Download Free Medical Hand Trauma PowerPoint Presentation

Hand Trauma PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : Check out this medical PowerPoint presentation titled "Hand Trauma” by Vijay Kama.

This medical PowerPoint presentation is about hand trauma, any injury or damage to the hand, which can involve the fingers, wrist, palm, or other parts of the hand. Hand trauma can occur due to a variety of causes, such as accidents, sports injuries, falls, and cuts.

Common types of hand trauma include Fractures, Dislocations, Sprains and strains, Cuts and lacerations, Burns, and Amputations.

Tags : Hand Trauma, Fractures, Dislocations, Sprains and strains, Cuts and lacerations, Burns, Amputations, Hand Surgery, Hand Surgery PowerPoint presentation

Published on : May 29, 2023 | Views : 2220 | Downloads : 18

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

Hand Trauma CT3 –MSK Day Vijay Kama Consultant EM Peterborough City Hospital
Slide 2-

Let us look ……… Why is it important? Basic anatomy Clinical examination Common injuries
Slide 3-

ppt slide no 3 content not found
Slide 4-

Hand Injuries
Slide 5-

The Importance of the Hand Communication Sensation Employment Independent Living
Slide 6-

The Hand - Communication Greetings
Slide 7-

Communication… Gestures
Slide 8-

Communication… Sign Language
Slide 9-

Sensation Large area brain structure devoted to touch. Highly sensitive.
Slide 10-

Sensation… Relationships
Slide 11-

Employment Use of hands fundamental to most vocations.
Slide 12-

Independent Living Without the use of our hands, most people would find independent living impossible.
Slide 13-

This equals 6-8 weeks off work!! No income for 2 months. How would your finances cope?
Slide 14-

Basic Anatomy of the Hand
Slide 15-

Anatomy - Tendons
Slide 16-

ppt slide no 16 content not found
Slide 17-

Anatomy - Nerves
Slide 18-

ppt slide no 18 content not found
Slide 19-

Anatomy of the Hand Small area – lots to injure. Even small lacerations may cause functional issues.
Slide 20-

Assessing the Injured Hand - Look
Slide 21-

Assess the Finger Posture
Slide 22-

Feel Is it cold? Is sensation intact?
Slide 23-

Frequently Presenting Hand Injuries Fractures Lacerations/Penetrating Injuries Amputations De-gloving Injuries Human (punch) Bites Animal Bites Hand infections
Slide 24-

Lacerations Very common cause of trauma. Typical culprits –
Slide 25-

Common Results
Slide 26-

Lacerations Regardless of size, always have a high suspicion for more serious injury. Remember, glass only ever stops cutting when it hits bone. Lacerated tendon when repaired takes 6-8 weeks of healing and hand therapy to recover. Nerve repairs often take 3-6 months to get some benefit from the repair
Slide 27-

Extensor tendon Injury: Divided into Zones according to anatomical location of injury In the hand and wrist there are 7 extensor tendon zones 27 Tendon injuries Ref. http://emedicine.medscape.com Orthopedic Surgery for Flexor Tendon Lacerations Author: Michael Neumeister, MD, FRCSC, FRCSC, FACS; Chief Editor: Harris Gellman, MD http://www.orthobullets.com- Flexor Tendon Injuries- Derek Moore MD
Slide 28-

ppt slide no 28 content not found
Slide 29-

29
Slide 30-

Deformities can be due to tendon, bone , nerve injury and joint dislocations Specific types – Tendon injuries Mallet finger
Slide 31-

Boutonniere deformity Z deformity of the thumb
Slide 32-

Swan neck deformity
Slide 33-

Flexor tendon injuries –5 zones in the hand and the wrist Zone 1 One tendon only (FDP) from middle of middle phalanx distallyZone 2 Two tendons (FDS & FDP) from MCP joints to middle of middle phalanxZone 3 Central palmZone 4 Tendons in the carpal tunnelZone 5 Tendons proximal to the carpal tunnel FDS Insertion Flexor Sheath
Slide 34-

Presentation Flexor injury 34
Slide 35-

Amputations Can occur at any level. Ability to re-plant / re-vascularise depends on both the level of amputation and the mechanism. Once past the distal third of the distal phalanx the vessels are too small to be anastamosed.
Slide 36-

Finger Tip Amputation Injured components may include skin, bone, nail, nail bed, tendon, and the pulp, the padded area of the fingertip .
Slide 37-

If just skin is removed and the defect is less than a centimeter in diameter, it is often possible to treat these injuries with simple dressing changes. If there is a little bit of bone exposed at the tip, it can sometimes be trimmed back slightly and treated with V-Y plasty
Slide 38-

Amputation...
Slide 39-

Decision is based on: Importance of the part, level of injury, mechanism of injury expected return of function.
Slide 40-

