Podcast
Questions and Answers
Which type of fracture is the most common in post-menopausal women and is usually caused by a FOOSH injury?
Which type of fracture is the most common in post-menopausal women and is usually caused by a FOOSH injury?
- Fracture blisters
- Arthroplasty
- Colles’ fracture (correct)
- Smith’s fracture
What is the common finding in a Colles’ fracture?
What is the common finding in a Colles’ fracture?
- Arthrodesis
- Arthroplasty
- Dinner fork deformity (correct)
- Fracture blisters
Which type of fracture occurs when there is a fall onto a flexed wrist or a direct blow to the back of the wrist?
Which type of fracture occurs when there is a fall onto a flexed wrist or a direct blow to the back of the wrist?
- Fracture blisters
- Arthrodesis
- Colles’ fracture
- Smith’s fracture (correct)
What is the treatment method appropriate for stable fractures, where muscular forces are not likely to displace the fracture?
What is the treatment method appropriate for stable fractures, where muscular forces are not likely to displace the fracture?
What is the term for the restoration of a fractured bone to its normal anatomical position?
What is the term for the restoration of a fractured bone to its normal anatomical position?
What is the term for joint replacement surgery?
What is the term for joint replacement surgery?
Which of the following is a treatment option for regaining wrist extension and forearm supination?
Which of the following is a treatment option for regaining wrist extension and forearm supination?
What is the recommended treatment for scaphoid fractures?
What is the recommended treatment for scaphoid fractures?
What type of orthosis is used to immobilize Boxer's fractures?
What type of orthosis is used to immobilize Boxer's fractures?
What is the recommended treatment for Mallet finger injuries?
What is the recommended treatment for Mallet finger injuries?
What causes flexion contracture of the MP and PIP joints?
What causes flexion contracture of the MP and PIP joints?
How are TFCC injuries typically treated?
How are TFCC injuries typically treated?
Which treatment modality is recommended for individuals with Swan Neck Deformity?
Which treatment modality is recommended for individuals with Swan Neck Deformity?
Which condition is associated with Boutonniere Deformity?
Which condition is associated with Boutonniere Deformity?
What is the recommended treatment for Trigger Finger?
What is the recommended treatment for Trigger Finger?
What is the cardinal sign of Trigger Finger?
What is the cardinal sign of Trigger Finger?
Which condition is associated with Swan Neck Deformity?
Which condition is associated with Swan Neck Deformity?
What causes or exacerbates symptoms in Activity modification?
What causes or exacerbates symptoms in Activity modification?
What is the recommended orthosis for Boutonniere Deformity?
What is the recommended orthosis for Boutonniere Deformity?
What is the recommended treatment for Boutonniere Deformity?
What is the recommended treatment for Boutonniere Deformity?
Which joint is affected by Dupuytren's Disease?
Which joint is affected by Dupuytren's Disease?
What is the initial presentation of Dupuytren's Disease?
What is the initial presentation of Dupuytren's Disease?
Which digits are commonly involved in Dupuytren's Disease?
Which digits are commonly involved in Dupuytren's Disease?
Which surgical procedure is indicated when functional status is affected in Dupuytren's Disease?
Which surgical procedure is indicated when functional status is affected in Dupuytren's Disease?
What is the recommended orthosis for Skier's Thumb?
What is the recommended orthosis for Skier's Thumb?
Which ligament is ruptured in Skier's Thumb?
Which ligament is ruptured in Skier's Thumb?
What is the primary stabilizer of the distal radioulnar joint?
What is the primary stabilizer of the distal radioulnar joint?
What is the most common cause of TFCC injuries?
What is the most common cause of TFCC injuries?
What is the recommended treatment for deQuervain's Tenosynovitis?
What is the recommended treatment for deQuervain's Tenosynovitis?
Which tendon sheaths are affected in deQuervain's Tenosynovitis?
Which tendon sheaths are affected in deQuervain's Tenosynovitis?
Which condition is characterized by the lateral bands moving in an excessive dorsal position in relation to the PIP joint axis, resulting in hyperextension of the PIP joint and flexion of the DIP joint?
Which condition is characterized by the lateral bands moving in an excessive dorsal position in relation to the PIP joint axis, resulting in hyperextension of the PIP joint and flexion of the DIP joint?
What is the recommended orthosis for immobilizing the area affected by Swan Neck Deformity?
