Wrist/Hand Pathologies Flashcards
Luno-Triquetral Sprain
- Repetitive trauma with axial load in extension and ulnar deviation.
S & S: Ulnar sided wrist pain, clicking, weakness
Lunate Dislocation
- Most severe of carpal instabilities
- Volar dislocation and forward rotation of lunate
- Murphys sign (Capitate drops into space vacated by lunate
Keinbocks Disease
- Idiopathic AVN of the lunate S & S - Loss of wrist ROM - Loss of grip strength - Painful swollen wrist - Point tender of lunate
Mallet Finger
Tear of distal aspect of extensor tendon
Jersey Finger
- Tear of distal aspect of Flexor Digitorum Profundus (shearing force)
- Held in extension, cant actively flex DIP
Swan Neck Deformity
- Dorsal subluxation of lateral tendons.
- PIP hyperextension, DIP hyperflexion
- Rupture of PIP volar plate
- Common in RA population
Boutonniere Deformity
- Overstretch of PIP jt capsule. Ultimate rupture of the central tendon
- Volar subluxation of of lateral tendons
- PIP jt into hyperflexion
- DIP too much extension
Dupuytren’s Contracture
- Finger flexors contract but cant re-extend.
- Due to nodule within tendon sheath, or sheath causes restriction
Rx: Cortisone, straighten out and brace
Trigger Finger
- Tenosynovitis from overuse of tendons, too much gripping
- Most commonly EPL, EPB, APL
- Middle finger and ring finger is common
Tendonitis/Tenosynovitis
MOI: Repetitive trauma Ex: bowling, throwing
- Tendonitis/inflammation of synovial fluid in sheath.
- Overworking of flexor hallicus longus is common
- Crackling in extensor tendons
De Quervain’s Tenosynovitis
Snuff box tendons
- Wrist extension, ulnar deviation
- Finkelsteins is good for this
Subungual Hematoma
- Blood forming under the nail beds from direct trauma
- Increasing pressure can lead to throbbing pain
Clubbed Nails
- At DIP Area, indicative of hypertrophy of underlying soft tissue/respiratory/cardisc problems
Ex: COPD
Spoon Shaped Nails
- Result of fungal infection, anemia, iron deficiency, long term diabetes, local injury, developmental abnormality, chemical irritants, or psoriasis
Paronychia
- An infection along the nail fold commonly following a hang nail
Fingertip Felon
- Abscess located within the fat pad of the fingertip
Carpal Tunnel Syndrome
Contents: 4- FDS 4- FDP 1- FPL Median nerve- digits 1-3.5
- Intrinsic or extrinsic
- Square wrist is a risk factor (non-modifiable risk factor)
Extrinsic: Overuse of wrist and finger flexors (typing) - Need nerve conduction velocity testing done
Ape Hand
Median Nerve Palsy
- Extreme carpal tunnel
- Loose thenar emminence muscles
Drop Wrist
- Radial Nerve palsy
Benediction (Bishop) Hand
Ulnar Nerve Palsy
- Wasting of the hypothenar emminence
- Loos of 4th and 5th digit lumbricals
Claw Hand (Intrinsic Minus)
- Loss of ulnar and median function
- No muscle function oppose EDC or EPB and EPL
Ulnar Neuropathy “ Cyclist’s palsy”
Grip, cycling, handle bars
- Entrapment over the hook of hamate “Guyons canal”
- Ring or little finger
- MMT of FDM, ADM, ulnar sited lumbricals
Colle’s Fracture
Distal radus fx w/ dorsal displacement
- Closed reduction, internal fixation
Smiths Fracture
- Distal radius fx with volar displacement
