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21 Cards in this Set
- Front
- Back
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What are the four possible causes of a swan-neck deformity?
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Lax PIP volar plate
Mallet finger Volarly subluxed MCP joint (as with rheumatoid arthritis) Chronic FDS laceration |
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What is the resultant PIP position?
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Hyperextended
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What is the DIP position?
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Flexed
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What are three treatment options for swan-neck deformity?
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Silver ring splint/figure-8 splint
Central slip tenotomy Oblique retinacular ligament reconstruction |
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Boutonniere deformity results from an injury to what two structures?
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Central slip
Triangular ligament |
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Then what happens?
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Lateral bands sublux volarly
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What is the resultant PIP position?
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Flexion
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What is the DIP position?
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Hyperextension
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What test is used for evaluation of a boutonniere finger?
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Elson test: bend PIP to 90 degrees; if resisted PIP extension sends DIP into rigid extension, then positive
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In what situation is acute operative intervention for boutonniere deformity required?
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A displaced avulsion fracture fragment is present
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What is the nonoperative treatment of acute boutonniere?
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Six weeks of PIP extension splint wear
Active flexion of the DIP (pulls lateral bands dorsally) |
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What are two operative treatments for chronic boutonniere deformity?
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Terminal tendon tenotomy (Fowler)
Central slip reconstruction |
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What nerves are involved in an intrinsic minus hand?
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Median (lumbrical muscles)
Ulnar (lumbricals and I0) |
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With claw hand, what is the position of the MCPs and IPs?
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MPs hyperextended
IPs flexed |
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What two clinical problems are associated with intrinsic minus hand?
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Decreased grip strength
Decreased pinch strength |
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What is the goal of operative intervention?
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Correct MCP hyperextension
Facilitate IP extension |
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What role do the intrinsics have on the thumb?
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Increase pinch
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With intrinsic plus hand, what is the position the MCPs and IPs?
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MCPs flexed
IPs extended |
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What clinical test is most relevant?
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Bunnell test
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How does the Bunnell test work?
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Differentiates extrinsic tightness from intrinsic tightness
If intrinsics are tight, when MCP is extended (relaxes EDC), cannot flex the PIP joints If extrinsics are tight, when MCP is flexed (tensions EDC), cannot flex PIP joints |
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What does nonoperative treatment involve?
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Intrinsic stretch (MP extension/IPs flexed)
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