What is the recommended orthosis for immobilizing the area affected by Swan Neck Deformity?
Which condition is characterized by the lateral bands falling volar to the PIP joint axis, resulting in excessive flexion of the PIP joint and hyperextension of the DIP joint?
Which condition is characterized by the lateral bands falling volar to the PIP joint axis, resulting in excessive flexion of the PIP joint and hyperextension of the DIP joint?
What is the recommended treatment for Boutonniere Deformity?
What is the recommended treatment for Boutonniere Deformity?
Which condition is characterized by the presence of a nodule or scarring of the tendon at the level of the A1 pulley, preventing the tendon from extending the finger?
Which condition is characterized by the presence of a nodule or scarring of the tendon at the level of the A1 pulley, preventing the tendon from extending the finger?
What is the recommended orthosis for Trigger Finger?
What is the recommended orthosis for Trigger Finger?
What causes or exacerbates symptoms in Activity modification?
What causes or exacerbates symptoms in Activity modification?
What is the term for the condition where the lateral bands move in an excessive dorsal position in relation to the PIP joint axis, resulting in hyperextension of the PIP joint and flexion of the DIP joint?
What is the term for the condition where the lateral bands move in an excessive dorsal position in relation to the PIP joint axis, resulting in hyperextension of the PIP joint and flexion of the DIP joint?
What is the term for the condition where the lateral bands fall volar to the PIP joint axis, resulting in excessive flexion of the PIP joint and hyperextension of the DIP joint?
What is the term for the condition where the lateral bands fall volar to the PIP joint axis, resulting in excessive flexion of the PIP joint and hyperextension of the DIP joint?
What is the term for the presence of a nodule or scarring of the tendon at the level of the A1 pulley, preventing the tendon from extending the finger?
What is the term for the presence of a nodule or scarring of the tendon at the level of the A1 pulley, preventing the tendon from extending the finger?
Which type of shoulder instability is usually caused by a fall on an outstretched hand (FOOSH)?
Which type of shoulder instability is usually caused by a fall on an outstretched hand (FOOSH)?
Which type of shoulder instability is typically bilateral and can be congenital?
Which type of shoulder instability is typically bilateral and can be congenital?
What is the primary treatment for atraumatic shoulder instability?
What is the primary treatment for atraumatic shoulder instability?
Which type of labral tear occurs when the labrum is torn away from the glenoid?
Which type of labral tear occurs when the labrum is torn away from the glenoid?
Which surgical procedure involves sewing the joint capsule to the detached glenoid labrum using stitches or bone anchors?
Which surgical procedure involves sewing the joint capsule to the detached glenoid labrum using stitches or bone anchors?
What is the primary goal of the non-operative treatment phase for instability/dislocation?
What is the primary goal of the non-operative treatment phase for instability/dislocation?
Which muscle weakness can lead to narrowing of the subacromial space and increased chance for impingement of RC and bicep tendons?
Which muscle weakness can lead to narrowing of the subacromial space and increased chance for impingement of RC and bicep tendons?
What is the most common treatment for calcific tendinitis?
What is the most common treatment for calcific tendinitis?
Which factor can cause problems with the length/tension relationship in the shoulder?
Which factor can cause problems with the length/tension relationship in the shoulder?
Which age group is most commonly affected by stage two impingement?
Which age group is most commonly affected by stage two impingement?
What is the normal translation of the head of the humerus during midrange elevation of the shoulder?
What is the normal translation of the head of the humerus during midrange elevation of the shoulder?
What is the primary cause of secondary extrinsic impingement?
What is the primary cause of secondary extrinsic impingement?
Which of the following is a treatment option for regaining wrist extension and forearm supination?
Which of the following is a treatment option for regaining wrist extension and forearm supination?
Which ligament is ruptured in Skier's Thumb?
Which ligament is ruptured in Skier's Thumb?
What is the recommended treatment for deQuervain's Tenosynovitis?
What is the recommended treatment for deQuervain's Tenosynovitis?
Which of the following is a common mechanism of injury for a SLAP lesion?
Which of the following is a common mechanism of injury for a SLAP lesion?
Which of the following is a characteristic of AC joint sprain/separation type III and greater?
Which of the following is a characteristic of AC joint sprain/separation type III and greater?
Which of the following is a potential complication of AC joint repairs?
