Wrist/Hand Flashcards
What is mallet/baseball/drop finger? Mechanism? Structures involved? What type of splint is best?
damage to the extensor tendon of the finger when a ball or other object strikes the tip of the finger. Presents as a drooped finger. Unable to extend DIP (flexion deformity). An aluminum, stack, or ring splint are all equally efficacious.
Boutonneriere deformity?
presents as flexion of the PIP joint, extension of the DIP joint. Caused by forceful blow to a bent finger, causing damage the central slip mechanism. Pt is unable to extend PIP.
Jersey Finger
usu occurs in tackling sport, usu to ring finger. Causes forced extension of DIP during active flexion. FDP tendon injury, so pt will be unable to flex DIP.
Gamekeepers Thumb/Skier’s Thumb
valgus force directed to thumb MCP joint that causes failure of ulnar collateral ligament (2nd digit side). Will present with pain at base of thumb.
Swan neck deformity
DIP hyperflexion, PIP hyperextension. Can be caused by RA (volar plate injury) or untreated mallet finger.
Bennett fracture
fx at base of thumb that extends into CMC joint. Usually associated with dislocation. Caused by fighting/punching.
Name of the carpal bones of the hand
Scaphoid Lunate Triquetrum Pisiform Trapezium Trapezoid Capitate Hamate
What is a stenar lesion? What is it associated with?
the proximal end of the UCL is trapped outside of the adductor aponeurosis. Associated with UCL injury.
What runs through guyon’s canal?
ulnar nn and ulnar artery. Adjacent to carpal tunnel.
What makes up the snuffbox and what’s inside?
APL, EPL, EPB. The scaphoid lies inside those borders.
What joint is the stack splint appropriate to use with?
DIP only (looks like a shoe)
What is the most commonly dislocated joint?
PIP (“coaches finger”)
If finger joint dislocation is dorsally directed… what structures compromised? how should finger be splinted?
volar plate injured. Should be splinted in flexion to avoid full extension.
If finger joint dislocation is volarly directed… what structures compromised?
dorsal structures injured. Should be splinted in extension to guard against full flexion.
After dislocation + reduction, make sure the nailbeds of all the fingers are ____ and ____.
in the same plane and pointing toward the scaphoid
boxer’s fracture
neck of 5th MC, splint in 70-90 degrees of flexion
kienbock’s disease
AVN of lunate
What is watson’s sign?
aka scaphoid shift test. Assess for scapholunate stability. Dorsally load the lunate and deviate wrist. (+) = pain and pop.
Special tests for TFCC?
supination lift, piano key, grind test
AIN vs PIN?
AIN is a branch of the median nerve and pt will be unable to make the OK sign with injury to AIN. PIN = branch of radial nerve.
Preiser’s disease
AVN of scaphoid
What is trigger finger?
thickening of flexor tendon sheath and inflammation of synovium. A1 pulley gets stuck and finger locks into flexion.
Exclusive dermatomal area of median nerve?
tip of index finger
Exclusive dermatomal area of ulnar nerve?
tip of pinky finger
