Hand injuries

jersey finger

• avulsion of the FDP tendon

• happens by forceful hyperextension of the DIP → grabbing someone at the jersey and tearing muscle off the bone

jersey finger

mallet finger

• forced hyper flexion at the DIP joint which abruptly tears the terminal tendon from its distal attachment

• happens by jamming finger, direct blow to fingertip

• unable to fully extend DIP, it’s held in partial flexion

mallet finger

trigger finger

• repeated movements of thumb or finger over time → working with vibrating tools: dentists, electricians, farmers, musicians

• inflammation, bump, finger in locked position → extensors are not strong enough to pull tendon back through annular ligament

trigger finger

swan neck

• lateral bands above axis of motion instead of staying lateral

• PIP joint hyperextends as force is transmitted to the terminal tendon, hyperflexing the DIP joint

swan neck

Boutonniere deformity

• lateral bands below the axis of motion → forceful flexion of PIP

• unable to extend PIP

• happens if you drop a brick on your fingers, someone steps on your fingers

Boutonniere deformity

carpal tunnel syndrome

problem with median nerve

• do a Tinel Test

• Phalen test: put wrist into flexion for a minute to see if there’s pain

• reverse phalen’s test: wrist into extension

colles fracture

• dorsal displacement of distal segment → hand goes dorsal

• happens from a FOOSH → distal radius fracture

Colles fracture

smith fracture

• volar displacement of distal segment → hand moves anterior

• happens when you fall and land on the back of your hand

smith fracture

Dupuytren’s contracture

• disease of palmar fascia which pulls on tendons so they become shorter and tighter over time

  • can tether digits into flexion

Dupuytren’s contracture

Boxer’s fracture

• most likely to happen with fracturing digit 5 metacarpal at the neck

• happens by striking objects with a closed fist

Dequervain’s

= Washerwoman’s syndrome from wringing out laundry

• excessive radial deviation at wrist and thumb gripping → new mom’s prone to this position

• inflammation in first dorsal compartment

Finkelstein test

• tests for Dequervain’s

• thumb in palm and ulnarly deviate wrist, puts stress on tendons and is painful

Finkelsein test for Dequervain’s

skier’s thumb

• ulnar collateral ligament disruption

• thumb is forcefully abducted and extended away from hand to where it tears ulnar collateral ligament of thumb at MCP

• also known as game keeper’s thumb

Skier’s thumb