Hand and Foot

Hand and Foot PowerPoint PPT Presentation

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Hand and Foot

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1. Common Hand and Foot Disorders

3. Function of the hand Motor grasp pinch - tip pressure - pulp pressure - lateral pressure hook

4. Function of hand sensory stereognosis (position ,size, shape,etc.) Pinprick light touch

5. Rapid assessment of hand function space and stability open and close pinch and touch

6. Muscles of the hand Three group of muscles act on the fingers long flexors long extensors intrinsic muscles

7. Ganglion cystic swelling in the neighbourhood of tendon or joint

8. Ganglion pathology wall lining content uni.. or multilocular cyst

9. Ganglion formation large no. of closely packed cells formation of cavity mucoid degeneration ? ischemia

10. Ganglion site 60-70% dorsal wrist ganglion (scapholunate joint) 18 -20% volar ganglion 10 - 20% in the flexor sheath

11. Ganglion treatment conservative surgical

12. Carpal Tunnel Syndrome (CTS) The entrapment of the median nerve at the fibro osseous tunnel of the carpus.

13. CTS Aetiology Decrease in the size of the canal osteoarthritis trauma acromegaly

14. CTS Aetiology 2 increase in the size of its contents pregnancy rheumatoid arthritis alcoholism tumour idiopathic

15. CTS Clinical Picture patients in their 40s female > male pain (nocturnal) numbness clumsiness

16. CTS signs wasting of thener eminence numbness weakness Tinnel sign Phalen sign

17. CTS Treatment non operative splint steroid injection surgical decompression arthroscopic open

18. De Quervains Disease Stenosing tenovaginitis of the first dorsal extensor compartment

19. De Quervains Treatment non operative rest steroid injection anti-inflamatory operative

20. Trigger Fingers stenosing tenovaginitis of the flexor tendon sheath(A1 pulley)

21. Trigger Finger aetiology congenital (thumb) often not recognised until toddlers 30% resolve spontaneously acquired (middle aged) idiopathic traumatic diabetes rheumatoid

22. Trigger Finger treatment non operative steroid injection operative release of A1 pulley

23. Dupuytrens Contracture nodular hypertrophy and contracture of the palmar fascia

24. Dupuytrens Contracture aetiology genetic geographical smoking alcohol epilepsy

25. Dupuytrens Contracture clinical middle aged male 10 x female nodular thickening in the palm contracture of the ring and little finger MCPJ and/or IPJ not DIPJ

26. Dupuytrens Contracture treatment Surgery if:- rapidly progressive contracture inconvenience fasciotomy fasciectomy amputation

27. Foot Disorders deformities arthritis pain

28. Deformities Pes Planus physiological congenital (vertical talus) joint hypermobility paralytic compensatory spasmodic (peroneal muscle spasm)

29. Pes Planus Peroneal muscle spasm tarsal coalition infection inflammatory arthritis fractures

30. Deformities Pes Cavus idiopathic neurological abnormality eg spinal dysraphism peroneal muscular atrophy Friedrichs ataxia

31. Deformities Hallux Valgus female > male adolescent (familial) middle aged

32. Hallux Valgus symptoms deformity pain bunion metatarsalgia MT-P OA hammer toe

33. Hallux Valgus treatment Soft tissue balancing distal osteotomy proximal osteotomy excision fusion

34. Deformities Lesser toes curly toes claw toes (neurological) hammer toes mallet toes overlapping

35. Lesser toe deformities treatment modify footwear tendon release / transfer excision arthrodesis

36. Osteoarthritis Hallux Rigidus male > female repeated trauma loss of dorsiflexion

37. Hallux Rigidus treatment rocker sole dorsal cheilectomy extension osteotomy arthrodesis excision replacement

38. Rheumatoid arthritis hindfoot Ankle pain and swelling tenosynovitis ankle or sub-talar joint Ankle and tarsal joint erosion and deformity

39. Rheumatoid arthritis forefoot hallux valgus claw toes MT-P dislocation

40. Foot pain Mechanical pressure foot-shoe mismatch joint inflammation bone lesion peripheral vascular disease muscle strain

41. Heel pain Severs disease heel bumps peritendonitis plantar fasciitis idiopathic ankylosing spondylitis Reiters disease gonorrhoea

42. Midfoot pain Khlers disease tarsal boss osteoarthritis tarsal tunnel syndrome

43. Forefoot pain hallux valgus hammer toe Freibergs disease stress fracture Mortons neuroma

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