Hand Injuries Mallet Finger

1
Hand InjuriesMallet Finger

• Mechanism
• Forced flexion of distal phalanx
• Longitudinal force of fingertip
• Signs and Symptoms
• Pain
• Inability to extend the distal phalanx
• Deformity
• Los of function
• Flexed finger (30 deg)
• Evaluation
• X-Ray

2

• Special Tests
• Tests for ROM, extension of distal phalanx
• Diagnostic Procedures
• Refer to ortho
• X-Ray for avulsion fracture

3
Boutonniere Deformity

• Mechanisms
• Forced flexion of PIP
• Rupture extensor tendon of middle phalanx
  (central slip)
• Signs and Symptoms
• Pt. Tenderness _at_ middle phalanx
• Flex deformity of PIP
• Inability to extend finger
• Hyperextension of DIP

4

• Diagnostic Procedure
• Ortho
• X-Ray for possible fracture

5
Jersey Finger

• Mechanisms
• Forced extension of flexed distal phalanx
• Signs and symptoms
• Swelling
• Loss of function
• Pain on volar side distal to DIP
• Cant fully flex DIP when hand in extension
• Palpate mass on palm of hand
• Special Tests
• FDP test
• MCP/PIP in extension

6
DeQuervains Syndrome(Tenosynovitis of wrist)

• Mechanism
• Extensive wrist motion to APL, EPB
• Increased inflammation (thickening and narrowing
  of sheath)
• Excessive radial deviation/ulnar deviation
• Common in gripping sports (i.e. golf)

7

• Signs and symptoms
• Aching
• Pain _at_ radial styloid which radiates into forearm
• Inability to grip
• Crepitus over radial styloid
• Weakness in thumb extension and abduction
• Localized swelling
• Loss of strength
• Point tenderness
• Paresthesia

8

• Special Tests
• Finkelsteins test
• Diagnostic Procedure
• Immobilize
• Ortho

9
Bartons Fracture(Fracture of distal radius)

• Mechanism
• Fall on outstretched hand
• Signs and Symptoms
• Pain
• Loss of function
• Deformity/deviation
• Crepitus/pt.tenderness
• Swelling
• Delayed ecchymosis

10

• Special Tests
• Diagnostic Procedures
• Ortho
• X-Ray

11
Bennetts Fracture

• Fracture _at_ 1st CMC joint
• Fracture with subluxation of 1st CMC joint
• Triangle shaped fragment
• Mechanism
• Indirect trauma- closed fist
• Forced abduction
• Striking an object with a closed fist

12

• Signs and symptoms
• Sudden pain
• Loss of function
• Deformity
• Swelling
• Crepitus/clunk as joint subluxes
• Ecchymosis
• Direct tenderness at base of 1st metacarpal

13
5th Metacarpal fracture(Boxers fracture)

• Mechanisms
• Striking object with closed fist
• Signs and Symptoms
• Pain
• Loss of function
• Inability to grip
• Deformity
• Tenderness/crepitus
• Swelling
• Ecchymosis

14

• Special Tests
• Axial load test
• Diagnostic procedures
• Ortho
• X-Ray

15
Phalange Fracture

• Mechanism
• Indirect trauma (torsion to end of finger)
• Signs and symptoms
• Pain
• Loss of function
• tenderness
• Deformity
• Swelling
• crepitus

16

• Special tests
• Axial load test
• Diagnostic Procedures
• Ortho
• X-Ray

17
Phalange Luxation (MCP, PIP, DIP)(Dislocated
finger)

• Mechanism
• Trauma to joint
• Indirect force to tip of finger
• Signs and symptoms
• Pain
• Loss of function
• Swelling
• Point tenderness
• deformity

18

• Special Tests
• Diagnostic Procedure
• Ortho
• X-Ray

19
Finger Collateral Ligament Sprain(Jammed
finger)

• Mechanisms
• Direct or indirect trauma
• Signs and Symptoms
• Hemorrhage
• Swelling
• Deformity
• Instability
• Pain on A/P/RROM
• Loss of function
• Tenderness
• Special Tests
• Varus/valgus

20
UCL sprain of thumb(Gamekeepers thumbs)

• Mechanism
• Forced abduction/hyperextension of thumb
• Signs and Symptoms
• Pain on A/P/RROM (abduction)
• Loss of function
• Tenderness over UCL
• Hemorrhage
• Deformity
• Instability
• Evaluation
• Abduction stress of thumb (varus/valgus)

21

• Special Tests
• Abduction stress test of thumb
• Diagnostic Procedure
• Refer to ortho
• X-Ray to check on possible avulsion fx

22
Tenosynovitis

• Mechanism
• Overuse
• Direct or repeated trauma
• Signs and Symptoms
• A/P/RROM
• Loss of function
• Swelling
• Thickening of tendon
• Inflammation
• Crepitus

23

• Special Tests
• A/P/RROM
• Diagnostic Procedures
• Refer to ortho