Hand, wrist, elbow- bones and joints Flashcards
List the carpal bones
proximal: scaphoid, lunate, triquetrum, pisiform
distal: trapezium, trapezoid, capitate, hamate
What motions are possible at the elbow?
bending- flexion/ extension
rotation- pronation and supination
What motions are possible at the wrist?
multiplanar movement- flexion/ extension and radial/ ulnar deviation
In radiographs of the wrist, ________ should not overlap
Gilula’s lines- between proximal and distal rows of carpal bones
In radiographs of the wrist, ________ should not overlap
Gilula’s lines- between proximal and distal rows of carpal bones
Distinguish between direct and indirect bone healing
direct: bones are rigidly fixed, no callus formation
indirect: periosteal healing via callus formation
List four factors that contribute to greater incidence of non-healing of scaphoid fractures
- poor blood supply
- delayed diagnosis
- intra-articular location
- mechanical instability
The more _____ a scaphoid fracture, the farther away from blood supply and less likely to heal it is
proximal
The wrist should be immobilized if a patient has __________ tenderness after a fall
anatomic snuffbox
_____ could aid in earlier diagnosis of scaphoid fractures
MRI
How does intra-articular location contribute to non-healing of scaphoid fractures?
scaphoid is covered in cartilage, so no callus formation and no periosteum contributing to healing cells
________ scaphoid fractures are often not evident on initial radiographs and may not be visible for several weeks
non-displaced
List some strategies to improve scaphoid healing
- improve blood supply using vascularized bone grafts
- restore mechanical stability by rigid internal screw fixation
________ are the most common fractures of the hand and wrist
distal radial fractures
Distal radial fractures often cause angulation leading to a classic ______ appearance
dinnerfork deformity
Angulated fractures of the fifth metacarpal are also called ______ fractures
Boxer’s
How to boxer’s fractures usually occur?
striking another person or object
Intra-articular fractures of the first metacarpal caused by axial load against a flexed metacarpal are also called _______ fractures
Bennett’s
Why are Bennett’s fractures often unstable?
free articular fragment is held in place by stout ligaments, while the metacarpal is adducted by the adductor and pulled proximally by the abductor policis longus
________ fractures often occur in conjunction with distal radial fractures
Ulnar styloid
________ fractures often occur in conjunction with distal radial fractures
Ulnar styloid
______ is a common subtype of phalangeal fracture
mallet fractures
What injury occurs when the ulnar collateral ligament of the thumb metacarpophalangeal joint pulls its distal bony insertion away from the rest of the proximal phalanx?
Bony skier’s thumb
– a ligamentous bony avulsion
Mallet finger is due to ________ tendon tear and can be have bony avulsion as well
extensor
