Wrist & Hand Disorders

Question 1

• Spoon Nailsa.k.a.- Koilonychia

Answer 1

1.) Natural convexity is replaced by concave nails in a saucer form2.) Nail plate is thinner and weaker3.) Result of a severe fungus infection

Question 2

• Clubbed Nails

Answer 2

1.) Pulmonary disease is the most common cause2.) Cardiovascular disease is the second cause

Question 3

• Colles’ Fracturea.k.a.- Dinner Fork Fracture

Answer 3

Fracture of the radius within 20-35mm of the wrist joint with posterior angulation of the distal fragment

Question 4

• Smith’s Fracture

Answer 4

Fracture of the radius within 20-35mm of the wrist joint with anterior angulation of the distal fragment

Question 5

• Bar Room Fracture

Answer 5

Fracture of the fourth or fifth metacarpal neck with anterior displacement of the head

Question 6

• Bennett’s Fracture

Answer 6

Fracture through the base of the first metacarpal neck with dorsal and radial displacement of the shaft

Question 7

• Boxer’s Fracture

Answer 7

Fracture of the second or third metacarpal neck with anterior displacement of the head

Question 8

Keinboch’s Disease

Answer 8

1.) Males 20-402.) Avascular necrosis of carpal lunate3.) Previous trauma, occupational excessive dominant hand use4.) Usually unilateral5.) Localized and radiating wrist pain; swelling and disability6.) Entrapment neuropathy, DJD7.) Increased lunate density8.) Short ulnar bone in 75% of cases9.) Treatment - Reduction of hand trauma - Replace lunate with plastic implant

Question 9

DeQuervain’s Diseasea.k.a.Stenosing tenosynovitis

Answer 9

1.) Overuse and repetitious ulnar and radial deviation of the wrist2.) Swelling and inflammation in Tunnel 13.) Tendons involved: a.) Abductor pollicus longus b.) Extensor pollicus brevis4.) Positive Finkelstein test5.) Rest from inciting activity

Question 10

Dupuytren’s Contracture

Answer 10

1.) There is evidence of a small painless nodule that can be palpated in the palmar aponeurosis near the base of the digit2.) Palpation of the palm reveals a hard core over the flexor tendon. Passive extension of the finger raises the cord taut where it can be readily seen

Question 11

Trigger Finger

Answer 11

1.) Either the middle or ring finger is usually involved2.) Flexion of the finger feels normal; but re-extension is accompanied by a painful snap that the patient sometimes refers to the dorsum of the hand

Question 12

Mallet Finger

Answer 12

1.) Terminal phalanx of the finger is permanently flexed at the distal joint; it cannot be voluntarily extended2.) Rupture of the extensor tendon that inserts on the terminal phalanx3.) Possibly a fracture of the distal phalanx

Question 13

Heberden’s Nodes

Answer 13

1.) Found on one or more fingers, except the thumb2.) Distal joints are enlarged by hard nodules, 2-3mm in diameter, one on either side of the dorsal midline3.) Nodules are painless; motion is unlimited4.) Process is a localized osteoarthritis5.) Involvement of several joints is more common in women in whom they appear at the menopausal age6.) Condition in women is usually hereditary7.) Single joint is more commonly involved in men8.) Condition in men is usually the result of trauma

Question 14

Felon

Answer 14

1.) Inflammation of the terminal finger pad is confined by tough fascia attached to the periosteum2.) Swelling of the fingertip and dull pain3.) Pain gradually heightens and becomes throbbing4.) Tenderness is intense5.) Presence of pus is indicated by induration of the pulp and loss or resilience 6.) Pressure in the confined space may cause the abscess to burst through the volar surface of the finger pad7.) May produce osteomyelitis

Question 15

Paronychiaa.k.a.Hangnail

Answer 15

1.) Skin over the mantle of the nail and the lateral nail folds is swollen, reddened, painful and tender2.) Pus is over the nail, light palpation over the inflamed area provokes exquisite pain3.) Pain from pressure on the nail indicates subungual abscess, between nail plate and periosteum

Question 16

Jersey Finger

Answer 16

Avulsion of the flexor digitorum profundus tendon