Term
| Motions at the wrist in the sagittal plane |
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Definition
flexion
extension
hyperextension |
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Term
| Motions at the wrist in the frontal plane |
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Definition
| radial and ulnar deviation |
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Term
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Definition
flexion
extension
adduction
abduction
circumduction (thumb)
opposition (putting each finger one at a time to the thumb) |
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Term
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Definition
Radiocarpal joint
Distal radioulnar joint:
TFC- Triangular Fibrocartilage disc (overlies distal ulnar head)
TFCC- Triangular Fibrocartilage Complex- stabilizer of distal radial ulnar joint, helps dissipate forces when stresses are put on it |
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Term
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Definition
palmar radiocarpal ligament
dorsal radiocarpal ligament
ulnar collateral
radial collateral |
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Term
| What is the closed pack position for the wrist? |
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Definition
| extension with radial deviation |
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Term
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Definition
carpomtacarpal
metacarpalphalangeal
interphalangeal |
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Term
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Definition
| joints between the carpals and the metacarpals, allows for finger flexion and extension |
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Term
| Metacarpalphalangeal Joints |
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Definition
| joint between the metacarpal and proximal phalanx, allows for finger abduction, adduction, flexion, and extension |
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Term
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Definition
articulations between phalanges
PIP- articulation of proximal and middle phalanges
DIP- articulation of middle and distal phalanges |
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Term
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Definition
palmar radiocarpal ligament- stability
dorsal radiocarpal ligament- restricts excess flexion
ulnar collateral ligament-restricts radial deviation
radial collacteral ligament- restricts ulnar deviation |
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Term
| What makes up the anatomical snuff box? |
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Definition
ulnar border- extensor pollicis longus
radial border- extensor pollicis brevis and abductor pollicis longus |
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Term
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Definition
| on thumb and foot, act as pully system for tendons |
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Term
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Definition
rupture of the extensor tendon dorsal to the middle phalanx and causes PIP to pop through extensor expansion and DIP joint to extend and PIP joint to flex
signs: pain, swelling, inability to extend DIP joint, deformity
management: splint middle of finger with Oval 8 splint in extension for 5-8 weeks |
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Term
| Pseudoboutonnierre Deformity |
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Definition
avulsion of volar plate from proximal phalanx
signs: at PIP joint, pain, swelling, tenderness, displays varying amount of degrees of hyperextension, passive hyperextension of PIP joint
management: RICE, analgesics, splinting at 20-30 degrees flexion for 3 weeks |
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Term
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Definition
inflammation of the tendon sheath that most commonly affects a flexor tendon due to overuse and causes a non smooth gliding of tendons, can form nodule
signs: with flexed finger theres resistance to re-extend and a snap can be heard/palpated, tenderness, lump at base of flexor tendon sheath
management: immobilization, rest, cryotherapy, NSAIDs, ultrasound, steroid injections |
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Term
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Definition
Compression of radial nerve by extensor muscles by scissoring of two muscle tendons that the nerve runs between
signs: initial symptoms may mimic lateral epicondylitis, pain and numbness on posterior surface of hand down thumb side, pain increased with pronation and inflammation can increase severity
management: avoidance of wearing watches, steroid injections , nerve decompression surgery |
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Term
| Anterior Interosseus Nerve Syndrome |
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Definition
compression of anterior interosseous nerve in forearm. anatomical variations predispose it to compression.
signs: forearm pain and trouble grasping objects (i.e. coffee cup, spray bottle), wont be able to flex their thumb and index finger at the DIP joint
management: PT, NSAIDs, surgery to remove possible cysts or compressive tissue surrounding nerve |
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Term
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Definition
bleeding under the nail due to direct blow to fingernail (i.e. slamming door or dropping heavy objects on it)
signs: intense pain due to pressure, red/maroon discoloration, if lumina absent nail will fall off
management: ice, elevation, NSAIDs, antibacterial soap soaks |
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Term
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Definition
nail infection due to bacterial entering the skin under the nail (superficial and localized, most common bacterial infection in hand)
signs: swelling, redness, pus, pain
management: antibacterial soap soaks, oral antibiotics, if pus pocket is formed, must be drained |
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Term
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Definition
infection or abscess at or distal to DIP joint secondary to contusions or lacerations (infection of fingertip pad)
signs: distal end of finger is red, swollen, tender, and warm
management: antibacterial soaps, oral antibiotics, refer to physician if spreads to hand |
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Term
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Definition
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Term
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Definition
hyperextension of PIP joint, seen in sports like basketball
signs: swelling, loss of function, could be subluxation of joint, swan neck deformity, pain on palpation
management: PRICEM, passive hyperextension test (compare to non injured PIP joint), xray to rule out possible avulsion fracture |
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Term
| Interphalangeal Collateral Ligament Sprain |
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Definition
due to excessive valgus or varus stresses or could happen from "jamming" the fingers
signs: point tenderness over ligaments, swelling, inflammation, possible deformity
management:PRICEM, valgus/varus stress tests, possible bracing or buddy taping, refer out if fractured |
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Term
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Definition
an avulsion of flexor digitorum profundus tendon usually affecting the ring finger causing inability to flex DIP joint. commonly caused when athelte grabs another atheltes jersey and finger is forced into extension as finger is trying to flex
signs: pain, swelling, increased pain during flexion, unable to flex DIP joint
management: surgical reattachment of tendon |
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Term
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Definition
injury to tendon or ulnar nerve from repeated friction of compression over the nerve during bowling. "spinning the ball" puts strain on tendons and ulnar nerve when ball is released at last possible moment
signs: at tip and pulp of thumb theres increased tingling sensation, small tender nodule in thumb w numbness, wasting of skin over pulp of thumb
management: rest, splint, prevent injury by widening hole on bowling ball and changing technique |
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Term
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Definition
UCL sprain of MCP joint of thumb, caused by FOOSH or valgus force on thumb.
