Exam 3 Hand Ortho Emergencies Flashcards Preview

Q4 EM Surg > Exam 3 Hand Ortho Emergencies > Flashcards

Flashcards in Exam 3 Hand Ortho Emergencies Deck (21)
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1
Q

Metacarpal Fxrs found in what areas? (4)

A

1) Head
2) Neck
3) Shaft
4) Base

2
Q

Metacarpal Fxrs U caused by what motion?

A

Direct blow

Smashed

3
Q

Boxer’s Fxr is?

Caused by?

A

Fxr of 5th metacarpal

Punching

4
Q

Boxer’s Fxr presentation? (3)

Always assess for what?

A

Significant swelling
Point tender
ROM preserved

Human bite

5
Q

Boxer’s Fxr tx? (3)

A

If no angulation = ulnar-gutter splint, refer to ortho

If angulation > 35° = reduction

If a/w bite = vigorous wound care, ABX

6
Q

Bennett’s Fxr is?

Tx?

A

Fxr of thumb metacarpal base
Disrupts carpometacarpal joint at volar base

Reduction + internal fixation

7
Q

Gamekeeper’s Thumb is?

Mechanism of Injury?

Presentation?

A

Tear in ulnar collateral ligament (UCL) of the MCP joint of the thumb

Ski pole, MVA

Point tender @ base of thumb
UCL > 40° angle
Complete rupture = difficulty pinching

8
Q

Gamekeeper’s Thumb tx?

A

Thumb Spica splint

Hand Ortho

9
Q

PIP/DIP dislocations U involve?

Mechanism of Injury?

Tx?

A

Ligament rupture
P fxr

Hyperextension or lateral force

Splint
Hand Ortho

10
Q

Reduction of MCP/PIP/DIP in fingers 2-5?

A

Longitudinal traction
w/ Hyperext for dorsal dislocation
w/ Hyperflex for volar dislocation

11
Q

Tuft Fxr is?

Tx?

A

Crush injury to fingertip

Splint
Refer

12
Q

Subungual Hematoma result of?

Tx?

A

Crushed fingertip
(bleeding under nail)

Evac w/ 18g needle or electrocautery
Dress/splint

13
Q

Subtotal Amputation result of?

Tx?

A

Crushed fingertip

Clean/Irrigate/Refer
Laceration and Nail bed need repair
Tetanus, ABX, pain meds

14
Q

Complete tip amputation tx?

A

Tetanus
ABX
Pain meds

15
Q

Compartment Syndrome is?

A

↑ pressure w/i osteofascial compartment causes ↓ perfusion ->
causes necrosis, limb loss, renal fail

16
Q

Forearm compartments? (4)

A

1) Superficial volar (flexor)
2) Deep volar (flex digi profundus, flex pollicis long, pronator quad mm/tendons)
3) Dorsal (extensor)
4) Mobile wad of Henry (barchioradialis, ext carpi rad brev/long mm/tendons)

17
Q

Hand compartments? (10 total/5 categories)

A

1) Dorsal interossei x 4
2) Volar interossei x 3
3) Add pollicis
4) Thenar
5) Hypothenar

18
Q

Compartment Syndrome presentation? (6)

A
Pain OOP
Pain w/ passive stretch
Parasthesia
Paralysis
Pulselessness
Swollen, hard shiny skin
19
Q

Compartment Syndrome caused by?

A
Fxr
Crush
Injection
Infection
Drugs
20
Q

High Pressure Injection injury is?

A

High pressure device (paint/grease guns) inject substance into hand
Type of substance important

21
Q

High Pressure Injection injury presentation?

Tx?

A

Initial findings scant

URGENT referral to ortho
Hospitalize
Prompt decompress/debridement/irrigation
Long recovery