Hand & Wrist - Clinical, SA
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35 Terms
What causes mallet finger?
Extensor tendon rupture or avulsion injury.
What position does the distal phalanx adopt in mallet finger?
A flexed position
What causes jersey finger?
A finger caught in a jersey causes hyperextension and tearing of the flexor tendon.
What may also occur with jersey finger?
Avulsion of a piece of bone.
What movement is lost in jersey finger?
The patient can no longer flex the affected finger.
What is the classic mechanism of a Colles’ fracture?
A fall on an outstretched hand (FOOSH).
Which bone is fractured in a Colles’ fracture?
The distal radius, sometimes with the ulna.
Approximately how far from the distal end does the fracture occur?
Approximately 2.5 cm.
In which direction does the distal radial fragment move in a Colles’ fracture?
Posteriorly and proximally.
What characteristic deformity can occur with a Colles’ fracture?
A “dinner fork” shape of the dorsal forearm.
What is another name for a Colles’ fracture?
A dinner-fork fracture.
In which age group is a Colles’ fracture particularly common according to the lecture?
People over 50 years old.
What is the typical mechanism of a Smith’s fracture?
A fall onto a flexed wrist.
What other mechanism can cause a Smith’s fracture?
A direct blow to the posterior distal forearm.
In which direction does the distal radial fragment move in a Smith’s fracture?
Anteriorly and proximally.
How does Smith’s fracture displacement compare with Colles’ fracture?
It is the opposite displacement.
Which carpal bone is most vulnerable to fracture?
The scaphoid.
What is the typical mechanism of a scaphoid fracture?
A fall on an outstretched hand with the hand abducted.
What are the three main regions of the scaphoid?
Proximal pole, waist and distal pole.
What is the main arterial supply to the scaphoid?
The dorsal scaphoid branch of the radial artery.
Where does this artery enter the scaphoid?
At the waist.
What percentage of the scaphoid does this blood supply provide?
Approximately 80%, supplying the proximal part.
Why is a fracture through the scaphoid waist clinically important?
It can interrupt blood supply to the proximal 80% of the bone.
What supplies the distal 20–30% of the scaphoid?
Branches from the superficial palmar arch.
Why might a scaphoid fracture not initially be visible on X-ray?
It may not become radiologically evident for 10–14 days.
What serious complication can occur after a scaphoid waist fracture?
Avascular necrosis (AVN)
Why can a scaphoid waist fracture cause AVN?
It can interrupt arterial supply to the proximal 80% of the scaphoid.
What happens to bone without its arterial blood supply?
It becomes avascular and can become necrotic.
According to the lecture, which fracture has a higher association with AVN than a scaphoid fracture?
Femoral neck fracture.
What can be identified on the dorsum of the hand?
PIP/DIP joints, MCP joints and extensor tendons.
What can be identified on the palmar surface of the hand?
MCP joints, interphalangeal joints and flexor tendons.
What forms the floor of the anatomical snuffbox proximally?
The scaphoid.
What forms the floor distally?
The trapezium.
What are the boundaries of the anatomical snuffbox?
Extensor pollicis longus, extensor pollicis brevis and abductor pollicis longus.
Which important carpal bones are found in the floor of the anatomical snuffbox?
Scaphoid proximally and trapezium distally