Hand injuries
Download
1 / 48

Hand Injuries - PowerPoint PPT Presentation


  • 120 Views
  • Uploaded on

Hand Injuries. Dr. Wahby Ghalib CABMS, FJMC, MRCS. The most common cx after hand injury is stiffness Results from swelling & immobilization Usually #s heal in 4w clinical evaluation : more important than XR evidence of healing. Safe immobilization.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about ' Hand Injuries' - blaine-harrington


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
Hand injuries

Hand Injuries

Dr. Wahby Ghalib

CABMS, FJMC, MRCS



Safe immobilization
Safe immobilization

  • Wrist extended

  • MPJs flexed

  • IPJs straight

  • Thumb abducted




Shaft
Shaft #

  • Direct force

  • Punching

  • Twisting force  spiral #


Rx

  • CR + volar or dorsal slab

  • Spiral # may need ORIF


Neck #

  • Usually 5th MCB

  • Usually due to punching

     Boxer`s #

  • May be open # (teeth)


Boxer s
Boxer`s #

  • Unstable

  • Palmar angulation : well tolerated

  • Needs reduction & K. wire to avoid malunion & 2ndary flexion of IPJ


Fractures of base of 1 st mcb
Fractures of base of 1st MCB

  • Epibasal #

  • Bennett`s #

  • Rolando`s #


Epibasal
Epibasal #

  • Rx : reduction ± K. wire


Bennett s
Bennett`s #

  • Punching

  • Triangular piece remains attached to the trapezium while the rest of the thumb subluxates

  • CR + K. wire


Rolando s
Rolando`s #

  • Comminuted intraarticular # of the base of the 1st MCB

  • Rx : CR + K. wires or ORIF



Rx

  • Undisplaced # : buddy strapping 2-3 w


Rx

  • Displaced # : reduction by traction

     stable : buddy strapping

     unstable : IF



Distal phalanx
Distal phalanx #

  • Tuft # : bone is shattered

    focus on swelling & nail injury

  • Shaft # : if displaced : CR + needle

  • Physeal # : Salter – Harris 2



Cmj dislocation
CMJ dislocation

  • Usually the thumb

  • Reduction by traction & hyper-pronation

    ± K. wire


Mpj dislocation
MPJ dislocation

  • Usually the thumb

  • Simple : CR

  • Complex : palmar plate lodged in the joint & MC head clasped between flexor tendon & the lumrical

     CR or OR


Ipj dislocation
IPJ dislocation

  • Rx : traction & buddy strapping


Injury to the ulnar collateral ligament of 1 st mpj
Injury to the ulnar collateral ligament of 1st MPJ

  • = gamekeeper or skier injury

  • Partial : thumb stable in extension  immobilize 4w

  • Complete : thumb unstable in flexion & extension  repair


Zones of tendon injury
Zones of tendon injury

  • I : beyond insertion of FDS

  • II : between distal palmar crease & insertion of FDS ( flexor sheath)

  • III : between end of carpal tunnel & distal palmar crease

  • IV : within carpal tunnel

  • Proximal to carpal tunnel




ad