Wrist and Hand Fractures/Pathologies
What is stenosing tenosynovitis?
(Trigger Finger) Problem with the sliding mechanism of a tendon in its sheath.
Treatment for a strain and sprain
- RICER: Rest, Ice, Compression, Elevate, Report - Splinting
What is a contusion of the hand?
- direct blow to the hand - leads to pain, swelling, hematoma - treat with ice, compression wrap and pad - protect for activity
What can a scaphoid bone fracture lead to?
Can lead to avascular osteonecrosis due to lack of blood supply from palmar carpal branch of radial artery s/p injury, can lead to collapse of the joint and arthritis
What is carpal tunnel syndrome?
Caused by compression (from inflamed synovial membranes) on the median nerve within the carpal tunnel.
What is skier's thumb?
Common injury among athletes, involves an acute tear of the ulnar collateral ligament of the thumb. (Gamekeeper's thumb)
What is mallet finger?
Disruption of the extensor mechanism on the DIP joint either because the tendon was severed, or the portion of bone where the tendon attached has avulsed from the distal phalanx.
What is boutonniere deformity?
Extension of the MCP joint, Flexion of the PIP joint and extension of the DIP joint.
What is swan neck deformity?
Flexion of the MCP joint with hyperextension of the PIP joint and flexion of the DIP joint.
What is a greenstick fracture?
Incomplete fracture usually of the radius. Most common in children.
What is de Quervain's disease?
Inflammation and thickening of the sheath containing the extensor pollicis brevis and abductor pollicis longus. Results in pain on the radial side of the wrist. (Also called Tenosynovitis)
What is Dupuytren's contracture?
Occurs when the palmar aponeurosis undergoes a nodular thickening. Most common in the area of the palm in line with the ring and little fingers.
What's the symptom of a scaphoid bone fracture?
swelling & pain in anatomical snuffbox
signs of a strain or sprain (3)
Pain, swelling, difficulty with motion, loss of strength
What is ulnar drift?
Ulnar deviation of the fingers at the MCP joints.
What is a ganglion cyst?
benign tumor mass commonly seen as a bump on the dorsal surface of the wrist.
What is a boxer's fracture?
fracture of the 5th metacarpal
What is a sprain?
injury to ligaments, ligament can be stretched (mild) or torn (severe)
What is a strain?
injury to muscles or tendons, injury to muscle is based on severity of strain
What is the most commonly fractured scaphoid bone?
Scaphoid fracture and caused by Compression of scaphoid between carpals and radius or FOOSH (fall on out stretched hand)
What is a Smith's fracture?
The distal fragment is displaced anteriorly and is caused by a fall on the back of the hand. (Reverse Colles')
Carpal tunnel syndrome can lead to what?
Thenar atrophy due to nerve damage from chronic untreated compression of median nerve, which results in weakness in thumb and index finger.
What is a Colles fracture?
a transverse fracture of distal radius with posterior displacement of the distal fragment. (Fall with outstretched hand; elderly)