signs: pain along ulnar aspect of MCP joint, limits opposition and decreases grip strength, swelling, ecchymossis, tenderness
management: incomplete tears: thumb spica 4-6 weeks, complete tears: surgery within 3 weeks of injury |
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Term
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Definition
UCL sprain of MCP joint of thumb, caused by FOOSH or valgus force on thumb.
signs: pain along ulnar aspect of MCP joint, limits opposition and decreases grip strength, swelling, ecchymossis, tenderness
management: incomplete tears: thumb spica 4-6 weeks, complete tears: surgery within 3 weeks of injury |
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Term
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Definition
complete rupture of extensor tendon due to forced flexion of DIP joint (common when finger is struck by a ball)
signs: pain at distal phalanx at 25-35 degrees of flexion, inability to extend distal phalanx actively, swollen
management: ice, splint in extension, possible surgery, may not treat since full use of hand is possible |
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Term
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Definition
dislocation of MCP joint due to avulsion of volar plate from the head of first metacarpal usually in thumb. MOI: shearing or twisting force causing excessive extension and abduction
signs: pain, swelling, stiffness at MCP joint, unable to perform AROM, deformity
management: RICE, splinting, analgesics, appropriate imaging, reduce injury and buddy tape |
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Term
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Definition
caused by twist of finger while its semi flexed
signs: pain, swelling, tenderness over PIP joint mostly on dorsal side, deformity
management: RICE, analgesics, proper imaging, reduction, splinted in full extension for 4-5 weeks and protection during activity for 6-8 |
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Term
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Definition
hyperextension that produces a disruption of volar plate. seen often
signs: pain and swelling over PIP joint, avulsion, deformity
management: RICE, analgesics, proper imaging, reduction, splinting in 20-30 degrees flexion for 3 weeks and after buddy taping for support |
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Term
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Definition
usually a dorsal dislocation occurring from ball striking tip of finger
signs: pain, tenderness, swelling over DIP joint, deformity
management: RICE, analgesics, proper imaging, splinting in 20-30 degrees flexion for 2 weeks |
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Term
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Definition
most commonly fractured carpal bone due to FOOSH, compresses scaphoid between radius and 2nd row of carpal bones
signs: swelling, point tenderness in anatomic snuff box, pain with radial flexion
management: ice, splint, refer for xrays/cast (6 weeks in cast) |
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Term
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Definition
due to FOOSH or contact while athlete is holding sports implement, can fracture the hamate or hook of hamate
signs: wrist pain, weakness, point tenderness, pull of muscular attachments can cause nonunion
management: casting of wrist, donut pad to protect hook of hamate |
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Term
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Definition
rarely seen. FOOSH with forcible palmar flexion or violent dorsiflexion of wrist
signs: pain, swelling, tenderness, restricted movement
management: RICE, wrist support, cast, PT |
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Term
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Definition
MOI: direct axial or compressive force (ie being stepped on)
signs: pain, swelling, deformity
management: RICE, analgesics, xray, splinting |
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Term
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Definition
most common fractures of hand
DP- crushing force
MP- direct trauma or twist
PP- spiral and angular
signs: pain, swelling, point tenderness, deformity, with distal, subungual hematoma often seen
management: RICE, analgesics, splint, for proximal immobilize wrist in ext, MCP 70 degrees in flexion and buddy tape |
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Term
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Definition
compression of median nerve as it passes through carpal tunnel due to hypothyroidism, arthritis, diabetes, trauma or repetitive movements
signs: pain, weakness or numbness, pain at night, may feel like need to shake out hand, decreased grip strength |
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Term
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Definition
due to tendons that cannot withstand constant stresses. tissues tear away from bone where they are attached when large force is exerted on muscles (similar to shin splints) (usually seen in gymnasts)
signs: sharp pains in forearm increases with flexion and extension, decreased strength
management: ice, elevation, compression, stop physical activities, strengthen muscles |
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Term
| Triangular Fibrocartilage Complex Injury |
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Definition
