583 hand

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583 hand
2012-12-08 18:03:36
583 hand

583 hand
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  1. an irritation of the digitalsheath which surrounds the flexor tendons.When the tendon sheath becomes thickenedor swollen it pinches the tendon andprevents it from gliding smoothly. In somecases the tendon catches and then suddenlyreleases
    trigger finger
  2. a hereditarythickening of the tough tissue calledfascia that lies just below the skin ofyour palm. This condition may varyfrom small lumps or bands to verythick bands which may eventually pullthe fingers into the palm.

    mainstay of treatment is surgicaland is recommended if there isprogressive contracture drawing thefingers into the hand. Sometimes asteriod injection will be used in apainful nodule. Small nodules or lumpsin the palm do not need treatment untilthey are very large and interfere withhand function. Even with successfulsurgical removal, the bands mayreappear or occur in other fingers.
    Dupuytrens contracture
  3. An irritation and swelling of the sheath or tunnel which surrounds the thumb tendons as theypass from the wrist to the thumb. Pain whengrasping or pinching and tenderness overthe tunnel are the most common symptoms.Sometimes a lump or thickening can be felt in this area.

    Many cases improve with short periods ofrest in a splint, followed by stretchingexercises designed to get the tendonsgliding. Injection with steroids and/or takinganti-inflammatory medications. More severecases or those that do not respond to othertreatment may require surgery. Modificationof the activities which caused the symptomsinitially also may be required.
    De Quervains
  4. Which test: If the hand is made into a fist with the thumb "tucked in" and bent towardsthe little finger, the pain gets worse
    Finkelstein test - for DeQuervains
  5. Treatment of fractures: 
    A plaster or fiberglass cast is the most common type of fracture treatment,because most broken bones can heal successfully once they have been repositioned and a casthas been applied to keep the broken ends in proper position while they heal.
    Cast immobilization
  6. Treatment of fractures:
    The cast or brace allows limited or "controlled" movement of nearbyjoints. This treatment is desirable for some but not all fractures.
    Functional cast or brace
  7. Treatment of fractures:
    Is usually used to align a bone or bones by a gentle, steady pulling action. The pulling force may be transmitted to the bone through skin tapes or a metal pin through a bone.
  8. Treatment of fractures:
    During this operation, the bone fragments are firstrepositioned (reduced) into their normal alignment, and then held together with special screws orby attaching metal plates to the outer surface of the bone. The fragments may also be heldtogether by inserting rods down through the marrow space in the center of the bone. Thesemethods of treatment can reposition the fracture fragments very exactly. Because of the risks ofsurgery, however, and possible complications, such as infection, they are used only when suchtreatment is to be the most likely to restore the broken bone to normal function.
    Open reduction and internal fixation
  9. Treatment of fractures: 
    In this type of treatment, pins or screws are placed into the broken bone aboveand below the fracture site. The pins or screws are connected to a metal bar or bars outside theskin. This device is a stabilizing frame that holds the bones in the proper position so they canheal. After an appropriate period of time, the external fixation device is removed.
    External fixation
  10. Common symptoms are numbness and tinglingin the hand, especially at night; pain with prolonged gripping such asholding a steering wheel; orclumsiness in handling objects.Sometimes the pain can go all the way up to the shoulder. These symptoms are caused by pressure on the median nerve as it enters the hand through atunnel in the wrist.

    Mild cases can be treated with a splintor brace to rest the wrist. Steroid injections into the carpal canal to decrease swelling may be used in addition to splinting. Those cases that do not respond to nonsurgical treatment and those that are diagnosed late often require surgery.
    Carpal tunnel syndrome
  11. Occurs when the tip of a finger or the thumb is forcefully bent. This condition is also known as baseball finger. It happens when a ball or other object strikes the tip of the digit. The force tears the thin tendon that allows you to straighten the finger.The force of the blow may even pull away a piece of bone along with thetendon.

    A person with this injury has pain,swelling and bruising of the fingertip.The fingertip may droop noticeably.Occasionally, blood collects beneath the nail and the nail can even become detached from beneath the skin fold at the base of the nail.
    Mallet finger
  12. The middle joint bends down and the fingertip end joint bends back, an injury to the tendons that straighten thefingers.

    Signs and symptoms:
    Inability to straighten the finger at the middle joint and bend the fingertip
    Swelling and pain on the top of the middle joint of the finger
    Diagnosis and treatment
    For the tendon or bone to heal properly, a splint is applied to straighten the finger at the middle joint. This keeps the ends of the tendon from separating as they heal. It is important to keep wearing the splint for the recommended length of time, usually six weeks. After the immobilization period, you may still have to wear the splint at night, and recommended exercises to improve strength and flexibility in your fingers. If you participate in sports, you may have to wear protective splinting or taping for several weeks after the splint is removed.
    Boutonniere deformity
  13. True or false:
    The more proximal (dorsum of hand, wrist, dorsal forearm) a tendon laceration is the less of a problem it is.
    False - it is more of a problem because everything else will be affected.
  14. Are just under the skin, directly on the bone, on the back of the hands and fingers. Because oftheir location, they can be easily injured even by a minor cut. Jamming a finger may cause these thin tendons to rip apart from their attachment to bone.
    Extensor tendons
  15. How are extensor tendon injuries treated?
    Cuts that split the tendon may need stitches, but tears caused by jamming injuries are usually treated with splints.Splints stop the healing ends of the tendons from pulling apart and should be worn at all times until the tendon isfully healed.
  16. What are the common extensor tendon injuries?
    • Mallet finger
    • Boutonnière deformity
    • Lacerations or cuts on the back of the hand
  17. What are the common flexor tendon injuries?
    Deep cuts on the palm side of the wrist, hand, or fingers
  18. Do cut tendons require surgery?
    Yes, because the cut ends of a tendon usually separate after an injury. It is unlikely that a cut tendon will heal without surgery.
  19. True or false:
    Full and normal movement returns after tendon surgery
    False. In most cases it doesn't because the scarring can make bending and straightening of the finger very difficult.
  20. Splints:
    Have no moving parts and are primarily used to provide support and immobilization
    Static splints
  21. Splints:
    Use devices such as rubber bands, velcro strips, or springs to alter the range of passive motion of one or more joints
    Dynamic splints
  22. What are the 4 main reasons for splinting?
    • 1. To prevent deformity bysubstituting for weak or absentmuscle strength occurring afterperipheral nerve injuries or neuro muscular disease
    • 2. To support, protect, or immobilizejoints to allow healing following tendon, nerve, joint, vascular, orsort tissue injury or inflammation
    • 3. Correction of an existing deformity
    • 4. To provide directional control and serve as a basis for the attachment of specialized outrigger devices to facilitate and enhance hand function.