Hand and forearm/elbow fx Flashcards
(106 cards)
How do you describe finger dislocations (distal relative to proximal, or proximal relative to distal)?
Distal relative to proximal
What is the treatment for an unstable vs stable finger dislocation?
Stable = buddy tape Unstable = formal splinting
Volar PIP dislocations are concerning for what other injury? What, then, is the management for these?
- Dosal slip injury
- Splint and close f/u with hand
What is the treatment for a tuft fx?
- Since can be open under the nail bed, thorough cleaning and splint for comfort.
- Abx probably not
How many degrees of angulation are acceptable for each metacarpal neck fx? (note cannot be midshaft or proximally)
5th = 40 degrees 4th = 30 degrees 3rd = 20 degrees 2nd = 10 degrees
How do you determine the angle of a metacarpal neck fx?
Intersection of the lines through the metacarpal bone and the line through the fx part
What must always be assessed with metacarpal fractures? How?
- Rotation
- have patient make fist and assess if fingers are at all rotated. Must splint in anatomic position
What is a Bennett’s/rolando fx?
Fx and dislocation of the base of the first metacarpal
What is a skier’s/gamekeeper’s thumb?
Hyperabduction injury of the ulnar collateral ligament of the thumb. Skier’s is acute, gamekeeper’s is chronic
What are the four Kanavel’s signs?
- Fusiform digit
- Pain with passive extension
- Pain with palpation of over the flexor tendon
- Finger is held in slight flexion
How do you incise a felon vertically or horizontally?
Vertically (proximal to distal)
What causes a mallet finger?
Hyperflexion injury, break at the extensor tendon
How do you splint a mallet finger?
In hyperextension
Can a person with a mallet finger take the splint off?
No–will have to start all over again, and it takes 8 weeks to heal due to poor blood supply to tendon
What are the tendons that are inflamed with de Quervain’s tenosynovitis?
- Extensor pollicis brevis
- Abductor pollicis longus
What is a nightstick fx?
midshaft ulnar fx
A line drawn through the radius should always intersect with what part of the elbow?
Capitellum
What are the components of the FUME mnemonic for galeazzi or monteggia fractures?
- Fx of
- Ulna is called
- Monteggia when at the
- elbow joint
What is a Monteggia fx?
Fracture of the ulna at the elbow, with radial head dislocation
What is the Galeazzi fracture?
Fractures of the radius at the wrist with ulnar dislocation
What is an Essex-Lopresti fracture?
A fracture of the radial head with concomitant dislocation of the distal radio-ulnar joint and disruption of the interosseous membrane.
What are the two radiographic signs of an elbow injury?
- Anterior sail signs
- Posterior fat pad
True or false: a posterior fat pad on an elbow radiograph is always abnormal
True
What lines should pass through the capitellum on a lateral elbow radiograph?
- Anterior humeral (should be at the middle third)
- Radial