Hand/Wrist Flashcards
1
Q
- 45-60, F (10:1)
- Sensory loss Distal cutaneous nerve
- Hand falls asleep/clumsy (loss of grip strength)
- Symptoms worse at night + activity related
- (-) Wrist flexion
- Management?
A
Carpal Tunnel Syndrome
Test
- Direct pressure (gold standard)
- Phalens
-PRICE, Brace > Mob > PFROM > Grip strength
2
Q
- Repetitive/prolonged wrist Ext
- Claw hand
- Can have dysfunction in only sensor or only motor or
both. - Management?
A
Guyon’s Canal Syndrome
aka “Handlebar Palsy”
- Educate (avoid MOI)
- Splint (night)
- Nerve gliding
3
Q
- Young mother of newborn
- Pain at wrist (rad) worse when picking up kid
- +/- swelling at wrist
- (-) Ulnar deviation, gripping
- Management
A
De Quervain’s Tenosynovitis
- EPB + AbdPL
- PRICE, avoid aggrev. > Brace with spica
4
Q
- 30 y.o, M
- Pain in the wrist (dorsal radial side)
- MOI: prolonged use of crutches
- Swelling, weak grip strength, crepitus
- +/- CTS symptoms
- Tests? Management?
A
Scapholunate dissociation
Test:
- Ballottement Test - Watson Test
Management:
- PRICE > Immobilize > RPFROM
5
Q
- 15-30, M
- Wrist pain post FOOSH
- (-) extension +/or radial deviation
- (+) immobilization
- Difficulty gripping and thumb movements
- Management?
A
Scaphoid fracture
Test:
Direct palpation of scaphoid causes pain
Management:
- Referral for surgical consult (AVN or non-union)
- Firm brace
- 4-6 weeks start PFROM > grip strengthening
6
Q
MOI: FOOSH in hyperextension and:
Radial deviation?
Ulnar deviation?
A
- Scaphoid fracture
- S-L Dissociation