Hand Injuries

Question 1

What does ABCDS when interpreting X-rays?

Answer 1

Alignment. Bone. Cartilage. Distribution of any changes. Soft tissues.

Question 2

State one thing to look for when analysing bone on X-rays.

Answer 2

Mineralization, osteopenia. New bone formation - osteophytes. Joint spaces. Erosions. Fractures.

Question 3

State one thing to look for when analysing cartilage on X-rays.

Answer 3

Joint spaces. Calcifications.

Question 4

State the most common type of carpal fracture.

Answer 4

Scaphoid fracture.

Question 5

Define a scaphoid fracture.

Answer 5

A scaphoid fracture is a break in one of the small bones on the thumb side of the wrist.

Question 6

State the 2 types of scaphoid fractures.

Answer 6

Non-displaced fracture - bone fragments line up correctly. Displaced fracture - bone fragments out of position.

Question 7

State a cause of a scaphoid fracture.

Answer 7

Fall onto an outstretched hand. Sports activities increase risk.

Question 8

State a symptom of a scaphoid fracture.

Answer 8

Swelling, pain near anatomic snuffbox. Pain worse when you move thumb/wrist.

Question 9

State a test used to assess a scaphoid fracture.

Answer 9

MRI - learn more about the bones and soft tissue in the wrist. CT - reveals fracture of the scaphoid/whether bones displaced. X rays - provides image of dense structures e.g. bone (determine fracture and whether broken pieces displaced).

Question 10

State a treatment of a scaphoid fracture.

Answer 10

Fracture near the thumb (doctor may place forearm/hand in a cast/splint. Fracture near the forearm - fracture treated with a cast.

Question 11

State other fractures in the hand.

Answer 11

Lunate fracture (in wrist). Tuft fracture (distal phalanx). Spiral fracture. Boxer’s fracture. Thumb fracture. Shier’s thumb.

Question 12

Define a lunate fracture.

Answer 12

Carpal bone in the wrist.

Question 13

Define a tuft fracture.

Answer 13

Fracture of the distal phalanx.

Question 14

State a cause of a tuft fracture.

Answer 14

Crush injury (e.g. finger in a door).

Question 15

State a feature of a tuft fracture.

Answer 15

Haetoma (collection of blood) under the nail bed.

Question 16

Define a spiral fracture.

Answer 16

Fracture of the phalanges/metacarpal bone - leads to rotation and shortening.

Question 17

Define a boxer’s fracture.

Answer 17

Transversal metacarpal fracture of the neck and common in 5th metacarpal.

Question 18

Whereabouts is the thumb fracture most located?

Answer 18

At the base.

Question 19

State how a thumb fracture can be distinguished.

Answer 19

2 part Bennett fracture.
3 part Rolando fracture.
Comminuted fracture.

Question 20

Define a shier’s thumb.

Answer 20

Ligament damage of the ulnar collateral ligament MCP - thumb joint.

Question 21

State a feature of Shier’s thumb.

Answer 21

Rupture of the ulnar collateral ligament may be associated with an avulsion fragment - bone fracture where fragments of bone tears away from the main mass of bone (due to physical trauma).

Question 22

What is Stener’s lesion?

Answer 22

Type of traumatic injury to the thumb.

Question 23

When the aponeurosis of the adductor pollicis muscle becomes intersposed between a ruptured ulnar collateral ligament (UCL) and site of insertion (base of proximal phalanx), it’s known as…

Answer 23

Stener’s lesion.

Question 24

Give an example of a dislocation to the joints.

Answer 24

Proximal interphalangeal joint dislocation. Metocarpophalangeal joint (MCP) dislocation (between metacarpal bones and proximal phalanges of fingers).

Question 25

State one tendon injury.

Answer 25

Mallet injury. Flexor digitorum profundus.

Question 26

Define a mallet injury.

Answer 26

An avulsion (fragment of the bone tears away) of the extensor tendon on the distal phalanx - prevents active extension.

Question 27

What is the flexor digitorum profundus?

Answer 27

Muscle in the forearm that flexes fingers.

Question 28

State a symptom of a flexor digitorum profundus rupture.

Answer 28

Muscle fans out into 4 tendons to palmar base of distal phalanx (affects whether fingers can make a fist).