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Elson Extensor Tendon Test

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1. Elson Extensor Tendon Test

Elson Extensor Tendon Test Elson Extensor Tendon Test Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Elson Extensor Tendon Test Elson (...) Extensor Tendon Test Aka: Elson Extensor Tendon Test , Elson's Test II. Anatomy Lewis (1918) Gray's Anatomy 20th ed (in at or ) III. Indications Extensor evaluation at PIP Joint Risk of and secondary IV. Exam: Elson Test Technique Patient rests their hand on table with involved finger flexed 90 degrees at the PIP Joint over the table edge Patient attempts to extend finger at PIP joint against resistance Interpretation Positive if weak extension against resistance ( ) Also observe if distal phalanx

2018 FP Notebook

2. Elson Extensor Tendon Test

Elson Extensor Tendon Test Elson Extensor Tendon Test Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Elson Extensor Tendon Test Elson (...) Extensor Tendon Test Aka: Elson Extensor Tendon Test , Elson's Test II. Anatomy Lewis (1918) Gray's Anatomy 20th ed (in at or ) III. Indications Extensor evaluation at PIP Joint Risk of and secondary IV. Exam: Elson Test Technique Patient rests their hand on table with involved finger flexed 90 degrees at the PIP Joint over the table edge Patient attempts to extend finger at PIP joint against resistance Interpretation Positive if weak extension against resistance ( ) Also observe if distal phalanx

2016 FP Notebook

4. CRACKCast E050 – Orthopedics – Hand Injuries

from forced abduction of the thumb. Exam shows pain over ulnar side of base of thumb, and laxity with valgus testing (full extension and in 30 degrees flexion) Partial rupture – 4 weeks in thumb spica cast, follow up with hand surgeon Complete rupture – surgical repair What is a Stener’s Lesion? Interposition of soft tissues between bone and adductor aponeurosis preventing it from ever reattaching and healing Diagnosed with MRI or U/S Extensor tendon injuries What extensor zones are reasonable (...) meticulous repair Look at Fig 50-15 – oblique/lateral bands/ etc.! Central slip injury Injury to the central tendon over the PIP Unopposed FDS flexes the PIP and the volar bands displace laterally. This in turn causes hyperextension of the DIP – bouttonière deformity. Deformity can be acute or delayed Make sure to explore dorsal lacerations fully in this region Easily missed if closed injury – suspect with trauma and pain/swelling of PIP Elson’s test – Attempt to extend finger against slight resistance

2016 CandiEM

5. Surgical Management of Osteoarthritis of the Knee

“Low” strength studies with consistent findings or evidence from a single study for recommending for or against the intervention or diagnostic test or the evidence is insufficient or conflicting and does not allow a recommendation for or against the intervention. 6 CIRRHOSIS/HEPATITIS C AS A RISK FACTOR Limited evidence supports that patients with cirrhosis or hepatitis C are at higher risk for complications with total knee arthroplasty (TKA). Strength of Recommendation: Limited Evidence (...) Description: Evidence from two or more “Low” strength studies with consistent findings or evidence from a single study for recommending for or against the intervention or diagnostic test or the evidence is insufficient or conflicting and does not allow a recommendation for or against the intervention. PREOPERATIVE PHYSICAL THERAPY Limited evidence supports that supervised exercise before total knee arthroplasty (TKA) might improve pain and physical function after surgery. Strength of Recommendation

2015 American Academy of Orthopaedic Surgeons

6. Management of Anterior Cruciate Ligament Injuries

Evidence from two or more “Moderate” strength studies with consistent findings, or evidence from a single “High” quality study for recommending for or against the intervention. Limited Low Strength Evidence or Conflicting Evidence Evidence from two or more “Low” strength studies with consistent findings or evidence from a single study for recommending for or against the intervention or diagnostic test or the evidence is insufficient or conflicting and does not allow a recommendation for or against (...) reconstruction because it reduces activity related disability and recurrent instability which may lead to additional injury. Strength of Recommendation: Limited Description: Evidence from two or more “Low” strength studies with consistent findings or evidence from a single study for recommending for or against the intervention or diagnostic test or the evidence is insufficient or conflicting and does not allow a recommendation for or against the intervention. ACL YOUNG ACTIVE ADULT Moderate evidence supports

2014 American Academy of Orthopaedic Surgeons

7. Boutonniere Deformity (Diagnosis)

K. Congenital aplasia or hypoplasia of the finger extensors. Hand . 1975 Feb. 7 (1):15-21. . Carneiro RS. Congenital attenuation of the extensor tendon central slip. J Hand Surg Am . 1993 Nov. 18 (6):1004-7. . Elson RA. Rupture of the central slip of the extensor hood of the finger. A test for early diagnosis. J Bone Joint Surg Br . 1986 Mar. 68 (2):229-31. . Boyes JH. Bunnell's Surgery of the Hand . 5th ed. Philadelphia: JB Lippincott; 1971. 393. Griffin M, Hindocha S, Jordan D, Saleh M, Khan W (...) and hyperextension at the distal interphalangeal (DIP) joint (see the image below). [ , ] Boutonnière deformity. Image courtesy of David Bozentka, MD, University of Pennsylvania School of Medicine, published by Medscape (Late Reconstruction of Flexor and Extensor Tendon Injuries at http://www.medscape.com/viewarticle/717388). This article will provide an overview of BD, discuss the pathophysiology of the deformity, and delineate the standard approach to management. Next: Anatomy A BD manifests after injury

