Flashcards in Surgery (Upper Limb and Trauma) Deck (98)
How do we manage a sternoclavicular joint injury?
True or false; The acromioclavicular joint is rarely injured?
False!! It is a very common injury
What condtion does an acromioclavicular joint injury often overlap with?
What can cause a glenohumeral joint dislocation?
What movement is often the first, and greatest, affected motion in a glenohumeral injury?
What surgical options exist for treating a glenohumeral joint injury?
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
During a reverse shoulder arthroplasty what are some of the surgical techniques carried out?
Increased lever arm of deltoid
What does a reverse arthroplasty prevent?
What can OA of the radiocapitellar joint result in?
What does the radial head act as?
What three things can result in wrist instability?
1. Scapulolunate advanced collapse (SLAC)
2. Scaphoid non-union advanced collapse (SNAC)
3. Post-traumatic OA
How is wrist instability treated?
4 corner fusion
Proximal row carpalectomy
Total wrist arthrodesis
What can result due to base of thumb OA?
Subluxation of CMCJ
What causes an elevation in pain in base of thumb OA?
What causes a swan-neck deformity?
- Volar plate of PIP becomes attenuated
- SMall ligament and limbrical tendons fall dorsally
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
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.
What is the process of events resulting in trigger finger?
1. Tendon swelling
3. More swelling
4. Tendon caught on A1 pulley
How can trigger finger be treated?
- Resolves spontaneously
Tendon sheath injection:
- Steroid + LA
- Repeat up to 3x
- Divide A1 pulley
What forms part of the 'Dupuytren's diasthesis'?
How do we examine a suspected Dupuytren's patient?
Measure angles (if MCP/PIP involvement)
Table top test
What is paronychia?
Nail fold infection
What people are at risk of paronychia?
How is paronychia treated?
Incision + drainage
How does a flexor tendon sheath infection present?
Tracking up palm + arm
How is a flexor tendon sheath infection treated?
- Wash out sheath
When and how do we treat a subungal haematoma?
If pressure is causing pain
Trephine -> Drills hole
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