Hand and Wrist Fractures Flashcards
What is this a presentation of?
Osteoporotic woman, FOOSH, dorsal displacement of distal radius.
Colle’s fracture
What is this a presentation of?
Osteoporotic woman, FOOSH, volar displacement of distal radius.
Smith’s fracture (reverse Colle’s)
What is the management for a distal radial fracture (Colle’s/Smith’s)?
- Closed reduction using Bier’s block (especially if elderly).
- Surgical open reduction internal fixation or K wires (especially if young).
What is this a presentation of?
Fall and hyperextension of wrist, pain in anatomical snuffbox, pain on ulnar deviation of pronated wrist and on resisted supination.
Scaphoid fracture
What is the main complication of a scaphoid fracture?
Fracture through the waist - avascular necrosis of proximal pole due to retrograde blood supply from distal pole.
How is a scaphoid fracture investigated?
Specific scaphoid series x-ray, if -ve and high suspicion then MRI.
What is the management for a scaphoid fracture?
Cast if clinical signs of a fracture even if x-ray -ve, repeat x-ray in 2 weeks, surgery if displaced fracture.
What is this a presentation of?
Pain inside hand following a punch.
Metacarpal fracture (5th most commonly)
How is a metacarpal fracture investigated and managed?
- X-ray
2. Splint/cast for 2 weeks if stable and closed fracture, unstable fractures - k wires/open reduction internal fixation
What is a proximal phalangeal associated with and how is it managed?
- Rotational deformity
2. Open reduction internal fixation
How is a middle phalangeal fracture managed?
Splint in flexion, strap finger to neighbour.
What causes a Mallet finger and how is it managed?
- Blow to extended finger, rupture of extensor tendon at distal phalanx, flexion of DIP.
- Splint for 6 weeks, surgery if refractory.
What is Boutonniere deformity?
Flexion at PIP, hyperextension of DIP, can be acute or secondary to RA.
