Conditions affecting the Wrist and Fingers

______ is damage to the radio-ulnar ligament leads to this deformity where the ulnar styloid moves up and down.

Piano key sign

The distal radioulnar joint (DRUJ) is a ________ ____ joint that allows pronation and supination.

uniaxial pivot

The DRUJ is formed by the distal radius, ulna, and the ________ __________ complex.

triangular fibrocartilage

The triangular fibrocartilage complex (TFCC) is located between the medial _____ carpal row and the distal ________.

proximal, ulna

The articular disc of the is made of fibrocartilage and is positioned between the _______ and _______.

lunate, triquetrum

The meniscus homologue is a disc located between the ________ ligament and the ________ tendon sheath.

ulnotriquetral, ECU

Name the 4 structures that are included in the TFCC.

Articular disc, ECU, ulnocarpal, radioulnar ligaments

The ulnocarpal ligaments of the TFCC include the ulnolunate and ________ ligaments.

ulnotriquetral

The dorsal and palmar ________ ligaments provide additional stability to the TFCC.

radioulnar

The TFCC helps cover the ___ head by extending the articular surface of the distal ________.

ulna, radius

The TFCC transmits load across the ulnocarpal joint and acts as a cushion against ________ force.

compressive

The TFCC allows forearm ________ by providing a strong but flexible connection between the distal radius and ulna.

rotation

TFCC injuries typically occur due to a fall on a ______ outstretched wrist or chronic ________ loading.

supinated, rotational

Type _ TFCC injuries are ________ and caused by force or laceration.

1, traumatic

Type _ TFCC injuries are ________ and result from repetitive movements.

2, degenerative

_____ wrist pain just distal to the ulna, worsened by pronation/supination and gripping, suggests a ________ tear.

Medial, TFCC

A positive McMurray test for the wrist is indicated by pain when the wrist is in ________ bend.

ulnar

Passive ______ combined with ________ deviation can reproduce TFCC injury pain.

supination, ulnar

Which imaging method is most sensitive and specific for identifying a TFCC tear?

MRI

What type of fracture might a radiograph reveal in a TFCC injury?

Ulnar styloid avulsion

Which imaging technique uses dye to identify TFCC tears but has low specificity?

Triple Injection Arthrography

How long should a wrist be immobilized for conservative TFCC injury treatment?

3-6 weeks

What type of therapy is recommended after immobilization in conservative management?

Physical therapy

What is the first-line medication for TFCC injury management?

NSAIDs

What type of injection can be used for pain relief in TFCC injuries?

Steroid injection

When can ROM exercises start after arthroscopic repair of a Type 1 TFCC injury?

One week

How soon can a patient start light ball contact after arthroscopic TFCC repair?

3 weeks

When can an athlete return to full sports activity after TFCC surgery?

4-6 weeks

True or False: One of the symptoms of a TFCC tear is numbness

False

Colles’ fracture is a fracture of the ______ with ____ displacement of the distal fragment.

distal radius, dorsal

The characteristic deformity seen in Colles’ fracture is called ______ deformity.

dinner fork

A predictor of subsequent fractures in osteoporosis is a fracture of the ______.

distal radius

Non-operative management of Colles’ fracture includes ______ and ___ immobilization.

closed reduction, cast

Colles’ fracture is treated nonoperatively if it is ______ (inside or outside) the joint.

Extra-articular

Nonoperative treatment is indicated if ______ shortening is less than ______ mm.

radial, 5

A dorsal angulation of less than ______ degrees qualifies for nonoperative treatment.

5

Nonoperative treatment is possible if the angulation is within ______ degrees of the contralateral distal radius.

20

Joint type of Radiocarpal joint (Wrist joint)

Condyloid joint

Smith’s fracture is sometimes called ______ Colles’ fracture.

Reverse

Smith’s fracture involves a complete fracture of the distal radius with ______ displacement of the distal fragment.

Palmar

The usual mechanism of injury for Smith’s fracture is a fall on the ______ of a flexed hand.

back

Madelung’s deformity is caused by instability of the ______ articulation.

Distal radioulnar

Movement affected with Madelung’s deformity?

Supination

The growth disturbance in Madelung’s deformity results in progressive ______ and ______ tilting of the distal radius.

Volar, ulnar

Madelung’s deformity is more common in ______ (gender).

Females

The most noticeable sign of Madelung’s deformity is a ______ prominence of the ______ end of the ulna.

