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):
1

Metacarpal Fxrs found in what areas? (4)

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

2

Metacarpal Fxrs U caused by what motion?

Direct blow
Smashed

3

Boxer's Fxr is?

Caused by?

Fxr of 5th metacarpal

Punching

4

Boxer's Fxr presentation? (3)

Always assess for what?

Significant swelling
Point tender
ROM preserved

Human bite

5

Boxer's Fxr tx? (3)

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

If angulation > 35° = reduction

If a/w bite = vigorous wound care, ABX

6

Bennett's Fxr is?

Tx?

Fxr of thumb metacarpal base
Disrupts carpometacarpal joint at volar base

Reduction + internal fixation

7

Gamekeeper's Thumb is?

Mechanism of Injury?

Presentation?

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

Gamekeeper's Thumb tx?

Thumb Spica splint
Hand Ortho

9

PIP/DIP dislocations U involve?

Mechanism of Injury?

Tx?

Ligament rupture
P fxr

Hyperextension or lateral force

Splint
Hand Ortho

10

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

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

11

Tuft Fxr is?

Tx?

Crush injury to fingertip

Splint
Refer

12

Subungual Hematoma result of?

Tx?

Crushed fingertip
(bleeding under nail)

Evac w/ 18g needle or electrocautery
Dress/splint

13

Subtotal Amputation result of?

Tx?

Crushed fingertip

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

14

Complete tip amputation tx?

Tetanus
ABX
Pain meds

15

Compartment Syndrome is?

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

16

Forearm compartments? (4)

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

Hand compartments? (10 total/5 categories)

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

18

Compartment Syndrome presentation? (6)

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

19

Compartment Syndrome caused by?

Fxr
Crush
Injection
Infection
Drugs

20

High Pressure Injection injury is?

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

21

High Pressure Injection injury presentation?

Tx?

Initial findings scant

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