1. FINGER AND THUMB ABNORMALITIES HAND INJURIES

2. FRACTURED PHALANGE

3. ANATOMY OF THE PHALANX DIP versus PIP

4. MALLET FINGER Distal Phalanx is forcefully flexed and tears the extensor tendon at the DIP joint

5. MALLET FINGER

6. TREATMENT FOR MALLET FINGER Splint is slight hyperflexion for 6-8 weeks DO NOT REMOVE

7. RUPTURE OF EXTENSOR TENDON PIP JOINT

8. 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.

9. SWAN NECK DEFORMITY

11. MOI – arthritis / imbalance of muscle forces on the PIP joint Treatment – splinting and PT to align the two joints

12. SWAN NECK AND BOUTONIERRE

13. GAME KEEPERS THUMB Tear of the ulnar collateral ligament of the MP joint of the thumb MOI – abduction and hyperextension Skiing

14. TX: SPLINT OR POSSIBLE SURGERY

15. METACARPAL FRACTURES MOI – direct blow S&S-ecchymosis in palm TX – x-ray - splint

16. ECCHYMOSIS OF PALM

17. WRIST SPRAIN MOI – FOTOSA with hyperextension ( land on palm) or hyperflexion (land on back of hand – wrist flexed)

18. WRIST SPRAIN S&S – loss of ROM and strength TX- RICE, splint, tape for activity

19. NAVICULAR/SCAPHOID FRACTURE S&S – point tender in anatomical snuffbox, pain with compression of 1 st and 2 nd metacarpals

20. SCAPHOID/NAVICULAR FRACTURE MOI – hyperextension of wrist while falling Commonly missed – mimics a sprain

21. SURGICAL SCREW – SCAPHOID FRACTURE

22. COMPLICATIONS Non-displaced – cast Non-union fracture is common due to disrupted poor blood supply- bone necrosis. Non-union usually occurs when unrecognized.

23. FINGER DISLOCATION MOI – high speed force to distal phalanx Most common – PIP joint – proximal interphalangeal joint. S&S – visual deformity, immobility Complication – fracture, Boutonneire deformity