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Hand Injuries

Hand Injuries. Finger and Thumb Abnormalities. Anatomy of the Phalanx. DIP versus PIP. Mallet Finger. Distal Phalanx is forcefully flexed and tears the extensor tendon at the DIP joint. Mallet Finger. Treatment for Mallet Finger. Splint is slight hyperflexion for 6-8 weeks DO NOT REMOVE.

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Hand Injuries

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  1. Hand Injuries Finger and Thumb Abnormalities

  2. Anatomy of the Phalanx • DIP versus PIP

  3. Mallet Finger • Distal Phalanx is forcefully flexed and tears the extensor tendon at the DIP joint

  4. Mallet Finger

  5. Treatment for Mallet Finger • Splint is slight hyperflexion for 6-8 weeks • DO NOT REMOVE

  6. Boutonniere Finger • MOI: forceful blow to bent finger • Laceration that cuts extensor tendon • Arthritis – 1/3 of patients • TX – splint – 6wks or surgery to repair tendon.

  7. Rupture of extensor tendon PIP joint

  8. Swan Neck Deformity

  9. Swan Neck Deformity

  10. Swan Neck Deformity • MOI – arthritis / imbalance of muscle forces on the PIP joint • Treatment – splinting and PT to align the two joints

  11. Swan Neck and Boutonierre

  12. Game Keepers Thumb • Tear of the ulnar collateral ligament of the MP joint of the thumb • MOI – abduction and hyperextension • Skiing

  13. TX: splint or possible surgery

  14. Metacarpal Fractures • MOI – direct blow • S&S-ecchymosis in palm • TX – x-ray - splint

  15. Ecchymosis of palm

  16. Wrist Sprain • MOI – FOTOSA with hyperextension ( land on palm) or hyperflexion (land on back of hand – wrist flexed)

  17. Wrist SpRain • S&S – loss of ROM and strength • TX- RICE, splint, tape for activity

  18. Navicular/Scaphoid Fracture • S&S – point tender in anatomical snuffbox, pain with compression of 1st and 2nd metacarpals

  19. Scaphoid/Navicular Fracture • MOI – hyperextension of wrist while falling • Commonly missed – mimics a sprain

  20. Surgical Screw – Scaphoid Fracture

  21. Complications • Non-displaced – cast • Non-union fracture is common due to disrupted poor blood supply- bone necrosis. • Non-union usually occurs when unrecognized.

  22. Finger Dislocation • MOI – high speed force to distal phalanx • Most common – PIP joint – proximal interphalangeal joint. • S&S – visual deformity, immobility • Complication – fracture, Boutonneiredeformity

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