Which of the following is a potential complication of AC joint repairs?
Which special test can help diagnose rotator cuff impingement?
Which special test can help diagnose rotator cuff impingement?
What is the recommended treatment for rotator cuff tendonitis?
What is the recommended treatment for rotator cuff tendonitis?
What is the primary indication for surgery in rotator cuff tears?
What is the primary indication for surgery in rotator cuff tears?
Which condition is characterized by pain in the neck at rest, pain with neck motion, and pain with overpressure on the neck?
Which condition is characterized by pain in the neck at rest, pain with neck motion, and pain with overpressure on the neck?
Which condition is associated with pain aggravated by postural positions and pain past the shoulder?
Which condition is associated with pain aggravated by postural positions and pain past the shoulder?
Which condition is characterized by altered peripheral sensation and guarded cervical spine motion?
Which condition is characterized by altered peripheral sensation and guarded cervical spine motion?
Which condition is associated with pain mainly on the dominant side and pain relief with local injections?
Which condition is associated with pain mainly on the dominant side and pain relief with local injections?
Which condition is associated with pain into the deltoid area and a painful arc of motion?
Which condition is associated with pain into the deltoid area and a painful arc of motion?
Which condition is characterized by a feeling of instability and local palpable tenderness in the shoulder?
Which condition is characterized by a feeling of instability and local palpable tenderness in the shoulder?
Which condition is associated with pain when working overhead and a history of FOOSH (fall on outstretched hand)?
Which condition is associated with pain when working overhead and a history of FOOSH (fall on outstretched hand)?
Which condition is characterized by weakness with no pain and no trauma?
Which condition is characterized by weakness with no pain and no trauma?
Which condition is associated with severe pain and no history of trauma?
Which condition is associated with severe pain and no history of trauma?
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Study Notes
Common Hand Conditions and Treatment Options
- Extensor digitorum should not be relied upon for extension.
- Regaining wrist extension and forearm supination can be challenging.
- Forearm rotation may be affected.
- The goals in the middle phase of treatment (6-8 weeks) include increasing range of motion, gentle strengthening, scar control, and functional use.
- Dynamic orthosis may be used to promote wrist and forearm strength.
- Early referral to an orthopedic specialist is recommended for scaphoid fractures.
- Finger fractures may require splinting or immobilization depending on the location of the injury.
- Boxer's fractures, which occur at the neck of the 5th metacarpal, can be immobilized with an ulnar gutter orthosis.
- Mallet finger injuries require immobilization of the DIP joint.
- Dupuytren's disease causes flexion contracture of the MP and PIP joints and may require surgery for treatment.
- Postoperative care for Dupuytren's disease includes wound care, edema control, scar management, and orthosis use.
- Skier's thumb, a rupture of the ulnar collateral ligament of the thumb, can be treated conservatively with an orthosis or surgically with ORIF.
- TFCC injuries, which affect the cartilage and ligaments in the wrist, may be treated conservatively with anti-inflammatory medications or surgically with arthroscopic evaluation and repair.
Rotator Cuff Pathologies and Treatment
- Special tests such as Hawkins/Kennedy and Yocum test can help diagnose rotator cuff impingement.
- A cluster of signs including Hawkins/Kennedy, painful arc, and infraspinatus test yield a 95% probability for impingement syndrome.
- Conservative treatment for impingement includes pain control, scapular stability restoration, RC strength restoration, and posture corrections.
- Surgical correction may be necessary for secondary instability or primary acromioplasty/decompression.
- Rotator cuff tendonitis presents with shoulder ache, fatigue, and pain with repetitive movement.
- Rotator cuff tears can be traumatic or due to overuse, commonly involving the supraspinatus tendon.
- Tears can be small, medium, large, or massive, and may cause decreased AROM and weakness.
- Diagnosis of tears involves examination, palpation, special tests, and imaging such as radiographs, MRI, arthrogram, or ultrasonogram.
- Conservative treatment for tears includes rest, ROM exercises, resistance exercises below 90 degrees, and modalities to decrease pain.
- Surgery may be appropriate for failed conservative treatment or full rotator cuff tears, usually in individuals over the age of 40.
- Post-surgical rehabilitation for rotator cuff repair involves different phases with specific goals and exercises.
- Rehab approaches for different tear types vary in the duration of sling use and progression of ROM exercises.
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