(1,3) Wrist & Hand Injuries Flashcards
What is the most common wrist fracture in geriatric patients?
Colles Fx
What population is primarily affected by Colles fractures?
- F > M
- elderly, osteoporosis
What is a Colles fracture?
fracture of distal radius with dorsal angulation of distal fragment (radial plateau)
What is the term for the appearance of a Colles fracture?
dinner fork deformity
(dorsal angulation of distal fragment)
What is the name for a reverse Colles fracture?
smith Fx
What is the mechanism of a Smith fracture?
FOOSH with flexed hand
What is a Smith fracture?
fracture of distal radius with anterior angulation of distal fragment (radial plateau)
What is a Barton fracture?
Fx of posterior rim of distal radius
What is another name for a Barton fracture?
rim Fx
What are the 3 names for a fracture of the radial styloid process?
- chauffeur Fx
- backfire Fx
- Hutchinson Fx
What is the most common carpal bone to fracture in adults?
scaphoid
What is the most common occult fracture in the human body?
scaphoid Fx
What is the mechanism of a scaphoid fracture?
FOOSH
What part of the scaphoid is most likely to fracture?
neck/waist
What is the best radiographic view for a scaphoid fracture?
PA wrist w/ ulnar deviation
What are the possible complications of a scaphoid fracture?
- AVN
- non-union
- carpal instability (pseudoarthrosis)
- degeneration
What is the term for an avulsion of the dorsal surface of the triquetrum?
fischer Fx
What is the 2nd most common carpal to fracture?
triquetrum
What is the mechanism of a Fischer fracture?
FOOSH + hyperflexion
What is the best view for a Fischer fracture?
lateral
What is the radiographic sign for a Fischer fracture?
pooping duck sign
What are the possible mechanisms of a hook of hamate fracture?
- golfing or racquet sports
- stress Fx
What is the best radiographic view for a hook of hamate fracture?
carpal tunnel view
What is the most common carpal dislocation?
lunate
What is the mechanism of a lunate dislocation?
FOOSH + hyperextension
What was does the lunate displace when dislocated?
anteriorly (into carpal tunnel)
What is the radiographic sign for a lunate dislocation?
pie sign
What is the best radiographic view for a lunate dislocation?
PA
What nerve is implicated in a lunate dislocation?
median n.
What is the term for dorsal displacement of all carpals except the lunate, which stays in contact with the radius?
Perilunate dislocation
What is another name for scapholunate dissociation?
rotary subluxation of the scaphoid
What structure is damaged with scapholunate dissociation?
scapholunate lig
What are the radiographic findings of scapholunate dissociation?
- Terry Thomas sign
- Signet ring sign
- DISI deformity
What is the stability of scapholunate dissociation?
unstable
What is the normal scapholunate angle?
30-60 deg
What is Dorsal Intercalated Segmental Instability (DISI)?
dorsal angulation of lunate
(scapholunate angle >60 deg)
What is Volar Intercalated Segmental Instability (VISI)?
volar angulation of lunate
(scapholunate angle <30 deg)
What injury is DISI associated with?
scapholunate ligament (dissociation)
What injury is VISI associated with?
lunotriquetral ligament
What is the most common metacarpal fracture?
neck of 5th metacarpal
What is the term for a fracture of the distal 2nd/3rd metacarpal?
boxer Fx
What is the term for a fracture of the distal 4th/5th metacarpal?
bar room Fx
What is Game Keeper thumb?
disruption of ulnar collateral ligament which may result in avulsion Fx at MCP jt of 1st digit
What is another name for Gamekeeper thumb?
skier thumb
What is the mechanism of Game keeper thumb?
hyperABduction of thumb
What is a complication of Game keeper thumb?
Stener lesion (UCL becomes trapped btwn adductor pollicis and base of prox phalanx)
What is the term for avulsion or impaction at the PIP in hyperextension?
volar plate Fx
What is the term for an avulsion fracture of the dorsal corner of the base of the distal phalanx by extensor digitorum?
mallet Fx
What is the mechanism of a mallet fracture?
forceful flexion of DIP
What injury results in loss of DIP extension?
mallet Fx
What is the term for avulsion of the flexor digitorum profundus?
jersey finger
What is the mechanism of jersey finger?
forceful hyperextension of DIP
What injury results in loss of DIP flexion?
jersey finger
What is the most common direction of metacarpophalangeal and interphalangeal joint dislocations?
posterior
What are the most common dislocated joints in the body?
- metacarpophalangeal
- interphalangeal