Hand abnormalities Flashcards Preview

Musculoskeletal > Hand abnormalities > Flashcards

Flashcards in Hand abnormalities Deck (20):
1

What is Dupuytren's contracture?

Increase in thickness of the subdermal fascia that overlies the tendons leading to fixed deformity of the finger.
Can affect any finger but most commonly affects the ring finger.

2

What is Dupuytren's contracture associated with?

Genetic
More common in men
Diabetics
Alcohol/cirrhosis
Smoking
Also connected to Peyronie's disease (affects the penis) and plantar fibromatosis

3

Treatment of Dupuytrens disease

Stretching and activity modification as conservative management.
Surgery- removal of all the diseased tissue (faciectomy)

4

What is trigger finger?

Tendonitis of the flexor tendon to a digit which can result in nodular enlargement

5

Which flexor tendon is usually affected

A1 pulley on the ring or middle fingers

6

Describe trigger finger and its symptoms

Movement of the finger produces a clicking sensation as the nodule passes through the pulley. The finger may get stuck in flexion because the nodule may not be able to pass back during extension. They patient may have to manually re-extend their finger.
Causes pain

7

Treatment of trigger finger

Injection of steroid around the tendon sheath
Surgery if it is a persistent case- involves incising the pulley.

8

Ganglion cyst

Outpouching of synovial cavity filled with synovial fluid. They fluctuate and are usually painless. Common in the wrist

9

Treatment of ganglion cysts

Many patients want them excised for cosmetic reasons- however they will be left with a scar which is also not particularly desirable.
Could try needle aspiration however be aware of the volar gangion and radial artery.
Excision can occur if they are causing localised discomfort.

10

Mucous cysts

Outpouching of synovial fluid at the DIP joint. It may fluctuate or discharge and may be painful.

11

Treatment of mucous cysts

Perfectly benign condition- get the patient to come to terms with it

12

DeQeurvains tenosynovititis

A tendon sheath holds the tendon that sits on the radius (has a convex surface therefore tendon likely to slip off without a tendon sheath)
If there is inflammation of the tendon sheath this can be painful

13

Presentation of DeQeurvains tenosynovitis

Painful and spontaneous. Red and swollen.
Finklesteins test

14

Treatment of DeQeurvains tenosynovitis

Steroid injection
NSAIDs
Splint

Surgery to decompress.

15

Paronychia

Infection in the nail fold which may result with pus collecting. Usually seen in children.

16

Risks of paronychia

Nail biting

17

Treatment of paronychia

Incise and drain
Elevate
Antibiotics.

18

Flexor tendon sheath infection

Infection within the tendon sheath which tracks up the arm. Rare and surgical emergency.

19

Presentation of flexor tendon sheath infection

Very painful
Limited extension of the hand.

20

Treatment of flexor tendon sheath infection

Wash out the tendon sheath.