Hand/Wrist

Question 1

List the most common hand / wrist injuries

Answer 1

• Fractures from falls
• Work related injuries (distal phalanges 50% of hand fractures) (butchers most at risk)
• Sports related injuries (triangular fibrocartilage complex tears)
• Compression neuropathies usually from repetitive strain:
  Carpal tunnel (median nerve) (hair dressers most at risk) Ulnar tunnel (usually d/t a mass)
  De quervains tenosynovitis (synovial sheath of abductor pollicis longus and extensor pollicis brevis tendons)

Question 2

Falls typically result in fracture of what bones in the hand/wrist?

Answer 2

• Adult = distal radius, scaphoid, lunate
• Children = distal radius

Question 3

List the order of diagnostic imaging choices for the hand/wrist

Answer 3

1. X-rays (initial screen, fracture, dislocations
2. CT (carpal collapse) – good for picking up carpal tunnel
3. MRI (radiographically occult fractures that don’t show up on x-ray)
4. US (ganglia, tenosynovitis, carpal tunnel, guiding interventional procedures)