Hand a wrist Flashcards
Which is the most common bone to fracture is your hand
Scahoid
what percentage of carpal bone fractures does scaphiod fracture make up
70-80%
most common mechanism of action for fracture of a scaphoid bone
fall on a out streached hand
hyperextension and impact of the scaphoid against the rim of the radius
patients with scaphoid fracture complain on
pain in the anatomical stuffbox
pain worsten by moving wrist
swelling around the radial and posterior aspects of the wrsit
fractures in the scaphoid occur in what region of scaphoid
waist of the scahoid (70-80%)
if fractures of the scaphoid do not occur at the waist where will they occur
occur in the proximal pole (20%)
or the distal pole (10%) AKA scaphoid tubercle
a fracture taken immediately after a injury is likely to show how on a x ray
may not reveal fracture
why is late diagnosis of carpal bone fracture common
cant see the fracture on a x-ray until 10-14 days after
why are carpal bone fractures more commonly seen on a x ray 10-14 days after
fracture line may become more visible after some bone reasorption
if still not sure of a scaphoid fracture after 10-14 days x ray what other imaging techniques can you use?
CT or MRI
Descrivbe the blood supple to the proximal pole of the scaphoid
retrograde
tenuous (weak)
fractures through the waist of the scaphoid can cause
avascular necrosis
displacements fractures through the wasit of the scaphoid have high risk of
non-union
malunion
avasualr necrosis
late complications of carpal instability and secondary oestoarthritis
colles’ fracture
an extra articular fracture of the distal radial metaphysis, with dorsal angulation and impaction
what kind of fracture do you also see in 50% of colles fractures
ulnar styloid fracture
colles’ fractures are commonly seen in
people with osteoporosis (reduced bone density)
post- menopausal women
high impact trauma
mechanism of injury for colle’s fracture
fall onto a outstretched hand with a pronated forearm and wrist in dorsiflexion
how patients present with colles’ fracture
painful
deformed
swollen wrist
x ray of colles’ fracture
dorsal angulation and impaction are usually visible on plain x-ray
how to treat colles’s fractrure
reduction and immobilisation in a cast
complications of colles’ fracture healing
malunion median nerve paldy and post traumatic carpal tunnel syndrome secondary osteoarthitis (more common with intra-articular fractures) tear of the extensor pollicis longus tendon (through attrition of the tendon over a shape fragment of bone
Smiths fracture
fracture of the distal radius with palmar angulation of the distal fracture fragment
smiths fractures can be though as the oppostie to
colles’ fracture
mechanism of injury for smith fracture
fall onto a flexed wrist or a direct ow to the back of the wrist