Flexor Tendon Avulsion - Jersey Finger - Hand SurgeryResource Podcast

In this episode of the Hand Surgery Resource Podcast, Dr. Larry Hurst shares more about Flexor Tendon Avulsion, more popularly known as the Jersey Finger.

This injury is typically caused by an attempted tackle in football or rugby when clothing is grasped. The forcible extension of the digit during active flexion can result in FDP avulsion.  This forceful extension occurs as the player who is being tackled runs away from the player attempting to make the tackle so quickly that this player cannot let go.

Find out more about it here: https://www.handsurgeryresource.net/flexor-tendon-avulsion

In this episode of the Hand Surgery Resource Podcast, Dr. Larry Hurst shares more about Giant Cell Tumor of the Tendon Sheath, more popularly known as Xanthoma.

A giant cell tumor of the tendon sheath (GCTTS) is a slow growing, usually painless benign lesion localized at the extremities. It is the second most common benign tumor of the hand after ganglion cyst.

Find out more about it here: https://www.handsurgeryresource.net/xanthoma

In this episode of the Hand Surgery Resource Podcast, Dr. Larry Hurst shares more about Scapholunate Advanced Collapse (SLAC) Wrist, more popularly known as Wrist Osteoarthritis.

Nearly 90% of the degenerative changes observed in patients with osteoarthritis of the wrist follow three predictable patterns, the most common of which is “scapholunate advanced collapse (SLAC)” wrist, coined by Watson and Ballet in 1984.1 Arthritic changes initially involve the radioscaphoid joint, and as cartilage disappears, the radial side of the wrist loses support. The capitate slides away from the radial side of the lunate, which in turn, leads to degeneration of the capitolunate joint and the hamatolunate joint. The radiolunate and lunotriquetral joints are often spared. The trapeziometacarpal joint is usually affected by arthritis that is unrelated to the SLAC wrist process.

In this episode of the Hand Surgery Resource Podcast, Dr. Larry Hurst shares more about Glomus Tumor.

Glomus tumors are rare, benign papules or nodules that appear predominantly at subungual sites in the distal extremities especially in middle aged women. Glomus tumors are very painful, often causing paroxysmal responses to changes in temperature or pressure. The pain is secondary to glomus body contractions.  Most tumors occur as solitary lesions; however, multiple tumors, even on one fingertip have been reported.  It is important to keep Carroll's triad described in 1972 in mind when attempting to diagnose glomus tumors.  There are three types of glomus tumors: mucoid hyaline, solid (glomus) and angiomatous.  Usually glomus tumors are smaller than 1 cm in diameter with most about 5mm in diameter.

Read more about conditions of the hand on Hand Surgery Resource for free: https://www.handsurgeryresource.net/

In this episode of the Hand Surgery Resource Podcast, Dr. Larry Hurst shares more about Mucoid/Mucous Cysts.

A mucous cyst is a benign ganglion that affects the distal interphalangeal (DIP) joint or in the proximal nail fold. Mucoid cysts are usually small with an average diameter of less than 10 mm. Most (90%) mucoid cysts are associated with the DIP joint osteoarthritis. Fingernail deformity secondary to the mucoid cyst occurs 25% of theb patients. Cysts are often asymptomatic and do not require treatment. When they are treated by aspiration, recurrence is common. Surgical recurrence is rare.

Read more about conditions of the hand on Hand Surgery Resource for free: https://www.handsurgeryresource.net/

In this podcast. Dr. Larry Hurst takes you through details of Mallet Finger

The classic "mallet finger" injury involves the forced flexion of the distal interphalangeal (DIP) joint while the finger is in active extension and results from the disruption in continuity of the extensor tendon over the DIP joint. There are four types of mallet finger injuries, including open and closed forms, and treatment depends on the patient’s age, mechanism of injury, duration of the deformity, associated fractures and presence of osteoarthritis. Chronic mallet finger may lead to swan neck deformity.

Read more about conditions of the hand on Hand Surgery Resource for free: ⁠https://www.handsurgeryresource.net/

In this podcast. Dr. Larry Hurst takes you through details of Gamekeeper's Thumb.

Gamekeeper’s thumb, also referred to as skier’s thumb, is an avulsion or rupture of the ulnar collateral ligament (UCL) of the metacarpophalangeal (MP) joint of the thumb, resulting in joint instability. It was originally described by CS Campbell1 and the mechanism of injury is forced radial deviation (abduction). Patients can present with a broad range of ulnar instability. In 1962, Stener described a series of patients with complete rupture of the UCL, and during surgery he found the adductor aponeurosis interposed between the distally avulsed UCL and its insertion at the base of the thumb. He concluded that unless contact was restored at the site of rupture, healing would result in a lax ulnar capsule, regardless of the period of immobilization.

Read more about conditions of the hand on Hand Surgery Resource for free: ⁠https://www.handsurgeryresource.net/

In this podcast. Dr. Larry Hurst takes you through Osteoarthritis of the Carpometacarpal (CMC) joint of the thumb.

Osteoarthritis of the CMC joint of the thumb is characterized by articular degeneration owing to compression and rotational shear forces on the trapezium. As the disease progresses, the thumb metacarpal may become dorsoradially subluxated on the trapezium, resulting in hyperextension deformity of the metacarpophalangeal (MP) joint. The thumb CMC joint is the most frequently affected joint of the hand to develop localized osteoarthritis.

Learn more about Osteoarthritis of the Carpometacarpal (CMC) joint of the thumb on Hand Surgery Resource: https://www.handsurgeryresource.net/osteoarthritis-thumbcmc

In this podcast. Dr. Larry Hurst takes you through Pediatric Trigger Thumb.

Pediatric trigger thumb is characterized by interphalangeal (IP) joint contracture and the presence of a flexor tendon nodule at the metacarpal head (Notta’s node). The pathophysiology is stenosing tenosynovitis of the flexor pollicis longus (FPL) tendon. There is ongoing debate as to whether the condition is present at birth or develops early postnatally. Results from numerous observational studies support the latter assertion.

Learn more about Pediatric Trigger Thumb on Hand Surgery Resource: https://www.handsurgeryresource.net/trigger-thumb-pediatric

In this podcast. Dr. Larry Hurst takes you through one of the most talked-about and diagnosed conditions of the hand - Carpal Tunnel Syndrome.

Carpal tunnel syndrome (CTS) is a symptomatic compression neuropathy of the median nerve at the level of the wrist and is characterized by pain and paresthesias in the palmar radial aspect of the hand. Symptoms are often worse at night and exacerbated by repetitive and forceful use of the hand. As the syndrome represents a collection of signs and symptoms, no one test absolutely confirms a diagnosis. CTS is the most common compression neuropathy of the upper extremity.

Typical History

Patients will present with symptoms that first appeared in one or both hands at night and then gradually increased to other times of the day. Patients report symptoms such as numbness and tingling in the palm and fingers, especially the thumb, index and middle fingers, which are intermittent and associated with specific activities such as driving, typing, knitting, etc. Patients will report difficulty grasping small objects or performing other manual tasks. In chronic, untreated cases the muscles at the base of the thumb may have atrophied; some patients are unable to discriminate between hot and cold by touch.

Learn more about Carpal Tunnel Syndrome on Hand Surgery Resource: https://www.handsurgeryresource.net/carpal-tunnel