Hand Flashcards
(27 cards)
What are important factors to consider when a hand injury has occurred?
Handedness DM Arthritis Occupation Hobbies e.g. instruments
What details of the injury needs to be accounted for?
Crush, burn, sharp injury
Gloves?
Timing of injury
Energy level of injury
What symptoms need to be noted?
How painful
Muscle weakness?
Loss of sensation
What factors about the wound needs to be noted?
Where How long How deep Dirty/clean Skin loss What structures are evident
What is a subungual haematoma?
Bleeding under the nailbed
Describe the zones in a nailbed injury
Zone 1 - to middle of nail
Zone 2- to under nailbed
Zone 3- between nailbed and DIP
Zone 4- at DIP
What is eschar?
Thick, leathery, inelastic skin which forms after burns.
What is a mucous cyst?
Outpouching of synovial fluid
What does a mucous cyst look like?
A blister.
May be painful, may fluctuate or discharge, may deform nail
What is a ganglion?
Outpouching of synovial cavity
Where are ganglions mostly found?
At synovial joints
What is in a ganglion?
Synovial fluid
If a ganglion needs to be treated, how can this be done?
Aspiration
Excision
What is trigger finger?
Tendonitis which gets caught on A1 pulley and causes sticking
What does A in A1 pulley mean?
Annular
Where do tendons run on the finger?
Within the flexor tendon sheath
What is the management for trigger finger?
Often conservative with splint
Steroid and LA injection
Surgery to divide A1 pulley
What is DeQuervain’s tenosynovitis?
Inflammed tendons, running through their sheaths
Which muscles are involved in DeQuervain’s tenosynovitis?
Abductor pollicis brevis
Adbuctor pollicis longus
What is Finklestein’s test?
For DeQuervain’s.
Put thumb inside fist and shake. Causes pain
What is the management for DeQuervain’s syndrome?
NSAIDs
Splint
rest
Steroid
What is Dupuytren’s contracture?
Thickening and contracture of the subdermal fascia, leading to cords which cause fixed flexion deformities
What are possible linkages with Dupuytrens?
DM
Cirrhosis
Smoking
Carbamazapine
What is the table top test?
If can put fingers flat on the table then ok if not then surgery
