Common Hand and Finger Deformities Flashcards
What is “Ape Hand Deformity” and Its causes?
Wasting of the thenar eminence of the hand
- Unopposed pull from extensor muscles
- Due to Median Nerve Palsy
Patient is unable to (oppose or Flex) the Thumb
What is “Bishop’s Hand or Benediction Hand Deformity” (Duchene’s Sign) and its causes?
Wasting of the hypothenar muscles and interossei muscles and 2 medial lumbricals
Due to Ulnar Nerve Palsy
What is “Boutonniere Deformity” and it Causes?
Extension of the MCP and DIP joints
Flexion of the PIP joint (primary deformity)
Due to Rupture of the central tendinous slip of the extensor hood, common after Trauma or in RA
What are “Claw Fingers” and its causes
Deformity due to loss of intrinsic muscle action and overaction of extrinsic (long) extensor muscles
Hyperextension of the MCP Joints
Flexion of PIP and DIP Joints
Usually secondary to combined median and ulnar nerve palsy
What is “Drop-Wrist Deformity” and its causes? “Fruity-Hand”
Extensor muscles of wrist are paralyzed
Due to Radial Nerve Palsy
Fingers and Wrist cannot actively be extended.
What is Dupuytren Contracture/Disease and its causes
It is a progressive disease of genetic orgin resulting in contracture of the palmar fascia
- Fixed finger flexion deformity
- usually seen in the ring or little fingers
(NGL kinda looks like benedictine hand)
Are males or females more affected by Dupuytren contracture? And what age range is this seen in?
Men
50-70 years of age
What is “Mallet Finger” and its causes?
Due to a rupture or avulsion of the extensor tendon where it inserts in the distal phalanx of the finger
DIP rests in a flexed position
What is “Swan Neck Deformity” and its causes?
Flexion of the MCP and DIP joints
Real deformity is Hyperextension of the PIP Joint
Due to rupture of the Volar Plate and is often seen in patients with RA, or following trauma.
What is “Trigger Finger” and its causes?
Due to thickening of the flexor tendon sheath.
- leads to sticking of the tendon during finger flexion.
When a patient attempts to flex the find, the tendon “sticks” and the finger “lets go” with a snap. (when brought into extension)
With further progression, there is eventual finger flexion, that will not let go.
What fingers are typically associated with Trigger Finger?
3rd or 4th Digit
Are males or females more affected by Trigger Finger?
Middle-Aged Females
What is Ulnar Drift? What condition is commonly associated with this deformity?
Commonly seen in patients with RA
Ulnar deviation of the digits due to weakening of the capsuloligamentous structures
What is Ulnar Variance?
This is the relationship between the distal articular surface of the ulna and the radius
What is a Positive (+) Ulnar Variance?
Ulna is situated more distal than the radius
What is a negative (-) Ulnar Variance?
Ulna is shorter/more proximal than the articulating surface of the radius
What is the difference between Clinical vs True Vs Equal Ulnar Variance?
Clinical: Utilizing two landmarks to measure ulnar variance
True: Referenced of ulnar head from X-Ray
Neutral: Articulating surfaces are Equal
What motions make Ulnar Variance more positive?
Pronation
and
During Power Grips
What is “Zigzag” Deformity of the Thumb, and its causes?
1st CMC Flexion
MCP Hyperextension
Mainly associated with RA
What is “Dinner Fork” deformity and its causes?
Due to malunion of distal radial fracture (colles fracture)
- Distal radial fragment angulated posteriorly
What are Heberden’s Nodules?
Nodules of the DIP
“B” (Proximal) before “H” (Distal)
What are Bouchard’s Nodules?
Nodules of the PIP
“B” (Proximal) before “H” (Distal)
Smiths vs Colles Fracture
Colles from FOOSH in wrist extension
Smiths from FOOSH in wrist flexion
