20230901 Stiff joints - Dr Dominic

A 25 year old man had a crush injury and presented with pain and swelling of the right index finger. Xray of the digit is as shown above. He refused treatment and came back 2 month later complaining of stiffness of the finger. The finger is not tender and repeated xray show united fracture. How would you manage this case?

• Perform aggressive ROM therapy

• Apply static progressive splint

• Apply static splint

• Apply serial static splint

• Offer surgical intervention

A 60 year old man presented with inability to straighten the left ring finger for 1 year that’s progressively worsening. Examination noted a nodule at palm with the MCPJ fixed at 45deg flexion. How would you manage this case?

• Perform aggressive ROM therapy

• Apply static progressive splint

• Apply static splint

• Apply serial static splint

• Offer surgical intervention

Mr A, a 30 year old man with history of injury to the little finger 6months ago presented with inability to flex PIPJ of the digit. Examination noted that upon flexing the wrist, the PIPJ is more difficult to flex. How would you manage this case?

• Perform aggressive ROM therapy

• Apply static progressive splint

• Apply static splint

• Apply serial static splint

• Offer surgical intervention

Mr A had aggressive therapy and splint prescribed. He however had poor compliance and had no improvement after 3 months. What would be the next step?

• Advice for compliance and continue non operative

• Perform tenolysis and adhesion release

• Perform capsulotomy

• Perform arthroplasty

• Perform flexor tenolysis

A 20 year old man had centipede bite at the left dorsum hand. He complained of pain and swelling of the hand. He is otherwise well and fit to be discharged. What is the advise that you need to give to the patient prior to discharge?

• Wrap the hand in tight bandage

• Elevate the hand above the level of the heart

• Apply cold compression on the hand every hour

• Take the analgesia regularly

• To come back to the hospital if the hand is discoloured/cold/extremely painful