Flashcards in Surgery (Upper Limb and Trauma) Deck (98)
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1
How do we manage a sternoclavicular joint injury?
Physio
Injection
Excision (rarely)
2
True or false; The acromioclavicular joint is rarely injured?
False!! It is a very common injury
3
What condtion does an acromioclavicular joint injury often overlap with?
Impingement
4
What can cause a glenohumeral joint dislocation?
Cuff tear
Instability
Previous surgery
Idiopathic
5
What movement is often the first, and greatest, affected motion in a glenohumeral injury?
EXTERNAL rotation
6
What surgical options exist for treating a glenohumeral joint injury?
Total arthroplasty
Reverse arthroplasty
7
How can a rotator cuff tear result in OA?
1. Torn rotator cuff muscle
2. Deltoid pulls humeral head upwards
3. Abnormal forces on glenoid fossa
4. OA
8
During a reverse shoulder arthroplasty what are some of the surgical techniques carried out?
Increased lever arm of deltoid
Deltoid lengthened
Joint resurfaced
9
What does a reverse arthroplasty prevent?
Upward migration
10
What can OA of the radiocapitellar joint result in?
Osteophyte impingement
11
What does the radial head act as?
Secondary stabiliser
12
What three things can result in wrist instability?
1. Scapulolunate advanced collapse (SLAC)
2. Scaphoid non-union advanced collapse (SNAC)
3. Post-traumatic OA
13
How is wrist instability treated?
4 corner fusion
Proximal row carpalectomy
Total wrist arthrodesis
14
What can result due to base of thumb OA?
Subluxation of CMCJ
15
What causes an elevation in pain in base of thumb OA?
Pincing
16
What causes a swan-neck deformity?
OA:
- Volar plate of PIP becomes attenuated
- SMall ligament and limbrical tendons fall dorsally
17
What causes a Boutonnière deformity?
1. Extensor hood of PIP is attenuated
2. Extensor tendon moves from dorsal -> Volar
- PIP flexion -> Middle phalangeal head through hood
3. Extensor tendon slips around PIPJ
- DIP hyperextension
18
A patient with known OA presents with a painful lump near the end of her finger. She says it changes in size. On examination it is tender and there is a discharge. You notice it is causing some nail ridging.
Mucous cyst
19
What is the process of events resulting in trigger finger?
1. Tendon swelling
2. Irritation
3. More swelling
4. Tendon caught on A1 pulley
20
How can trigger finger be treated?
Conservative:
- Resolves spontaneously
- Splint
Tendon sheath injection:
- Steroid + LA
- Curative
- Repeat up to 3x
Surgery:
- Divide A1 pulley
21
What forms part of the 'Dupuytren's diasthesis'?
Lederhosen's (feet)
Peyronie's
22
How do we examine a suspected Dupuytren's patient?
Feel cords
Measure angles (if MCP/PIP involvement)
Table top test
23
What is paronychia?
Nail fold infection
24
What people are at risk of paronychia?
Children
Nail biters
25
How is paronychia treated?
Elevation
Antibiotics
Incision + drainage
26
How does a flexor tendon sheath infection present?
Extreme pain
Limited extension
Tracking up palm + arm
Tracking lymphangitis
27
How is a flexor tendon sheath infection treated?
Surgically:
- Wash out sheath
28
When and how do we treat a subungal haematoma?
If pressure is causing pain
Trephine -> Drills hole
29
What are the types of nailbed injuries?
Type 1 -> Soft tissue only
Type 2 -> Soft tissue + nail
Type 3 -> Soft tissue, nail + bone
Type 4 -> Proximal third of phalynx
Type 5 -> Proximal to DIPJ
30
