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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 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
Treatment for Mallet Finger • Splint is slight hyperflexion for 6-8 weeks • DO NOT REMOVE
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.
Swan Neck Deformity • MOI – arthritis / imbalance of muscle forces on the PIP joint • Treatment – splinting and PT to align the two joints
Game Keepers Thumb • Tear of the ulnar collateral ligament of the MP joint of the thumb • MOI – abduction and hyperextension • Skiing
Metacarpal Fractures • MOI – direct blow • S&S-ecchymosis in palm • TX – x-ray - splint
Wrist Sprain • MOI – FOTOSA with hyperextension ( land on palm) or hyperflexion (land on back of hand – wrist flexed)
Wrist SpRain • S&S – loss of ROM and strength • TX- RICE, splint, tape for activity
Navicular/Scaphoid Fracture • S&S – point tender in anatomical snuffbox, pain with compression of 1st and 2nd metacarpals
Scaphoid/Navicular Fracture • MOI – hyperextension of wrist while falling • Commonly missed – mimics a sprain
Complications • Non-displaced – cast • Non-union fracture is common due to disrupted poor blood supply- bone necrosis. • Non-union usually occurs when unrecognized.
Finger Dislocation • MOI – high speed force to distal phalanx • Most common – PIP joint – proximal interphalangeal joint. • S&S – visual deformity, immobility • Complication – fracture, Boutonneiredeformity