due to direct blow to medial side of wrist, FOOSH, constant twisting of wrist
signs: clicking or catching and pain on ulnar side due to damage of cartilage, decreased wrist motion
management: splint/cast, ice, MRI, NSAIDs, PT, possible surgery |
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Term
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Definition
benign collection of thick fluid within a tendinous sheath or joint capsule and can possibly be caused by rheumatoid arthritis or after injury
signs: tender with touch and hardens with time, may be asymptomatic
management: rest, splinting, aspiration |
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Term
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Definition
FOOSH, forcing radius backward and upward (hyperextension).DORSALLY DISPLACED
signs: profuse bleeding and swelling in wrist, possible torn or avulsed tendons, possible median nerve damage
management: ice, splint, sling, xrays |
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Term
| Reverse Colles' Fracture (Smiths) |
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Definition
transverse fracture of distal radial metaphysis. Anterior displacement of distal fracture fragment, PALMAR DISPLACEMENT. known as dinner fork deformity
signs: profuse bleeding and swelling in wrist, possible torn or avulsed tendons, possible median nerve damage
management: ice, splint, sling, xrays |
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Term
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Definition
fracture of the fifth metacarpal due to compressive force (ie punch)
SIMPLE- no rotation
COMPLEX- rotation of bone
signs: pain, point tenderness, swelling, deformity, depressed 5th MCP joint, crepitus
Management: PRICEM, xrays, refer out, cast, reduction, possible epiphyseal fracture in children |
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Term
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Definition
intraarticular fracture with dislocation of radial carpal joint due to falling on back of hand
management:PRICEM, refer, zrays, splint/cast, possible epiphyseal fracture in children |
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Term
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Definition
factures of the base of the first metacarpal that extends into articular surface due to fall on thumb or direct blow
signs: severe pain at thumb, swelling at thumb and wrist, instability of thumb
management: internal fixation, if joint is lined up a cast can be used |
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Term
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Definition
compromised vascular supply and degeneration of lunate due to repeated trauma
signs: pain during passive extension of third finger, decreased grip strength, weakness during wrist extension
management: immobilization of wrist for 3 weeks in cast allowing good blood flow, if symptoms worsen refer out, if untreated may result in loss of ulnar deviation, tenderness, pain, and swelling over lunate |
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Term
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Definition
occurs when lunate is disassociated from surrounding carpals due to FOOSH. Displaces dorsally or palmarly.
signs: pain along radial side of palmar or dorsal aspect of wrist, limits ROM,semi flexed fingers, swelling, point tenderness, crepitus, paresthesia of middle finger, fracture to scaphoid
management: refer to orthopedist, will do closed reduction if seen in 3 weeks and immobilization, if window for reduction is missed then open reduction is needed. |
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Term
| Distal Radial Ulnar Dislocations |
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Definition
also known as dislocated wrist due to excess supination of pronation
signs:pain on rotation of wrist, loss of function, deformity, swelling, point tender, increased prominence at ulnar head
management: refer to orthopedist,xrays for possible fracture |
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Term
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Definition
most common injury to wrist and can be due to any abnormal forced movement, FOOSH most common, repeated sprains may disrupt blood supply
signs: pain, swelling, difficulty moving it, tenderness, limited ROM
management: PRICEM, splinting, analgesics, taping for support, refer out if severe |
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Term
| DeQuervain's Tenosynovitis |
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Definition
also known as Hoffman's disease. stenosing tenosynovitis in thumb, first tunnel of wrist becomes contracted and narrowed due to inflammation of synovial lining effecting ext. pollicis brevis and abductor pollicis longus
signs:aching pain that may radiate in hand or forearm, positive Finkelsteins test, point tenderness, painful snapping and catching of tendons
management: immobilization, rest, NSAIDs, cryotherapy, ice massage, ultrasound |
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Term
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Definition
condition due to increased pressure on ulnar nerve. ulnar nerve very susceptible due to little padding and its position right next to medial epicondyle
signs: weakness,numbness tingling in ring or little finger, may be difficult to hold objects, pinch fingers together, coordinate fingers
management: padding over ulnar nerve, NSAIDs, wrist splint |
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