Hand And Wrist Clinical Conditions

Question 1

Give 2 symptoms of scaphoid fracture.

Answer 1

Pain in snuff box - worsens with wrist joint movement

Lateral/ posterior wrist swelling.

Question 2

Give 4 complications of a Cole’s fracture.

Answer 2

Malunion resulting in dinner fork abnormality
Secondary OA
EPL tendon tear
Median nerve palsy (Post traumatic CTS)

Question 3

What 2 fractures may occur after a fall on a pronated and dorsiflexed hand?

Answer 3

Colle’s fracture (distal radial metaphysis fracture) - extra articular
Ulnar styloid process

Question 4

What 2 deformities can be seen as a result of RA?

Briefly describe them.

Answer 4

Swan neck deformity
- Hyperextended PIPJ and flexed DIPJ

Boutonnière deformity

• Hyper extended MCPJ and DIPJ
• PIPJ flexion

Question 5

Give 4 symptoms/ signs of psoriatic arthropathy.

Answer 5

Oncholysis
Stiffness
Fusiform digit swelling - dactylitis
Nail pitting

Question 6

What are herbendens nodes and Bouchards nodes a sign of and where are they located?

Answer 6

OA

DIPJ

PIPJ

Question 7

In terms of the nerve itself what are four complications of nerve compression.

Answer 7

Ischaemia
Focal demyelination
Decrease in axonal calibration
Axonal loss

Question 8

Give risk factors for CTS.

Answer 8

MEDIAN TRAP

Myxoedema (hypothyroidism) 
ETOH (alcohol)
DM 
Idiopathic 
Amyloidosis 
Neoplasia 
Trauma 
RA/ Repetitive arthritis 
Acromegaly 
Pregnancy 

Obesity