Recommended ischemia times for replantation: Major replant: 6 hours of warm and 12 hours of cold ischemia. Digit: 12 hours for warm ischemia and 24 hours for cold ischemia. Preoperative preparation: radiography of both amputated and stump parts to determine the level of injury and suitability for replantation 40
Slide 41-

Outcome Overall success rates for replantation approach 80%. Better outcome with Guillotine (sharp) amputation (77%) compared to severely crushed and mangled body parts(49%). In general, the prognosis for ring avulsion injuries is poor. Studies have demonstrated that patients can expect to achieve 50% function and 50% sensation of the replanted part. Ref. Plastic Surgery, Goldwyn and Cohen, 3rd edition. Plastic Surgery, Grabb and Smith, 3rd edition. 41
Slide 42-

De-gloving Injuries
Slide 43-

Followup Can get large areas of skin loss. Typically treated as a skin graft with original skin, or debrided and skin grafted from the thigh. Can get contraction of the scar.
Slide 44-

Punch Bite Injuries Very common. Injury occurs after punching someone in the mouth. Usually small laceration to the 2nd or 3rd MCPJ. Often extends into the joint with damage to the extensor tendon. Always requires IVABs and a washout. Common consequences – septic arthritis, extensor tendon loss.
Slide 45-

Punch Bite
Slide 46-

Followup Usually require at least 1 washout. Sometime multiple. Tendon cannot be repaired if already infected. Tendon, although intially intact can be completely destroyed by infection. Always, always refer.
Slide 47-

Animal Bites Cat bites – frequently become infected. Cat teeth puncture like a needle and deposit bacteria at the base to then form an abscess. Dog bites – easier to treat than cat bites as dog teeth typically tear leaving the wound open and able to be irrigated. Cosmetically more difficult to treat.
Slide 48-

Fractures and dislocations
Slide 49-

Diagnosis….. Tenderness in anatomical Snuff box Xray- fracture line
Slide 50-

Treatment Scaphoid cast (3-4 months) Dorsiflexion & radial deviation (glass holding position)
Slide 51-

Internal fixation Herbert’s screw
Slide 52-

Complications Avascular necrosis Delayed / non union Wrist osteoarthritis
Slide 53-

Lunate dislocations Lunate dislocation perilunate dislocation Open reduction Avascular necrosis
Slide 54-

Bennett’s fracture dislocation Base of 1st metacarapal Intra articular Longitudinal force to thumb
Slide 55-

ppt slide no 55 content not found
Slide 56-

ppt slide no 56 content not found
Slide 57-

Rolando Fracture Comminuted First Metacarpal Base # Presents as ‘Y’ or ‘T’ Pattern Differs from Bennette that usually no diaphyseal displacement
Slide 58-

ppt slide no 58 content not found
Slide 59-

CMC dislocation 4th 5th MC
Slide 60-

#dislocation of 5th mc , reduced and fixed with k wires
Slide 61-

Fracture phalanges Fall of heavy object or crush injury Undisplaced Displaced Strapping Open reduction
Slide 62-

PIPJ dislocations/volar plate disruption
Slide 63-

PIPJ dislocation Mechanism of Injury – hyperextension of the PIP joint with or without dislocation often initial injury seems trivial
Slide 64-

PIPJ dislocation If dislocation without # OR If # fragment less than 30% joint surface → reduce then manage conservatively in dorsal blocking splint (DBS)
Slide 65-

Dorsal blocking splint PIPJ in 30 degrees flexion volar structures off stretch slowly increase out to neutral
Slide 66-

#’s 5th Metacarpal Assess ROM and digit Rotation Usually managed conservatively
Slide 67-

#’s 4th Metacarpal Spiral # Assess ROM and digit Rotation Tendency to rotate Impacted #’s result in extension lag = poor function.
Slide 68-

Paronychia infection of the finger that involves the tissue at the edges of the fingernail superficial and localized to the soft tissue and skin most common bacterial infection seen in the hand ( staph; strep).
Slide 69-

Paronychia treatment wound care alone. collection of pus - drain. a simple incision over the collection of pus to allow drainage. scalpel may be inserted along the edge of the nail to allow drainage. If the infection is large, a part of the nail may be removed. oral antibiotic. wound care at home.
Slide 70-

Felon infection of the fingertip. This infection is located in the fingertip pad and soft tissue associated with it.
Slide 71-

Felon treatment incision and drainage incision will be made on one or both sides of the fingertip. break up the compartments gauze will be placed into the wound to aid the initial drainage. flush out with a sterile solution antibiotics.
Slide 72-

Infectious flexor tenosynovitis & Deep space infection infection involves the tendon sheaths and deep spaces penetrating trauma that introduces bacteria surgical emergency and will require rapid treatment with IV antibiotics.
Slide 73-

Kanavel’s cardinal signs intense pain along the course of tendon with extension this is the earliest and most important sign flexion posture uniform swelling percussion tenderness along the course of the tendon sheath
Slide 74-

ppt slide no 74 content not found
Slide 75-

ppt slide no 75 content not found