2014 eMedicine Surgery

8. Boutonniere Deformity (Follow-up)

):1004-7. . Elson RA. Rupture of the central slip of the extensor hood of the finger. A test for early diagnosis. J Bone Joint Surg Br . 1986 Mar. 68 (2):229-31. . Boyes JH. Bunnell's Surgery of the Hand . 5th ed. Philadelphia: JB Lippincott; 1971. 393. Griffin M, Hindocha S, Jordan D, Saleh M, Khan W. Management of extensor tendon injuries. Open Orthop J . 2012. 6:36-42. . Strickland JW. Flexor Tendon Injuries: I. Foundations of Treatment. J Am Acad Orthop Surg . 1995 Jan. 3 (1):44-54. . Burton RI (...) of a large avulsion of the dorsal lip of the middle phalanx, fixation with a Kirschner wire (K-wire) or screw fixation can be employed to reconstitute the extensor mechanism. If the fragment is small and nondisplaced, the injury can be managed nonoperatively with the splinting protocol as described above. Open injuries should always be irrigated appropriately. The central slip should be repaired if it is completely lacerated. The proximal central slip tendon can be directly repaired to the residual

2014 eMedicine Surgery

9. Nail Surgery (Treatment)

must be considered before performing matricectomy: (1) All excisions must extend to the periosteum with caution to avoid the insertion of the extensor tendon on the distal phalanx. (2) No remnant of the lateral matrix horn must be left behind to prevent recurrence of nail spicules. [ , ] In the surgical management of onychocryptosis, several procedures and techniques are available to the nail surgeon, with each technique having benefits and disadvantages. When performing a partial matricectomy (...) the proximal extensor tendon. [ ] Hemostasis of the wound may be achieved by means of spot electrodesiccation. Gelfoam or Instat pads are used to control capillary bleeding. A bulky, loose dressing is applied over the wound. The wound is cleansed twice daily with dilute hydrogen peroxide followed by the application of an antibiotic ointment and a replacement of the dressing. If the wound is allowed to heal by secondary intention, the new position of the PNF will be 3-5 mm more proximal to the original

2014 eMedicine.com

10. Nail Surgery (Follow-up)

must be considered before performing matricectomy: (1) All excisions must extend to the periosteum with caution to avoid the insertion of the extensor tendon on the distal phalanx. (2) No remnant of the lateral matrix horn must be left behind to prevent recurrence of nail spicules. [ , ] In the surgical management of onychocryptosis, several procedures and techniques are available to the nail surgeon, with each technique having benefits and disadvantages. When performing a partial matricectomy (...) the proximal extensor tendon. [ ] Hemostasis of the wound may be achieved by means of spot electrodesiccation. Gelfoam or Instat pads are used to control capillary bleeding. A bulky, loose dressing is applied over the wound. The wound is cleansed twice daily with dilute hydrogen peroxide followed by the application of an antibiotic ointment and a replacement of the dressing. If the wound is allowed to heal by secondary intention, the new position of the PNF will be 3-5 mm more proximal to the original

2014 eMedicine.com

11. Boutonniere Deformity (Overview)

K. Congenital aplasia or hypoplasia of the finger extensors. Hand . 1975 Feb. 7 (1):15-21. . Carneiro RS. Congenital attenuation of the extensor tendon central slip. J Hand Surg Am . 1993 Nov. 18 (6):1004-7. . Elson RA. Rupture of the central slip of the extensor hood of the finger. A test for early diagnosis. J Bone Joint Surg Br . 1986 Mar. 68 (2):229-31. . Boyes JH. Bunnell's Surgery of the Hand . 5th ed. Philadelphia: JB Lippincott; 1971. 393. Griffin M, Hindocha S, Jordan D, Saleh M, Khan W (...) and hyperextension at the distal interphalangeal (DIP) joint (see the image below). [ , ] Boutonnière deformity. Image courtesy of David Bozentka, MD, University of Pennsylvania School of Medicine, published by Medscape (Late Reconstruction of Flexor and Extensor Tendon Injuries at http://www.medscape.com/viewarticle/717388). This article will provide an overview of BD, discuss the pathophysiology of the deformity, and delineate the standard approach to management. Next: Anatomy A BD manifests after injury

2014 eMedicine Surgery

12. Boutonniere Deformity (Treatment)

):1004-7. . Elson RA. Rupture of the central slip of the extensor hood of the finger. A test for early diagnosis. J Bone Joint Surg Br . 1986 Mar. 68 (2):229-31. . Boyes JH. Bunnell's Surgery of the Hand . 5th ed. Philadelphia: JB Lippincott; 1971. 393. Griffin M, Hindocha S, Jordan D, Saleh M, Khan W. Management of extensor tendon injuries. Open Orthop J . 2012. 6:36-42. . Strickland JW. Flexor Tendon Injuries: I. Foundations of Treatment. J Am Acad Orthop Surg . 1995 Jan. 3 (1):44-54. . Burton RI (...) of a large avulsion of the dorsal lip of the middle phalanx, fixation with a Kirschner wire (K-wire) or screw fixation can be employed to reconstitute the extensor mechanism. If the fragment is small and nondisplaced, the injury can be managed nonoperatively with the splinting protocol as described above. Open injuries should always be irrigated appropriately. The central slip should be repaired if it is completely lacerated. The proximal central slip tendon can be directly repaired to the residual

2014 eMedicine Surgery

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