Dorsal, lower

Barton’s fracture is an ______ fracture of the distal radius with dislocation of the _______ joint.

Intra-articular, radiocarpal

Barton’s fracture is caused by direct violent injury or sudden _____ of the distal _____ on a fixed wrist.

pronation, forearm

The more common type of Barton’s fracture involves the ______ rim of the ______.

Volar, distal radius

Conservative treatment for Barton’s fracture includes ______ _______ with the wrist in ______, ______, and ______.

closed reduction, full supination, mid extension, ulnar deviation

The scaphoid is palpated just distal to the ______ in the anatomic snuffbox.

Radial styloid

The ______ is the most commonly fractured carpal bone.

Scaphoid

Avascular necrosis of the scaphoid is called ______ disease.

Preiser’s

The ______ is the most commonly dislocated carpal bone.

Lunate

The ______ articulation is the most common area for carpal instability.

Scapholunate

Spontaneous osteonecrosis of the lunate is called ______ disease.

Kienbock’s

In radiographic findings, osteonecrosis appears ______ initially but later shows flattening and abnormal density.

Negative

The ______ retinaculum prevents tendons from ______ when they turn a corner at the wrist.

extensor, Bowstringing

The extensor retinaculum also extends to the ulnar styloid, ______, and ______.

Triquetrum, pisiform

There are ______ dorsal compartments in the extensor retinaculum.

6

The lateral boundary of the anatomic snuffbox consists of the tendons of ______ and ______.

Abductor pollicis longus, extensor pollicis brevis

The medial boundary of the anatomic snuffbox is formed by the tendon of ______.

Extensor pollicis longus

The floor of the anatomic snuffbox consists of the ______ and ______ bones.

Scaphoid, trapezium

De Quervain’s is a ______ inflammation of the ___ dorsal compartment.

Stenosing tenosynovitis, 1st

The tendons affected in De Quervain’s include ______ and ______.

Abductor pollicis longus, extensor pollicis brevis

Postpartum women are prone to De Quervain’s due to ______ ligaments during pregnancy.

Laxed

Pain in De Quervain’s is located on the ______ side of the wrist.

Lateral

In De Quervain’s, pain can radiate into the ______ or up into the forearm.

Thumb

The special test for De Quervain’s is ______ test.

Finkelstein’s

A positive Finkelstein’s test occurs when pain is felt over the ______ process of the _____.

Styloid, radius

Ice therapy is used for ______ cases, while heat is used for ______ cases.

Acute, chronic

The carpal tunnel contains the ________ and ________ flexor tendons.

Median nerve, 9

Name the 10 structures that pass deep in the flexor retinaculum.

Flexor digitorum superficialis, profundus, flexor pollicis longus, median nerve

The roof of the carpal tunnel is formed by the ________.

flexor retinaculum

The ulnar border of the carpal tunnel is the ________.

hook of hamate

The radial border of the carpal tunnel is the ________.

trapezium

The floor of the carpal tunnel consists of the ________ ligaments and the palmar ligament complex.

radiocarpal

The median nerve originates from the ________ cord of the brachial plexus.

median lateral

The ________ nerve is superficial to the flexor retinaculum and provides sensory innervation to the central palm.

anterior cutaneous

The median nerve enters the hand through the ________.

carpal tunnel

The median nerve divides into a ________ branch and a _____ branch.

motor, sensory

The motor branch of the median nerve passes ________ to the flexor retinaculum.

posterior

Carpal tunnel syndrome is caused by compression of the ________ nerve.

median

A common traumatic cause of carpal tunnel syndrome is ________ fracture.

Colles

Numbness and tingling in carpal tunnel syndrome commonly affect the ____, ________, and _____ fingers.

thumb, index, middle

Canal of Guyon syndrome is caused by impingement of the ________ nerve.

ulnar

Weakening of the hand grip in Canal of Guyon syndrome is due to paralysis of the ________ muscles.

intrinsic

A positive Froment’s test indicates weakness of the ________ muscle.

adductor pollicis

In Wartenberg’s sign, the ________ digit is observed in an over-adducted position.

fifth

Sensory involvement in Canal of Guyon syndrome affects the medial palm and ________ half of the fourth digit.

ulnar

Absence of extrinsic muscle weakness points to a lesion at ________.

Guyon’s canal

______ ____is performed by tapping at the site of suspected nerve compression.

Tinel’s sign