6 - The Hand Part2 - D3

6 - The Hand Part2 - D3 - 1 st part: Fatima Mirza Hammad 2...

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Unformatted text preview: 1 st part: Fatima Mirza Hammad 2 nd part: Naeema Abdulla Ali Injury of the extensor digitorum tendon of the fingers at the distal interphalangeal (DIP) joint. Results from hyperflexion of the extensor digitorum tendon 1 st : Commonly an athletic or work related injury. Occurs when a ball (basketball, or volleyball), while being caught, hits an outstretched finger and jams it. 2 nd : Other common mechanisms of injury include forcefully tucking in a bedspread or slipcover or pushing off a sock with extended fingers. With or without fracture. 1. Mallet splint for 6 to 8 weeks 2. Extension block by k-wire for 4 weeks , (when there is involvement of more than one third of the base of the distal phalanx). This allows the tendon to reattach. If the finger is bent during these weeks the healing process must start all over again. A surgical pin acts like an internal cast to keep the DIP joint from moving so the tendon can heal. The pin is removed after 6 to 8 weeks A type of stenosing tenosynovitis narrowing of the sheath that surrounds the tendon in the affected finger, or a nodule forms on the tendon. The tendon can NO longer slide freely through its sheath. teno Affected digits may become painful to straighten once bent May make a soft crackling sound when moved. It props back suddenly when straightened It is called trigger finger because when the finger unlocks , it pops back suddenly, as if releasing a trigger on a gun. Trigger finger is usually idiopathic. Injection of the tendon sheath with a corticosteroid is effective over weeks to months in more than half of patients. Surgery: cut the sheath that is restricting the tendon. Recurrency is rare Flexion deformity of the PIP joint, due to interruption of the central slip of the extensor tendon (part that insert extensor tendon to the middle phalanx) Hyperflexion at the PIP joint with hyperextension at the DIP. Makes it difficult or impossible to extend the proximal interphalangeal (PIP) joint actively . Passive extension of the PIP joint is easy. The lateral bands separate The head of the proximal phalanx pops through the gap like a finger through a button hole The DIP joint is drawn into hyperextension. The lateral bands separate The head of the proximal phalanx pops through the gap like a finger through a button hole The DIP joint is drawn into hyperextension. Lateral band Central slip Distal phalanx 1.Traumatic injury 2.Inflammatory conditions (like rheumatoid arthritis) 3.Severe burn 4.Dupuytren's contracture (thickening of the palmar fascia , producing a flexion deformity of a finger) 1...
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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6 - The Hand Part2 - D3 - 1 st part: Fatima Mirza Hammad 2...

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