Finger Injuries, and splinting

Boutonniere deformity

DIP in hyperextension, should be splinted with DIP and PIP in extension

Boutonniere deformity

DIP joint is brought into hyperextension while the PIP joint is flexed past normal ROM

OPQRST, Last oral intake, Exposure to illness, Bowel/bladder, Family history

History questions for the chest include? (5)

Ape Hand

If an athlete has an inability or weakness to flex or oppose the 1st MCP/IP joints, which of the following conditions are possible?

Rib Fx.

MOI for this injury is acute compression, symptoms include pain, difficulty breathing, pain w/breathing/compression. Tests include rib compression test ddx includes costochondral injury, pnemothorax, hemothroax, flail chest

Kidney contusion/laceration

MOI for this injury is acute trauma, main symptoms include hematuria, tenderness/ridgity over site, and signs of shock

Hemothorax/Pneumothorax

MOI of this injury is direct or indirect trauma, includes symptoms of rapid shallow breathing, distended veins, deviated trachea, abscense of breath sounds, cyanosis, dizziness, SOB, labored breathing, decreased BP, and hemaptysis

jersey finger

Splinting should be done in flexion and referred to an orthopedic

External intercostals, abdominals

What are the expiration muscles ? (2)

intercostals, scalenes, serratus anterior, pec minor, diaphragh

What muscles help breath air in? (5)

Jersey finger

avulsion of the flexor digitorum profundus tendon off the palmar aspect of the DIP joint, causes inability to flew disal phalanx (happens to athlete who tries to hold opponents jersey and gets it pulled back into extension)

Dupuytren's contracture

disease that is common in men ages 40+, its hereditary, there is abnormal thickening of the tissue just beneath the skin, typically starts in the palm and extends to the fingers, there is a contracture of the MCP and PIP joints

Claw hand

extended MCP joint, flexed DIP and PIP joint (caused by congenital abnormality, burns to forearm, nerve palsy)

Swan neck deformity

finger with a hyperextended PIP joint and a flexed DIP joint (90 degree deformity, normal bending impossible)

Mallet finger

flexion of DIP joint (caused by Extensor tendon rupture or avulsion of the tendon from the phalange)

bishop's deformity

hyperextension of MCP joint and flexion of IP joints 4th & 5th (caused by ulnar neuropathy on the hypothenar eminence)

De Quervain's syndrome

injury caused by repetitive stress which causes compartment to become inflamed, tenosynovitis of extensor pollicis brevis and abductor pollicis longus tendons. Thickening and narrowing of tendon sheaths, common in women between 20-40

Commotio Cortis

injury is caused by direct trauma prior to T wave, .1 second window, includes an arrhythmia, and AED is used to treat it

appendix

referred pain site is McBurneys

spleen

referred pain site is kohr's sign

kidney

referred pain site is the lower back

gall bladder

referred pain site is the right scapula

liver

referred pain site is the upper right shoulder

MOI for Swan neck deformity

rheumatoid arthritis, finger tendon rupture, misalignment of the healing of a fx.

PIP and DIP in extension

splinting of Boutonniere deformity

position found

splinting of a Phalanx fx.

palmar surface of hand/wrist

splinting of metacarpal fx.

DIP in extension

splinting of the Mallet finger

position found

splinting of unreduced dislocation

Dupuytren's disease/contracture

this disease can be tx. by tabletop tests, needling, enzyme injections, surgery, splinting, hand therapy

Splenic injury

this injury is caused by direct trauma or increased abdominal pressure and has symptoms of kehr's sign and signs of shock

acute-surgery, chronic-can't fix

treatment of acute or chronic bishop's deformity (2)

surgery, splinting, physical therapy

tx. for swan neck (3)

Ape hand

tx. for this injury is RICE, possible surgery, rest, physical therapy

DeQuervain's syndrome

tx. for this injury is corticosteriod injection, RICE, splinting to limit ulnar deviation, surgery to release sheaths surrounding tendons

NSAIDs, immobilization, corticosteroid injection, PT

tx. of claw hand