

central extensor slip

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19
Q

how should a volar PIP dislocation be immobilzed after reduction?

A

full PIP extension

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20
Q

t/f early follow up radiographs are mandatory for PIP dislocation s/p reduction

A

true

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21
Q

how long should reduced volar PIP dislocations be splinted in full extension to protect the central slip?

A

6 weeks

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22
Q

intraarticular head or base fractures of the metacarpals typically require what type of management?

A

surgical

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23
Q

non operative management for a metacarpal neck or shaft fracture will typically be done initially with what period of wrist / hand splint?

A

3-4 weeks

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24
Q

transverse fractures of the metacarpal shaft usually angulate dorsally by pull of what muscles?

A

interossei

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25
Q

what two metacarpals are more prone to rotational deformity from fracture due to lack of surrounding ligamentous stabilizers?

A

2nd/5th

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26
Q

where does the central slip of the extensor tendon insert?

A

dorsal base of the middle phalanx

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27
Q

central slip extensor tendon injury tends to result in what deformity?

A

boutonniere

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28
Q

t/f in an injury to the central extensor slip, if left untreated, the lateral bands will migrate palmarly

A

true

29
Q

what physical exam test can be used to assess the integrity of the central extensor slip?

A

Elson test - digit placed on a table with PIP flexed over the edge - patient attempts active extension of the PIP joint

30
Q

t/f in the treatment of central extensor slip injury, immobilization should encompass the PIP in full extension but leave the DIP to allow active flexion/extension

A

true

31
Q

what motion of the PIP joint is contraindicated during the treatment / recovery from central extensor slip injury?

A

flexion

32
Q

a tuft fracture or displaced phalangeal shaft fracture usually presents with what external sign?

A

subungual hematoma

33
Q

a non displaced, stable fracture of the phalanx can usually be treated with custom splinting and ROM exercises over what period of time?

A

2-3 weeks

34
Q

displaced distal phalangeal shaft fractures are unstable and often require what?

A

surgery - pin fixation

35
Q

in an injury to the thumb UCL ligament avulsion will most often happen from what portion of the ligament?

A

insertion at the base of the proximal phalanx

36
Q

what is a Stener lesion of the thumb?

A

avulsion of the UCL ligament and interposition of the adductor pollicus between the torn ligament and the insertion, preventing healing

37
Q

to determine the integrity of the UCL ligament of the thumb, valgus stress should be applied with what degrees flexion of the proximal phalanx?

A

30 degrees

38
Q

for a partial tear of the thumb UCL resulting in minimal laxity, how long should the MCP and IP be immobilized? in what type of splint?

A

4-6 weeks, thumb spica splint

39
Q

what is the treatment for a Stener lesion?

A

surgery

40
Q

if a UCL lesion of the thumb completely heals, what is the normal return to play window?

A

2-3 months

41
Q

what is the difference between simple and complex dislocation of the thumb?

A

simple - can be reduced manually
complex - requires open reduction to remove interposed tissue

42
Q

what is the typical MOI of an MCP joint dislocation?

A

hyperextension

43
Q

most MCP dislocations occur with the proximal phalanx moving in what direction relative to the metacarpal?

A

dorsal

44
Q

a volar skin “dimple” near the A1 pulley after hyperextension injury to the MCP joint is pathognomonic for what type of injury?

A

complex dislocation

45
Q

in what type of MCP joint dislocation will the proximal phalanx appear 70 -90 degrees hyperextended?

A

simple

46
Q

up to what percentage of MCP joint dislocations have an associated fracture?

A

50%

47
Q

for a simple dislocation of the MCP in the fingers 2-5, how long should the joint be immobilized following reduction?

A

2 weeks

48
Q

for a thumb MCP joint dislocation, how long should rigid immobilization occur after reduction? how long should subsequent splinting to protect against forced hyperextension last?

A

4 weeks rigid immobilization followed by 2 weeks of protection against hyperextension

49
Q

t/f most second to fifth CMC dislocations require closed or open reduction with surgical pinning

A

true

50
Q

what is the typical time of RTP to gripping or hand contact after CMC joint dislocation?

A

6-8 weeks

51
Q

where would you palpate the proximal pole of the scaphoid for tenderness?

A

at the scapholunate junction just distal to the dorsal radial tubercle

52
Q

t/f for scaphoid injury, forced passive wrist extension produces pain at a fracture site

A

true

53
Q

in what type of dislocation does the lunate remain in place relative to the radius while the capitate dislocates relative to the lunate?

A

perilunate dislocation

54
Q

what is the treatment for displaced scaphoid fracture?

A

surgery

55
Q

t/f management of non displaced scaphoid waist fracture is controversial as there are similar union rates and functional results when non operative immobilization is compared to percutaneous screw fixation

A

true

56
Q

how is a proximal pole scaphoid fracture treated?

A

surgically

57
Q

what is the MOI of perilunate injury?

A

wrist hyperextension and ulnar deviation during axial loading

58
Q

lunate dislocation volarly can cause deficit in what nerve?

A

median nerve

59
Q

what measurement of widening between the scaphoid and the lunate may indicate scapholunate ligament tear?

A

> 3mm

60
Q

what is the treatment for all acute perilunate fractures and dislocations?

A

surgical repair

61
Q

what is the most common MOI for distal radius fracture?

A

FOOSH

62
Q

dorsal displacement in conjunction with distal radius fracture results in what type of deformity?

A

dinner fork deformity

63
Q

dorsally displaced distal radius fracture pose risk to what nerve structure?

A

median nerve

64
Q

t/f < or equal to 10 degrees of dorsal tilt of the articular surface is generally considered acceptable for displacement of distal radius extraarticular fractures in the skeletally mature

A

true

65
Q

t/f for an intraarticular pattern distal radius fracture, most practitioners generally accept < or equal to 2mm gap or 1mm step off at the joint surface

A

true

66
Q

what is the minimum amount of recovery time for a distal radius fracture prior to RTP?

A

4-6 weeks

67
Q

participation in contact sports or load bearing after distal radius fracture is precluded until what is evident?

A

stable union of the fracture site

68
Q
A

Sports Medicine (12 decks)

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