Fractures: Wrist and Hand Flashcards
What is a Colles’ fracture?
- Transverse # of radius along metaphysis
- Dorsal displacement and angulation
- 1 inch proximal to radiocarpal joint
NO ARTICULAR INVOVLEMENT
When do Colles’ fracture classically present?
FOOSH
What type of deformity is a/w Colles’ fractures?
Dinner fork type deformity
What is a Bennett #?
Intra-articular # at the base of the thumb metacarpal
Due to forced abduction of first metacarpal (e.g. in fist fights)
What is seen on x-ray in a Bennet #?
Triangular fragment at base of thumb metacarpal
What is a Dupuytren #?
Medial malleolus avulsion fracture
Posterior malleolus fracture
Tibiofibular ligament rupture
What is a Galeazzi #?
fracture of the radial shaft
dislocation of the ulna from its articulation with the radius at the distal radio-ulnar joint
When do Galeazzi # typically occur?
Fall on hand with rotational force
In whom do Galeazzi #s present?
Children
What is a Smith #?
Distal radius # a/w volar angulation and displacement (‘Garden spade deformity’)
How are Smith # commonly caused?
Falling onto the POSTERIOR aspect of the outstretched hand
(E.g. by falling backwards or falling with flexed wrists)
Another term for Smith #?
Reverse Colles’ #
When do Galeazzi # typically occur?
Fall on hand with rotational force
What is seen on x-ray in Galeazzi #?
Displaced radial fracture
Prominent ulnar head due to dislocation of inferior radioulnar joint
What is seen on examination in Galeazzi #?
Bruising, swelling, tenderness over lower forearm
What is a Barton’s #?
Distal radius fracture + radiocarpal dislocation
How may Barton’s # occur?
Fall onto extended and pronated wrist
What is the most common type of carpal fracture?
Scaphoid
What does the scaphoid form in the anatomical snuffbox?
Floor
A FOOSH can cause what types of scaphoid fractures?
Tubercle
Waist
Proximal 1/3
Main signs of scaphoid fractures?
Tenderness and swelling in anatomical snuffbox - MAIN
Pain on wrist movement
Pain on longitudinal thumb compression (telescoping)
Ix for suspected scaphoid fracture?
Ulnar deviation AP
How may scaphoid fractures occur?
Direct hard blow to palm
FOOSH
define a monteggia fracture?
proximal third of ulnar shaft
anterior dislocation of radial head at capitellum
mx of unstable fractures?
open repair in adults
manipulation under anaesthesia and cast for children
what is seen in a monteggia fracture on xray?
radiocapitellar line does not pass through middle of capitellum of humerus
what is seen in a galeazzi fracture on xray aside from the fracture?
widened distal radioulnar joint (ap)
ulna displaced dorsally (lat)
what is a chaffeur’s fracture?
intraarticular fracture of radial styloid
due to direct trauma or forced dorsiflexion and abduction of wrist
what is a boxer fracture?
transverse # through MT5
punching hard surface
comps of colles’ fractures?
mal/nonunion
sudek’s atrophy
extensor pollicis longus rupture
median n. injury
carpal tunnel syndrome
frozen shoulder (due to fall causing shoulder injury as well rather than due to fracture itself)
mx of scaphoid fracture?
place wrist in beer glass position and cast it
start treatment even if no initial radiographical evidence of fracture
how does scaphoid AVN present?
pain and stiffness at the wrist
indications for surgery in a boxer’s fracture?
Significant rotation or angulation of the affected fingers.
Articular involvement of the fracture
Multiple metacarpal fractures
Open fractures
most common carpal bone fracture?
scaphoid
then triquetrum
