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Lecture

April 8 - ch19 finger injuries.doc

by OneClass22947 , Winter 2013
6 Pages
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Department
Physical Education and Sport
Course Code
PEDS240
Professor
Brad Kern

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April 8 – Ch 19 – Recognition and Management of Finger injuries
Mallet Finger
Cause of Mallet Finger
Caused by a blow that contacts tip of finger avulsing extensor tendon from
insertion
Occurs distally to the DIP
If you rupture the extensor tendon, finger will look flexed at 30 degrees.
Sometimes it is associated with an avulsion fracture
Signs of Mallet Finger
Pain at DIP; xray shows avulsed bone on dorsal proximal distal phalanx
Unable to extend distal end of finger (carrying at 30 degree angle)
Point tenderness at sight of injury
Caring for Mallet Finger
RICE and splinting (in extension) for 6-8 weeks
Keep the brace on at all times
Boutonniere Deformity
Cause of Boutonniere Deformity
Rupture of extensor tendon dorsal to the middle phalanx
Forces and locks DIP joint into extension and PIP into flexion. You can
passively move the joint out of this lock.
This can occur when the tip of the finger gets a blow
Signs of a Boutonniere Deformity
Severe pain, obvious deformity and inability to extend DIP joint
Swelling, point tenderness
Caring for a Boutonniere Deformity
Cold application, followed by splinting of PIP
Splinting must be continued for 5-8 weeks
Because injury is mainly to the extensor, they just brace the PIP
Athlete is encouraged to flex distal phalanx
Jersey Finger
Cause of Jersey Finger
Rupture of flexor digitorm profundus tendon from insertion on distal phalanx
Athlete will be unable to flex their finger
Often occurs with ring finger when athlete tries to grab a jersey
Signs of Jersey Finger
DIP cannot be flexed, finger remains extended
Pain and point tenderness over distal phalanx
Caring for Jersey Finger
Must be surgically repaired
Rehab requires 12 weeks and there is often poor gliding of tendon with
possibility of re-rupture
Gamekeeper’s Thumb

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Description
April 8 – Ch 19 – Recognition and Management of Finger injuries Mallet Finger Cause of Mallet Finger • Caused by a blow that contacts tip of finger avulsing extensor tendon from insertion • Occurs distally to the DIP • If you rupture the extensor tendon, finger will look flexed at 30 degrees. Sometimes it is associated with an avulsion fracture Signs of Mallet Finger • Pain at DIP; xray shows avulsed bone on dorsal proximal distal phalanx • Unable to extend distal end of finger (carrying at 30 degree angle) • Point tenderness at sight of injury Caring for Mallet Finger • RICE and splinting (in extension) for 6-8 weeks • Keep the brace on at all times Boutonniere Deformity Cause of Boutonniere Deformity • Rupture of extensor tendon dorsal to the middle phalanx • Forces and locks DIP joint into extension and PIP into flexion. You can passively move the joint out of this lock. • This can occur when the tip of the finger gets a blow Signs of a Boutonniere Deformity • Severe pain, obvious deformity and inability to extend DIP joint • Swelling, point tenderness Caring for a Boutonniere Deformity • Cold application, followed by splinting of PIP • Splinting must be continued for 5-8 weeks • Because injury is mainly to the extensor, they just brace the PIP • Athlete is encouraged to flex distal phalanx Jersey Finger Cause of Jersey Finger • Rupture of flexor digitorm profundus tendon from insertion on distal phalanx • Athlete will be unable to flex their finger • Often occurs with ring finger when athlete tries to grab a jersey Signs of Jersey Finger • DIP cannot be flexed, finger remains extended • Pain and point tenderness over distal phalanx Caring for Jersey Finger • Must be surgically repaired • Rehab requires 12 weeks and there is often poor gliding of tendon with possibility of re-rupture Gamekeeper’s Thumb Cause of Gamekeepers Thumb • Sprain of UCL and MCP joint of the thumb • Mechanism is forceful abduction of proximal phalanx occasionally combined with hyperextension • Gamekeepers thumb happens alot to skiers due to valgus force on thumb which can damage the ulnar collateral ligament in the thumb Signs of gamekeepers thumb • Pain over UCL in addition to weak and painful pinch • Tenderness and swelling over medial aspect of thumb • With thumb injuries, we should always check for avulsion fractures Caring for Gamekeepers Thumb • Immediate follow-up must occur • If instability exists, athlete should be referred to orthopedist • If stable, xray should be performed to rule out fracture • Thumb splint should be applied for protection for 3 weeks o
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