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Overview

Overview. Introduction Hand Assessment Treatment principles Specific injuries. General Principles. Initial evaluation and primary care of the injured hand are critical Accurate assessment Restore altered anatomy Return to normal function. Complications. Stiffness Pain Loss of function.

mirella
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Overview

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Presentation Transcript

  1. Overview • Introduction • Hand Assessment • Treatment principles • Specific injuries

  2. General Principles • Initial evaluation and primary care of the injured hand are critical • Accurate assessment • Restore altered anatomy • Return to normal function

  3. Complications • Stiffness • Pain • Loss of function AIM: AVOID THE BAD HAND

  4. Swelling Reduction • Elevation • Initial splinting • Hand therapy

  5. HISTORY • Age • Hand Dominance • Occupation

  6. Injury Details • Mechanism • Where did injury occur? • When? • Treatment?

  7. Examination • Local swelling • Tenderness • Deformity • Angulation • Rotational malalignment

  8. Rotational malalignment

  9. Investigations • Radiographs • PA, Lateral and Oblique • Referral to Hand Fracture Clinic

  10. Finger Tip

  11. Distal Phalanx • Most # require only splinting • Warning: • Subungual haematoma • Nail avulsion = ? NAIL BED INJURY

  12. Mallet Injury • Extensor insertion disruption • Tendinous versus bony

  13. SPLINT

  14. Warning: • >50% articular surface • Joint subluxation

  15. FDP avulsion • HISTORY!!!!! • EXAMINATION • Ring finger involved in 75% of cases

  16. Examination

  17. PIPJ Dislocations

  18. PIPJ dislocations • Dorsal • Lateral • Volar • Fracture-dislocation

  19. Dorsal Dislocation • Most common • Easily reduced • Stable • Dorsal blocking splint

  20. Lateral Dislocation • Rupture of lateral ligaments • Often volar plate involved • Reduction • Assessment of stability

  21. Volar Dislocation • Less common • Central Slip Injury • Referral < 1 week

  22. Ulnar Collateral Ligament Injury

  23. Assessment

  24. Stener Lesion

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