Plastic Surgery Flashcards
What are the 5 compartments of muscles in the forearm?
superficial anterior (5)
deep anterior (3)
lateral (3)
superficial posterior (3)
deep posterior (3)
which hand muscles are the intrinsic ones?
interossei (dorsal - PAD, adduction DAB palmar)
lump
……
Allen’s test
occlude both arteries of the wrist
wait for the hand to become pale
re-introduce BF to hand
claw shaped hand in 4th and 5th digit - which nerve is damaged?
ulnar
Key Qs to ask in plastics hx
mechanism of injury (high vs low)
timing of injury
pre-morbid hand function - occupation
hand dominance
systemic features
flexor sheath tenosynovitis - what is it?
Surgical emergency -> call plastics
most commonly due to bacterial infection (penetrating trauma, spreading infection)
4 Kanavel’s signs in flexor sheath tenosynovitis
sausage finger
pain on percussion or palpation along the tendon
held in fixed flexion
pain with passive extension
flexor sheath tenosynovitis - mx
X-ray to look for radio-opaque FB
IV abx
elevation
urgent washout - may require a relook 48h later
what is paronychia?
localised infection at the side of the nail
pain and redness
usually self resolves
can progress and become and abscess
most commonly bacterial but can also be caused by HSV or fungal
RF for paronychia
artificial nails
nail biting
finger sucking
aggressive manicuring
ingrown nails
trauma
chemical irritant exposure
frequent hand immersion in water and excessive hand washing
management of acute paronychia
no abscess -> antibiotics or other antimicrobial if not bacterial
abscess -> drainage of pus (refer to plastics - if you just cut with a knife you can cause damage to the nail bed)
Bennet fracture
fracture at the base of the 1st metacarpal (hand)
Boxer’s fracture
fracture of the head of the 5th metacarpal
mallet finger
inability to extend the DIP
///
gustilo Anderson score
for open lower limb fractures
