Fractures of the wrist

Question 1

Colles’ fracture

Answer 1

Transverse fracture of the distal radius with dorsal displacement of the distal fracture fragement

Distal portion displaces posteriorly (upwards) causing a ‘dinner fork deformity’

FOOSH

Question 2

Greenstick fracture

Answer 2

Incomplete fracture seen in childhood

Question 3

Smith fracture

Answer 3

Reverse of Colles’
fracture of the distal radium but displacement is towards the palm

Question 4

Monteggia

Answer 4

fracture of the ulnar shaft
dislocation of the proximal radioulnar joint

Question 5

Galeazzi

Answer 5

fracture of the distal radius with an associated dislocation of the distal radioulnar joint

Question 6

Nursemaid’s elbow

Answer 6

subluxation of the radial head
most common in children aged 2-5 years old
longitudinal traction applied to an extended arm from swinging or sudden pulling of the arm

child presents holding elbow in slight flexion and forearm pronation. pain and tenderness localised to the lateral aspect of the elbow

radiographs are normally negative

tx: closed reduction of radial head subluxation by manually supinating the forearm and flexing the elbow past 90 degrees

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Question 7

Scaphoid fracture

Answer 7

often caused by a FOOSH
one of the carpal bones in the wrist below the thumb

tenderness at the anatomical snuffbox (the groove between tendons when extending the thumb)

!risk of avascular necrosis and non union becuase the scaphoid has a retrograde blood supply.