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Hand and Wrist
Ortho
Question | Answer |
---|---|
pain over styloid w/o truama | DeQuervain's |
Pain at base of thumb | CMC arthritis |
Pain w/ well defined mass | ganglion |
pain, loss of motion. on xray lunate appears really white | Kienbochc's, osteonecrosis of the lunate |
widening of space between the scaphoid and lunate consistant w/dislocation | Terry-Thomas Sign |
numbness in the hand is .... | carpal tunnel until proven otherwise |
what is ulanr sided numbness consistant w/ | cubital tunnel |
what organism is most common in dog/cat bites? | pasteurella multocida |
Tx for carpal tunnel | wrist splint, NSAID, injections, decrease activity, surgery |
Adverse outcomes of carpal tunnel | permanent loss of sensation, thenar atrophy, weakness of opposition |
indicated by a positive Findlestein Test | deQuervain Synovitis |
Tx for deQuervain Synovitis | thumb spica splint, NSAID, injection, surgery |
nodular thickening and contracture of the palmar fascia; seen in northern european decent and men >50 | Dupuytren Dz |
Presents w/ one or more painless nodules at distal palmar crease; finger may not flex at MCP; ring finger most common, extension limitied. Pt has trouble griping/holding obj/putting hand in pockets | Dupuytren Dz |
Tx Dupuytren Dz | splints, surgery |
In what infxn of the fingertip is I&D contra-indicated | Herpetic Whitlow |
presents as severe pain and swelling at the finger pad, swollen red and tense w/ possible puncture wouldn | Felons: tx I&D |
Swelling of tissues around the finger nail, usually one side at the base; not as painful | paronychia |
What should you never inject into digits? | EPINEPHERINE |
Lacerated FDP - unable to flex... | DIP |
Lacerated FDS - uanble to flex... | PIP |
"Jersey Finger" is an avulsion of... | FDP at the insertion |
Most common raius fracture: fragment is upward and dorsal | Colles fracture |
Radius fracture: fragment is downward and volar | Smith fracture |
Where do most scaphoid fractures occur? | 60% in waist |
How long may it take for a schaphoid fracture to show on xray? | 1 month |
What is the most common hand fracture? | 5th metacarpal |
Fracture of distal metaphysiseal injuries from striking a closed fist against a hard surface | Boxer's Fracture - 5th metacarpal |
Oblique fracture at the base of the thumb that enters the CMC joint | Bennett fracture |
Y-Shaped intra-articular fracture at the base of the thumb | Rolando |
Osteonecrosis of the lunate aka... | Kienboch Disease |
What age range does Kienboch Dz affect | men 20-40 y/o |
presents w/ pain stiffness, diffuse swelling over the dorsum of the wrist. possible weaness. inability to grasp heavy obj. lunate tenderness. | Keinboch dz |
WHITE LUNATE on xray | Keinboch dz |
Rupture or avulsion of the insertion of extensor tndon into the dorasl aspect of the distal phalanx; may be bony or soft tissue | Boney or soft tissue mallet |
Pain and inability to straighten fingertip. DIP is flexed. dorsal areal over DIP is tender and swollen | Boney or soft tissue mallet |
ulnar collateral ligament injury of thumb | Gamekeeper's Thumb |
flexor tendon can not bowstring | trigger finger |
2 causes of trigger finger | idiopathic or RA |