Hand conditions Flashcards by Jay Slater

dupuytrens contracture common fingers

ring and little fingers

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what type of deformity is there in dupuytrens contracture

fixed flexion deformity

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generally, what is the pathophysiology of dupuytrens contracture

palmar thickening

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proliferation of myofibroblasts causes

dupuytrens contracture

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which group of people are most likely to get dupuytrans contracture (age and sex)

males >60

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what 2 conditions predispose someone to getting dupuytrens contracture

diabetes

alcoholic cirrhosis

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what type of collagen is produced in dupuytrens contracture

type 3 (normally type 1)

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what is peyronies disease

dupuytrens contracture in the penis

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where can dupuytrenscontratcure also occur (as weel as the hands)

penis

plantar foot

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what is dupuytrens contracture in the palmar foot called

ledderhose disease

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dupuytrens contracture investigation and explanation

hueston table top test

try to put hand flat on table, if >30 degrees = needs surgery

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likelihood of dupuytrens contracture recurrence

likely

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tigger finger common fingers

middle and ring fingers

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inflammation of flexor tendon digit causing nodular enlargement

trigger finger

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why is nodular enlargement significant in trigger finger

catches on A1 pulley in metacarpal neck on flexion = can get stuck there

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what 2 things is dequervains tenosynovitis associated with

pregnancy

rheumatoid arthritis

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aetiology of dequervains tenosynovitis

repetitive strain

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presentation of dequervains tenosynovitis

pain over radial styloid process

red, hot, swollen tendon

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investigation for dequervains tenosynovitis

finklesteins test

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finklesteins test description

make a fist with thumb inside, move wrist in ulnar direction, if painful = positive test

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dequervains tenosynovitis treatment (4)

splint, rest, NSAIDs
physio
steroid injection
surgery - for decompression

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infection in nail fold in kids that bite nails

paronychia

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subungal haematoma

collection of blood under nail

subungal haematoma treatment (2)

nothing

trephine if painful

what happens if you do nothing to a subungal haematoma

will eventually fall off

what is a staved finger clinically known as

mallet finger

which tendon is affected when you sprain your finger (think about it)

extensor tendon

aetiology of mallet finger

sports injury eg ball | mallet finger is a staved finger!

treatment of mallet (staved) finger

splint for 4 weeks

any carpal dislocation treatment complication of no treatment

emergency surgery osteoarthritis

treatment of finger dislocation (2)

local anaesthetic and reduce dislocation | then splint to neighbouring finger asap

arthritis type involving MCP and carpals

rheumatoid arthritis

arthritis type involving PIP, DIP, base of thumb

osteoarthritis

where do ganglion cysts occur

synovial joints eg knee (bakers cyst), wrist

what are ganglion cysts filled with

mucous/synovial fluid

fluid filled cyst at DIP joint transiluminate well defined firm

ganglion cyst

ganglion cyst treatment (3)

leave alone | needle aspirate excision if painful

if you leave a ganglion cyst alone, what is likely to happen

recurrence

flexor tendon sheath infection presentation

v v painful, hot and swollen | down arm to index finger

treatment of flexor tendon sheath infection

surgery to wash out tendon

compression of median nerve

carpal tunnel syndrome

aetiology of carpal tunnel syndrome (3)

hand injury pregnancy rheumatoid arthritis

bilateral carpal tunnel syndrome aetiology

rheumatoid arthritis

why is pregnancy a risk factor for carpal tunnel syndrome

increased fluid retention = pressure in carpal tunnel

early presentation of carpal tunnel syndrome

pins and needles

late presentation of carpal tunnel syndrome (2)

weakness in thenar (thumb) muscles | numbness in digits 1-3 and lateral half of 4

2 investigations for carpal tunnel syndrome

tinnels test | phalens test

what is tinnels test

for carpal tunnel syndrome tap wrist for 30 seconds and will feel pins and needles

carpal tunnel syndrome treatment

steroid injection | surgery - for carpal tunnel decompression

most likely group of people for carpal tunnel syndrome (age and sex)

females >30

compression of ulnar nerve behind the medial epicondyle at the elbow

cubital tunnel syndrome

which nerve do you hit when you hit your 'funny bone'

ulnar nerve

most likely group of people for cubital tunnel syndrome (age and sex)

males >60

aetiology of cubital tunnel syndrome (2)

tight band of fasica on roof of cubital tunnel tight intermuscular septum = ulnar nerve compression

early presentation of cubital tunnel syndrome

pins and needles

late presentation of cubital tunnel syndrome

paraesthesia in ulnar 1.5 fingers | weakness of 1st dorsal interosseous and adductor pollicis muscles (thumb muscles)

treatment of cubital tunnel syndrome

surgery for nerve decompression