Injuries of Hand MCQs

The patient is a post menopausal female with t score of -2.5, with a past history of Colles fracture, is an indication for anti resorptive treatment. The anti-resorptive agent in the given option is alendronate.

The complication rate is 55%, with the most common complication being some degree of residual finger and wrist stiffness (39%). Most common complication of Colles fracture → Finger stiffness, 2nd most common complication of Colles fracture → Malunion Complications of Colles fracture: Stiffness of fingers and joints Stiffness of finger; wrist and shoulder are the most common avoidable complication of collie's fracture. This occurs due to lack of exercise. Therefore, patient should be encouraged for active exercise of finger and shoulder. Malunion It is the second most common complication It results in dinner fork deformity Sudek's osteodystrophy (reflex sympathetic dystrophy) Carpal tunnel syndrome: Median nerve may get compressed in carpal tunnel Carpal instability Rupture of the extensor pollicis longus tendon TFCC injury Reference: Maheshwari 4th /e p. 110

A Colles fracture consists of a fracture of the distal radius at the cortico cancellous junction with dorsal angulation and impaction, but without the involvement of the articular surface. Chauffeur’s fracture is an intraarticular fracture of radial styloid A die-punch fracture is a depressed intra-articular fracture of the lunate fossa of the distal radius Barton fracture is an intraarticular fracture involving the dorsal/ volar lip of the distal radius with subluxation of the carpus and hand bones. Reference: Maheshwari ortho 5th edition page no 111

Malunited Colles fracture can cause Extensor pollicis longus tendon rupture. It will not produce FPL rupture. Complications of Colles fracture are Joint stiffness Malunion - causes dinner fork deformity Carpal tunnel syndrome Sudek's osteodystrophy EPL tendon rupture Reference: J. Maheshwari's 5th Edition of Essential Orthopaedics page no. 114

The Piano-Key Sign Test is a test carried out for the clinical assessment of wrist instability. It is used as an indicator for distal radio-ulnar joint instability and tears of the triangular fibrocartilage complex of the wrist. TECHNIQUE: In the Piano-key Sign Test, the wrist is supported in pronation and the hand is stabilized in the neutral position. Force is applied to the head of ulna. The test is positive if the ulnar head goes back to its anatomic position after the removal of the force applied to the ulnar head. This bears resemblance with when a piano key springs up after the force from a finger is removed from the key, hence, the name 'piano-key' sign. This instability and pain are judged relative to the contralateral wrist. No instability or movement observed on removal of pressure on the ulnar head. Reference: Manish kumar varshney 1st edition page no 1674

Radiological findings in RA Soft tissue shadow at the level of the joint because of joint effusion or synovial hypertrophy Reduced joint space Erosion of articular margins Subchondral cysts Juxta-articular osteopenia Deformities of the hand and fingers Reference- Manish Kumar Varshney 1st edition page no 405