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Just if you thought you were having a bad day…. https://www.youtube.com/watch?v=r-2oPR3fptQ.

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Presentation on theme: "Just if you thought you were having a bad day…. https://www.youtube.com/watch?v=r-2oPR3fptQ."— Presentation transcript:

1 Just if you thought you were having a bad day…. https://www.youtube.com/watch?v=r-2oPR3fptQ

2 GENERAL ANATOMY https://www.youtube.com/watch?v=zyl6eoU-3Rg

3 Boutonniere deformity https://www.youtube.com/watch?v=1_78tHcZXMg

4 Mallet finger https://www.youtube.com/watch?v=w1NQJ7Tosm0

5 Boxer’s Fracture https://www.youtube.com/watch?v=JC98hEcWkkc

6 Colles’ fracture https://www.youtube.com/watch?v=_XEHl1WOwKE

7 Scaphoid fracture https://www.youtube.com/watch?v=pNqBwML4owE

8 So much better when the British guy says it…. Ganglion Cyst https://www.youtube.com/watch?v=cADk4WSqC6g

9 Palpations Ulna, radius, carpal bones, scaphoid, hook of hamate, metacarpals, proximal phalanx, middle phalanx, distal phalanx, ulnar/radial carpal joint, metacarpal phalangeal joint, proximal interphalangeal joint, distal interphalangeal joint, interphalangeal joint (thumb only).

10 ROM AROM wrist flexion, MMT wrist flexion, AROM wrist extension, MMT wrist extension, AROM ulnar deviation, MMT ulnar deviation, AROM radial deviation, MMT radial deviation, AROM flexion of MCP joint, MMT flexion of MCP joint, AROM extension of MCP joint, MMT extension of MCP joint, AROM PIP flexion, AROM PIP extension, AROM DIP flexion, AROM DIP extension, AROM phalanges 2-5 abduction, AROM phalanges 2-5 adduction, AROM thumb flexion, AROM thumb extension, AROM thumb abduction, AROM thumb adduction, AROM thumb opposition.

11 Special Tests Tap/Percussion Test Steps Athlete is sitting or standing with finger extended Examiner applies a firm tap to the end of the finger being tested Positive Test Pain at the site of injury Positive Test Implications Possible fracture (NO VIDEO)

12 MP Torsion/Grind/Compression, Transverse Compression Test StepsAthlete is sitting or standing with finger extended Examiner holds the distal phalanx and applies compression along the axis of the bone of the finger being tested Positive Test Pain at the site of injury Positive Test Implications Possible fracture https://www.youtube.com/watch?v=_cKMVReLLLk

13 More on de Quervain’s https://www.youtube.com/watch?v=fsvttSKwH2s

14 Finkelstein Test StepsAthlete is sitting or standing and forms a fist around the thumb Examiner grasps the athlete's forearm with the proximal hand and the athlete's fist with the distal hand Examiner stabilizes the athlete's forearm with the proximal hand and ulnarly deviates the athlete's wrist and the distal hand Positive Test Pain over the abductor pollicis longus and extensor pollicis brevis tendons distally Positive Test Implications Possible tenosynovitis or pollicis longus and extensor pollicis brevis tendons https://www.youtube.com/watch?v=41mBOd-rr6M

15 Phalen Test StepsAthlete is sitting or standing with the dorsal aspect of both hands in full contact so that both wrists are maximally flexed Athlete applies a steady compressive force through the forearms so that the wrists are maximally flexed for 1 minute Positive Test Numbness and tingling in the median nerve distribution of the fingers Positive Test Implications Carpal tunnel syndrome or median nerve compression https://www.youtube.com/watch?v=RpGHYujo37o

16 Tinel's Sign Test (Radial & Ulnar Nerve) StepsAthlete is sitting next to a flat surface Examiner taps the volar aspect of the athlete's wrist over the area of the carpel tunnel Positive Test Tingling, paresthesia or pain in the area of the thumb, index finger, middle finger, and radial one–half of the ring finger Positive Test Implications Compression of the median nerve in the carpal tunnel or carpal tunnel syndrome https://www.youtube.com/watch?v=XcDhqKRT2aU&spfreload= 1 https://www.youtube.com/watch?v=XcDhqKRT2aU&spfreload= 1

17 Ouchies! https://www.youtube.com/watch?v=YVPe5WTl5yg

18 https://www.youtube.com/watch?v=cx_YgYzlbw0 Murphy's Sign Test Steps Athlete is sitting or standing Athletes makes a fist and examiner observes the position of the third metacarpal Positive Test Third metacarpal is level with the second and fourth metacarpals Positive Test Implications Dislocated lunate

19 Varus (Radial) Stress Test Steps Examiner maintains stabilization of the proximal bone between the thumb and forefinger and grasps the distal bone Examiner provides a varus force to the joint Positive Test Excessive gapping and/or pain Positive Test Implications Collateral ligament tear/sprain

20 Valgus (Ulnar) Stress Test Steps Examiner maintains stabilization of the proximal bone between the thumb and forefinger and grasps the distal bone Examiner provides a valgus force to the joint Positive Test Excessive gapping and/or pain Positive Test Implications Collateral ligament tear/sprain https://www.youtube.com/watch?v=bWpg3PCn7sQ

21 Fromet's Sign Test StepsPatient is asked to hold a piece of paper between the thumb and index finger while the examiner attempts to pull it away Positive Test Flexion of the first IP joint Positive Test Implications Adductor pollicis paralysis due to ulnar nerve damage https://www.youtube.com/watch?v=yJTIhm1VfSI

22 Long Finger Flexion Test StepsExaminer maintains stabilization of digits in extension except for digit being tested Examiner stabilizes MCP and PIP of digit being tested Examiner asks patient to flex DIP If suspected flexor digitorum superficialis rupture repeat without stabilization of PIP and ask patient to flex PIP Positive Test Loss of flexion of DIP Loss of PIP flexion Positive Test Implications Flexor digitorum profundus rupture or nerve damage Flexor digitorum profundus and superficialis rupture or nerve damage https://www.youtube.com/watch?v=q4mXkUQ2sD0


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