Hand Fractures Flashcards
Boxer’s fracture
- MC neck is compromised due to a compressive force that travels proximately from the MC head towards the base
- typically occurs when head of fifth (and fourth) MC comes in contact with something solid with digits in full composite flexion
Bennet’s fracture
- intra-articular fracture at the first CMC joint
- avulsion of the ulnar aspect of base of the first
- occurs when there is forced first CMC abduction and an axial blow along the MC shaft when the MC is slightly flexed
Management MC fractures
- initial immobilization with radial or ulnar gutter orthosis or cast
- MP 70-90 deg flex, IP 0 deg ext, wrist 20 deg ext
- AROM of all uninvolved joints
- edema control
Bunnell-Littler test
- determines whether stiffness is from intrinsic, extrinsic, or joint capsule tightness
- performed by flexing the IP joints as far as possible with the MP joints extended and then with the MP joints flexed
Intrinsic tightness
IP joint tightness with MP ext but not MP flex
Extrinsic tightness
IP joint tightness with MP flex but not MP ext
Joint capsule tightness
IP joint tightness same with both MP flex and ext
Rolando’s fracture
fracture of the MC base that presents with a “T” or “Y” fracture pattern that splits the articular surface of the base of the first MC
P-1 fracture
proximal phalanx fracture
P-2 fracture
middle phalanx fracture
P-3 fracture
distal phalanx fracture
PIP fracture dislocation
caused by axial compression on semi-flexed or hyperextended digit
results in a dorsal dislocation of the PIP joint