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ORTHOBULLETS > HAND > Flashcards

HAND Flashcards

1
Q

Tx AVN of capitate

A

vascularized bone raft

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2
Q

best coverage for dorsal thumb wounds

A

1st DMA flap

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3
Q

best coverage for volar thumb pulp

A

moberg advancement

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4
Q

best coverage for volar soft tissue finger defect

A

cross finger

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5
Q

best coverage for dorsal soft tissue finger defect

A

reverse cross finger

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6
Q

what is most that can be repaired w/o gap formation w epitendinous repair

A

partial lac up to 75% flexor tendon

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7
Q

tx proximal pole scaphoid fx

A

ORIF dorsal

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8
Q

tx distal pole scaphoid fx

A

ORIF volar

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9
Q

side effect of collagenase injection

A

pruritic rash

axillary LAD

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10
Q

what can arise from DIPJ in OA

A

mucous cyst

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11
Q

main restraint against ulnar translation of carpus

A

Radioscaphocapitate ligament

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12
Q

tx for CMC arthritis w thumb MCP hyperextension more than 30 deg

A

excision trapezium +/- LRTI

AND MCPJ arthrodesis to avoid adduction contracture

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13
Q

thenar flap best for

A

volar oblique defect of long or index finger in less than 30 y/o

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14
Q

mallet finger

A

disruption of extensor tendon distal to DIPJ so volar subluxation of distal phalanx

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15
Q

over tension of FDP tendon so can’t form grip

A

quadrigia effect

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16
Q

extension lag at MCPJ after metacarpal fx due to

A

shortening more than 2-5 mm

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17
Q

Best option for PIPJ arthroplasty

A

silicone implant

volar approach

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18
Q

volar subluxation of carpus after DRF due to damage to

A

short volar radiolunate ligament

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19
Q

Wartenberg sign due to

A

SF held in abducted position from ulnar nerve palsy

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20
Q

martin gruber anastamosis

A

connection btwn ulnar/median nerve in forearm

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21
Q

volar PIP disloation
what is usu ruptured
tx?

A

central slip of extensor tendon –> leads to boutonniere

immobilize in extension splint x6 wks

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22
Q

strength of tendon repairs depends on

A

number of strands crossing repair site (at least 4-6 strains)

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23
Q

best way to repair tendon

A

core suture 10 mm from cut edge

circumferential simple running epitendinous suture

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24
Q

digit amps where have poor function for replant

A

proximal to insertion of FDS (btwn FDS and distal palmar crease- zone 2)

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25
Q

best way to see hook of hamate fx

A

carpal tunnel view xr

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26
Q

central slip injury appears like

A

PIP flexion

DIP extension

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27
Q

tx central slip injury

A

full time extension split of PIPJ x5 wks with ACTIVE DIP flexion encouraed

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28
Q

MC mech for TFCC injury

A

wrist extension

forearm pronation

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29
Q

order of release for PIPJ flexion contracture

A

1) pulley takedown
2) release check rein lig
3) release accessory collateral lig and volar plate
4) proper collateral lig

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30
Q

in dupuytren’s

bands are __
cords are ___

A 
bands = nl
cords = abnl
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31
Q

spiral cord travels ___ to NVBundle and displaces it ___

A

spiral cord = dorsal to NV and displaces it volarly

32
Q

radial tunnel vs PIN compression

A

radial tunnel = NO motor or sensory changes

33
Q

tx radial túnel

A

initial = nonop

then release Arcade of Froshe, distal supinator

34
Q

PIN syndrome

A

dorsal wrist pain w thumb, wrist, finger extension and pain w resists supination d/t leash of Henry/arcade of Froshe

35
Q

what must be done during surgery for radioulnar synostosis

A

interposition btwn radius and ulna

36
Q

position immobile ECU subluxation

A

pronation extension radial deviation

37
Q

gene assoc w congenital radioulnar synostosis

A

47 XXY

38
Q

ulnar nerve relation to ulnar artery

A

nerve = ulnar and dorsal to ulnar artery

39
Q

tx arterial insuff after replant

A

heparin

stellate ganglion block

40
Q

tx Kienbock (AVN lunate) w/o sig OA

A

radial shortening osteotomy

41
Q

boutonniere deformity due to (volar dx of PIPJ)

