Orthopaedic Problems of the Hand Flashcards
What are the common soft tissue disorders of the hand?
- Dupuytrens Disease
- Trigger Finger
- Nerve entrapments (carpal or cubital tunnel syndrome)
- Ganglion
- OA of base of thumb
What are the clinical features of Dupuytren’s disease?
Clinical features:
- Bilateral
- Early onset
- Strong family history
- Painless
- Loss of finger extension
What are the clinical features of Trigger Finger?
Clinical features:
- Clicking sensation with movement of digit
- Palpable lump in palm under pully (sheath made of tendons)
- Using other hand to unlock
What are the clinical features of De Quervain’s Tenovaginitis?
Clinical Features:
- Several weeks pain localised to radial side of wrist
- 1st dorsal extensor compartment
- Fibro-osseous tunnel at the distal radius
- Finklestein’s Test
- Resisted thumb extension
Management:
1) Non-operative - splints or steroid injections
2) Operative - decompression in the fibro-osseous tunnel
What are the clinical features of OA base of thumb?
Clinical features:
- Pain
- Stiffness
- Swelling
- Deformity
- Loss of function (pain opening jars)
- MCPJ Hyperextension
Management:
1) Non-operative:
- life style modifications
- NSAIDS
- Splint
- Steroid Injections
2) Operative:
- Trapeziectomy
- Fusion
- Replacement
What is the presentation of soft tissue ganglia?
Presentation:
- Firm, non-tender lump on hand or wrist
- Smooth
- Normally not fixed to underlying to tissues
- Never fixed to skin
- Females 2:1 Males
- Most common on dorsal aspect of hand
What type of inheritance is Dupuytrens?
Autosomal dominant
Who is most likely to get Dupuytrens?
Males 15-64 y.o.
Who is most likely to get trigger finger?
Woman 40’s-60’s
Most common on ring finger and thumb
Who is most likely to get De Quervains syndrome?
Female 50’s-60’s
Which test is used for De Quervains syndrome?
Finklesteins Test
Who is most likely to get soft tissue ganglia?
Females 20-40 years
More common on dorsum of hand
Who is most likely to suffer with base of thumb OA?
Woman
