1. Trauma and Overuse: Hand and Wrist

Question 1

Most common carpal bone fracture.

Answer 1

Scaphoid Fracture

Question 2

most susceptible to AVN and Non-Union.

Answer 2

Proximal Pole

Question 3

The first sign ofAVN =

Answer 3

Sclerosis (the dead bone can’t turn over / recycle)

Question 4

Most common fracture site

Answer 4

Waist

Question 5

Fixation screw is need if the displacement is > __ mm?

Answer 5

> 1mm.

Question 6

The SL ligament is composed of 3 parts.

What is the most important part for carpal stability?

Answer 6

Volar
Dorsal
Middle

Dorsal Band being the most important for carpal stability (opposite o f luno-triquetral which is volar

Question 7

This deformity results from angulation of the proximal and dista fragments - in the settingofawaist fracture.

Answer 7

Humpback Deformity

Can progress to progressive collapse and non-union.

Question 8

is an atraumatic AVN of the scaphoid

Answer 8

“Prieser Disease”

Question 9

occurs with injury (or degeneration via CPPD) to the S-L ligament.

Answer 9

SLAC Wrist (Scaphoid-Lunate Advanced Collapse)

Question 10

occurs with a scaphoid fracture.

Answer 10

SNAC Wrist (Scaphoid Non-Union Advanced Collapse)

Question 11

the scaphoid always wants to rotate in flexion - what ligmanets is the only thing holding it back?

Answer 11

Scaphoid-lunate ligament

Question 12

Answer 12

Scapholunate Ligament Tear

Question 13

The 3 parts of the Scapholunate Ligament Tear

Answer 13

volar, dorsal, and middle

Question 14

The dorsal Schapolunate ligaments tear =

Answer 14

Sacphoid and lunate migrate away

Question 15

Just remember the scaphoid wants to ___ and the lunate wants to extend ____.

Answer 15

Scaphoid = Flex (volar)

Lunate = extend (dorsal)

The only thing holding them back is their ligamentous attachment to each other.

Question 16

Widening of the SL angle - with dorsiflexion of the lunate.

Answer 16

DISI (Dorsal Intercalated Segmental Instability)

Question 17

Normal Scaphoid- Lunate Angle

Answer 17

30-60 degrees

Question 18

Schaphoild-lunate angl ein DISI?

Answer 18

Question 19

“Radial sided iniurv”

Answer 19

DISI (Dorsal Intercalated Segmental Instability)

Question 20

volar-flexion (palmar-flexion)
instability

Answer 20

VISI (Volar Intercalated Segmental Instability)

Question 21

“Ulnar sided iniury” (lunotriquetral side), the lunate no longer has the stabilizing force of the lunotriquetral ligament and gets ripped volar with the scaphoid

Answer 21

VISI (Volar Intercalated Segmental Instability)

Question 22

Narrowing of the SL angle - with volar-flexion of the lunate & scaphoid.

Answer 22

VISI (Volar Intercalated Segmental Instability)

Question 23

What are the carpal dislocation?

Answer 23

Question 24

the Lunate stays put - it’s the carpal bones around the lunate (“peri­ lunate bones”) that move.

Answer 24

Question 25

Peri-lunate dislocation is associated with what fractures?

Answer 25

Scaphoid fracutre

Question 26

Lunate and capitate lose radial alignement

Answer 26

Question 27

Carpal dislocation Associated with Triquetro-Lunate interosseous ligament disniption

Answer 27

Question 28

Mid-carpal dislocation is associated with what fracture?

Answer 28

Triquetral Fracture

Question 29

Lunate moves, others stay

Answer 29

Lunate dislocation

Question 30

It happens with a Dorsal radiolunate ligament injury

Answer 30

Lunate dislocation

Question 31

"Most severe Carpal Dislocation"

Answer 31

Lunate dislocation

Question 32

Dislocations around the lunate are described in two flavors

Answer 32

Lessare Arc Greater Arc

Question 33

Vulnerable zone with pure ligament injury

Answer 33

Lesser Arc

Question 34

Vulnerable zone associated with fractures

Answer 34

Greater arc Described by saying “trans” the name of the fracture then the dislocation. Example “Trans-scaphoid, peri-lunate dislocation”

Question 35

Ligament free part of the carpal bones

Answer 35

Space of Poirier Ligament free (“poor”) area, that is a site of weakness

Question 36

Which synovial spaces normally communicate ?

Answer 36

The answer is pisiform recess and radiocarpal joint.