HAND Flashcards by D N

Tx AVN of capitate

vascularized bone raft

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best coverage for dorsal thumb wounds

1st DMA flap

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best coverage for volar thumb pulp

moberg advancement

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best coverage for volar soft tissue finger defect

cross finger

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best coverage for dorsal soft tissue finger defect

reverse cross finger

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

partial lac up to 75% flexor tendon

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tx proximal pole scaphoid fx

ORIF dorsal

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tx distal pole scaphoid fx

ORIF volar

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side effect of collagenase injection

pruritic rash

axillary LAD

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what can arise from DIPJ in OA

mucous cyst

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main restraint against ulnar translation of carpus

Radioscaphocapitate ligament

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

excision trapezium +/- LRTI

AND MCPJ arthrodesis to avoid adduction contracture

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thenar flap best for

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

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mallet finger

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

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over tension of FDP tendon so can’t form grip

quadrigia effect

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extension lag at MCPJ after metacarpal fx due to

shortening more than 2-5 mm

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Best option for PIPJ arthroplasty

silicone implant

volar approach

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volar subluxation of carpus after DRF due to damage to

short volar radiolunate ligament

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Wartenberg sign due to

SF held in abducted position from ulnar nerve palsy

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martin gruber anastamosis

connection btwn ulnar/median nerve in forearm

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volar PIP disloation
what is usu ruptured
tx?

central slip of extensor tendon –> leads to boutonniere

immobilize in extension splint x6 wks

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strength of tendon repairs depends on

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

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best way to repair tendon

core suture 10 mm from cut edge

circumferential simple running epitendinous suture

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digit amps where have poor function for replant

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

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best way to see hook of hamate fx

carpal tunnel view xr

central slip injury appears like

PIP flexion | DIP extension

tx central slip injury

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

MC mech for TFCC injury

wrist extension | forearm pronation

order of release for PIPJ flexion contracture

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

in dupuytren's bands are __ cords are ___

``` bands = nl cords = abnl ```

spiral cord travels ___ to NVBundle and displaces it ___

spiral cord = dorsal to NV and displaces it volarly

radial tunnel vs PIN compression

radial tunnel = NO motor or sensory changes

tx radial túnel

initial = nonop then release Arcade of Froshe, distal supinator

PIN syndrome

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

what must be done during surgery for radioulnar synostosis

interposition btwn radius and ulna

position immobile ECU subluxation

pronation extension radial deviation

gene assoc w congenital radioulnar synostosis

47 XXY

ulnar nerve relation to ulnar artery

nerve = ulnar and dorsal to ulnar artery

tx arterial insuff after replant

heparin | stellate ganglion block

tx Kienbock (AVN lunate) w/o sig OA

radial shortening osteotomy

boutonniere deformity due to (volar dx of PIPJ)

central slip of extensor tendon

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

yoke splint

contracture of triangular ligament leads to

swan neck deformity

EPB is more ___ than APL which may be in accessory compartment

EPB DORSAL to APL EPB may be in accessory comps

EPB is more ___ than APL which may be in accessory compartment

EPB DORSAL to APL EPB may be in accessory comps

BUNNELL test for intrinsic tightness positive when

loss of PIP flexion when MCPJ extended | w MCP flexed, PIP motion nl

bony inj assoc w dorsal PIPJ fx dx

middle phalanx palamar lip fx

best flap for 1st web space

PIA flap

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

radial tunnel syndrome

risk factors for Kienbock

decr radial inclination vascular congestition 2/2 high intraosseous pressure medical dz ulnar neg variance

when to operate on bony mallet

if volar subluxation of distal phalanx

positive intrinsic tightness test means

decr PIPJ flexion w extension of MCPJ contracture of the intrinsics

first joint affected in SLAC wrist

radioscaphoid

roof and floor of cubital tunnel

osborne's lig | MCL

borders of guyon canal

``` superficial palmar carpal lig deep flexor retinaculum hypothenar pisiform hook hamate ```

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

tendon grafting with palmaris longus tendon

when to do 2 stage flexor recon

if tendon sheath not intact

for PIP fx dx, when to do surgery

if more than 25% joint involved and doesn't reduce w flexion OTHERWISE extension block splinting

tx prox pole scaphoid vs distal pole

prox pole = dorsal distal pole = volar

wartenberg sign

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

recurrent br of median n innerv what

opponens pollicis

beyond what finger lvl is there poor function with replant

if amputation is proximal to insertion of FDS

good prognostic factor with pediatric cubital tunnel syndrome

- ulnar nerve instability / subluxation

flexor tendon zone 2 gets nutrition from

diffusion from synovial sheath

mc fracture with dorsal PIP fx-dx

middle phalanx palmar lip fx

tx acute unstable and chronic dorsal PIP fx dx

volar plate arthroplasty

tx if flexor tendon inj less than 60%

trim frayed edges | begin early ROM

MFC vascularized bone graft blood supply

longitudinal br of descending genicular artery

basis for Froment sign

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

diff btwn ulnar tunnel and cubital tunnel

ulnar tunnel - less clawing - sensory deficit to dorsal hand

diff btwn C8 radiculopathy and cubital tunnel

C8 = sx improve w shoulder abduction

poor prognosis in cubital tunnel correlates most with

intrinsic muscle atrophy

acrosyndactyly with proximal sinus tracts assoc w what

amniotic band syndrome

another name for hypothenar hammer syndrome

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

what is stener lesion

when UCL superficial to adductor aponeurosis