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COMMON HAND DISSORDER ,[object Object],[object Object],[object Object]
COMMON HAND DISSORDER ,[object Object],[object Object],[object Object],[object Object]
CARPAL TUNNEL SYNDROME ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],CARPAL TUNNEL SYNDROME
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],CARPAL TUNNEL SYNDROME
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],CARPAL TUNNEL SYNDROME
[object Object],[object Object],[object Object],[object Object],[object Object],CARPAL TUNNEL SYNDROME
[object Object],[object Object],[object Object],[object Object],CARPAL TUNNEL SYNDROME
[object Object],[object Object],[object Object],CARPAL TUNNEL SYNDROME
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],CARPAL TUNNEL SYNDROME
TRIGGER FINGER Stenosing tendovaginitis, or trigger finger (TF), is one of the most common causes of hand pain and disability. The condition begins as discomfort in the palm during movements of the involved digit(s). Gradually, or, in some cases, acutely, the flexor tendon causes painful popping or snapping as the patient flexes and extends the digit. The patient may present with a digit locked in a particular position, more often flexion, which may require gentle passive manipulation into full extension.
[object Object],TRIGGER FINGER
TRIGGER FINGER ,[object Object],[object Object],[object Object],[object Object],[object Object]
TRIGGER FINGER ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TRIGGER FINGER ,[object Object],[object Object],[object Object],[object Object],[object Object]
TRIGGER FINGER ,[object Object],[object Object],[object Object],[object Object],[object Object]
TRIGGER FINGER ,[object Object],[object Object],[object Object]
TRIGGER FINGER ,[object Object],[object Object],[object Object]
TRIGGER FINGER ,[object Object],[object Object],[object Object]
TRIGGER FINGER ,[object Object],[object Object],[object Object],[object Object]
DEFINITION . A localized formation of scar tissue in the palm of the hand. The scarring accumulates in a tissue called the fascia beneath the skin of the palm that normally covers the tendons that pull the fingers grip. As Dupuytren contracture progresses, more of the fascia becomes thickened and shortened. Dimpling and puckering of the skin over the area eventually occur. DUPUYTREN’S DISSEASE
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],DUPUYTREN’S DISSEASE
[object Object],DUPUYTREN’S DISSEASE Pretendinous cord  causes MCPJ contractures  Central & spiral cords  cause PIPJ contractures  The  spiral cord  pushes the NVB towards the skin & midline of the finger. Involvement of the  natatory ligament  causes web space contractures .  The  superficial transverse ligament  is not involved  Sagittal fibres  are not involved in the disease process
[object Object],DUPUYTREN’S DISSEASE Stage    Description     Management   1 Early palmar disease with no contracture     Leave alone  2 One finger involved, with only MCPJ contracture    Surgery  3 One finger - MCPJ + PIPJ     Surgery not easy  4 stage 3 + > one finger involved     Surgery prolonged & only partly succesful  5 Finger-in-palm deformity    consider amputation
[object Object],DUPUYTREN’S DISSEASE ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],DUPUYTREN’S DISSEASE
DUPUYTREN’S DISSEASE 7. SURGICAL  TECHNIQUE   Incision     Advantages     Disadvantages  Transverse midpalm       for pretendinous band - can be left open (McCash technique) or Full thickness graft (Hueston)     Requires frequent dressings & cooperation post-op.  Bruner's zig-zag       Good exposure     Can be difficult to raise flaps if skin is thin, incr. risk of NVB damage, can cause troublesome scarring at the sides & base of finger.  Longit. incision &  Z-plasties       Good exposure, less chance of damaging NVB     Can be difficult to match incisions in 2 finger disease
DUPUYTREN’S DISSEASE 7. Procedures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],DUPUYTREN’S DISSEASE
DUPUYTREN’S DISSEASE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
GANGLIONS Cystic swollen in the neigbourhood of tendon or joint.  Ganglion cysts are generally asymptomatic or minimally symptomatic. Symptoms such as limitation of motion, pain, paresthesias, and weakness are possible.
GANGLIONS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
GANGLIONS ETIOLOGY A more recent theory, attributes cyst formation to trauma or tissue irritation. Modified synovial cells lining the synovial-capsular interface are stimulated to produce mucin.
GANGLIONS ,[object Object],[object Object],[object Object],[object Object],[object Object]
GANGLIONS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
GANGLIONS ,[object Object],[object Object],[object Object],[object Object],[object Object]
GANGLIONS ,[object Object],[object Object],[object Object]
THANK YOU

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Common Hand Dissorder

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  • 11. TRIGGER FINGER Stenosing tendovaginitis, or trigger finger (TF), is one of the most common causes of hand pain and disability. The condition begins as discomfort in the palm during movements of the involved digit(s). Gradually, or, in some cases, acutely, the flexor tendon causes painful popping or snapping as the patient flexes and extends the digit. The patient may present with a digit locked in a particular position, more often flexion, which may require gentle passive manipulation into full extension.
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  • 21. DEFINITION . A localized formation of scar tissue in the palm of the hand. The scarring accumulates in a tissue called the fascia beneath the skin of the palm that normally covers the tendons that pull the fingers grip. As Dupuytren contracture progresses, more of the fascia becomes thickened and shortened. Dimpling and puckering of the skin over the area eventually occur. DUPUYTREN’S DISSEASE
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  • 27. DUPUYTREN’S DISSEASE 7. SURGICAL TECHNIQUE Incision    Advantages    Disadvantages Transverse midpalm      for pretendinous band - can be left open (McCash technique) or Full thickness graft (Hueston)    Requires frequent dressings & cooperation post-op. Bruner's zig-zag      Good exposure    Can be difficult to raise flaps if skin is thin, incr. risk of NVB damage, can cause troublesome scarring at the sides & base of finger. Longit. incision & Z-plasties     Good exposure, less chance of damaging NVB    Can be difficult to match incisions in 2 finger disease
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  • 31. GANGLIONS Cystic swollen in the neigbourhood of tendon or joint. Ganglion cysts are generally asymptomatic or minimally symptomatic. Symptoms such as limitation of motion, pain, paresthesias, and weakness are possible.
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  • 33. GANGLIONS ETIOLOGY A more recent theory, attributes cyst formation to trauma or tissue irritation. Modified synovial cells lining the synovial-capsular interface are stimulated to produce mucin.
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