A

central slip of extensor tendon

42
Q

tx sagittal band rupture (when tendon slides to the side w flexion)

A

yoke splint

43
Q

contracture of triangular ligament leads to

A

swan neck deformity

44
Q

EPB is more ___ than APL

which may be in accessory compartment

A

EPB DORSAL to APL

EPB may be in accessory comps

45
Q

EPB is more ___ than APL

which may be in accessory compartment

A

EPB DORSAL to APL

EPB may be in accessory comps

46
Q

BUNNELL test for intrinsic tightness positive when

A

loss of PIP flexion when MCPJ extended

w MCP flexed, PIP motion nl

47
Q

bony inj assoc w dorsal PIPJ fx dx

A

middle phalanx palamar lip fx

48
Q

best flap for 1st web space

A

PIA flap

49
Q

pain distal to lateral epicondyle + pain w active extension of long finger

A

radial tunnel syndrome

50
Q

risk factors for Kienbock

A

decr radial inclination

vascular congestition 2/2 high intraosseous pressure

medical dz

ulnar neg variance

51
Q

when to operate on bony mallet

A

if volar subluxation of distal phalanx

52
Q

positive intrinsic tightness test

means

A

decr PIPJ flexion w extension of MCPJ

contracture of the intrinsics

53
Q

first joint affected in SLAC wrist

A

radioscaphoid

54
Q

roof and floor of cubital tunnel

A

osborne’s lig

MCL

55
Q

borders of guyon canal

A 
superficial palmar carpal lig
deep flexor retinaculum
hypothenar 
pisiform
hook hamate
56
Q

if scar more than 1 cm in flexor tendon injury tx?

A

tendon grafting with palmaris longus tendon

57
Q

when to do 2 stage flexor recon

A

if tendon sheath not intact

58
Q

for PIP fx dx, when to do surgery

A

if more than 25% joint involved and doesn’t reduce w flexion

OTHERWISE
extension block splinting

59
Q

tx prox pole scaphoid vs distal pole

A

prox pole = dorsal

distal pole = volar

60
Q

wartenberg sign

A

SF in abducted/extended position d/t accessory slip of EDM (radial n) unopposed pull (weak SF lumbrical)

61
Q

recurrent br of median n innerv what

A

opponens pollicis

62
Q

beyond what finger lvl is there poor function with replant

A

if amputation is proximal to insertion of FDS

63
Q

good prognostic factor with pediatric cubital tunnel syndrome

A
  • ulnar nerve instability / subluxation
64
Q

flexor tendon zone 2 gets nutrition from

A

diffusion from synovial sheath

65
Q

mc fracture with dorsal PIP fx-dx

A

middle phalanx palmar lip fx

66
Q

tx acute unstable and chronic dorsal PIP fx dx

A

volar plate arthroplasty

67
Q

tx if flexor tendon inj less than 60%

A

trim frayed edges

begin early ROM

68
Q

MFC vascularized bone graft blood supply

A

longitudinal br of descending genicular artery

69
Q

basis for Froment sign

A

thumb IP flexion by FPL (AIN) compensates for loss of metacarpal adduction by adductor pollicis

70
Q

diff btwn ulnar tunnel and cubital tunnel

A

ulnar tunnel

  • less clawing
  • sensory deficit to dorsal hand
71
Q

diff btwn C8 radiculopathy and cubital tunnel

A

C8 = sx improve w shoulder abduction

72
Q

poor prognosis in cubital tunnel correlates most with

A

intrinsic muscle atrophy

73
Q

acrosyndactyly with proximal sinus tracts assoc w what

A

amniotic band syndrome

74
Q

another name for hypothenar hammer syndrome

A

ulnar artery thrombosis = cold sensation, poor flow in ulnar artery

75
Q

what is stener lesion

A

when UCL superficial to adductor aponeurosis

ORTHOBULLETS (9 decks)

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