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

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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
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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
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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

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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

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6
Q

MOI: FOOSH in hyperextension and:

Radial deviation?
Ulnar deviation?

A
  • Scaphoid fracture
  • S-L Dissociation
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