UE & LE Labs

Question 1

Define a Galeazzi fracture

Answer 1

Fx of the distal radial shaft with dislocation of the ulnar/carpal articulation

Question 2

What is the indication, procedure, & positioning for the volar splint?

Answer 2

Indications:

• Soft tissue injuries of the hand and wrist, Carpal bone fractures, 2nd to 5th metacarpal head fractures

Procedure:

• Start at metacarpal heads and end at distal forearm

Positioning:

• Forearm in neutral position with thumb pointing up
• Wrist extended 10-20° (as if holding a can)

Question 3

What is the indication, procedure, & positioning for the sugar tong splint?

Answer 3

Indications:

• Distal radius and/or ulna fracture

Procedure:

• Start at dorsal metacarpal heads and end at volar MCP joints

Positioning:

• Elbow flex to 90°
• Forearm in neutral position with thumb up
• Wrist extended 10-20° (as if holding a can)

Question 4

What is the indication, procedure, & positioning for the thumb spica splint?

Answer 4

Indications:

• Injuries to scaphoid, lunate, thumb and first metacarpal
• Game keepers/skiers thumb
• de Quervain’s tenosynovitis

Procedure:

• Start at mid distal phalanx of thumb, end at mid-forearm

Positioning:

• Forearm in neutral position
• Wrist extended 10 to 20° (as if holding a can)
• Thumb AB-ducted (as if holding a wine glass)

Question 5

What is the indication, procedure, & positioning for the ulnar gutter splint?

Answer 5

Indications:

• 5th digit fractures and/or soft tissue injuries
• 4th and 5th metacarpal fractures of the neck, shaft, and/or base

Procedure:

• start at ulnar side of mid-forearm, end at mid distal phalanx of 4th and 5th digits

Positioning:

• Forearm in neutral position
• Wrist extended 10-20° (as if holding a can)
• MCP flexed 50-70° (90° for boxers fracture)
• Proximal and distal interphalangeal joints flexed 5-10°

Question 6

What is the indication, procedure, & positioning for the long posterior splint?

Answer 6

Indications:

• Olecranon fractures
• Humerus fractures
• Radial head and/or neck fractures

Procedure:

• Start at posterior proximal arm, down the ulnar forearm, end at MCP joints

Positioning:

• Elbow flex 90°
• Forearm in neutral position with thumb pointing up
• Wrist extended 10-20° (as if holding a can)

Question 7

What is the indication, procedure, & positioning for the single finger/fingertip guard splint?

Answer 7

Indications:

• Phalanx fractures and or dislocations
• PIP or MCP dislocations
• Tendon injuries

Procedure:

• Typically use prefabricated splint or cut splinting material to proper size
• Can be placed on dorsal or volar side, extending from fingertip to mid-hand or distal forearm depending on the joints requiring immobilization

Positioning:

• MCP flexed 50°
• Proximal and distal interphalangeal joints flexed 15-20°
• For tendon repair injuries, splint in flexion or extension as indicated

Question 8

What was the elbow imaging?

Answer 8

AP and lateral with elbow flexed

Question 9

What was the forearm imaging?

Answer 9

AP and lateral

Question 10

What was the imaging for the wrist?

Answer 10

AP, lateral and oblique

(the oblique view is helpful for curved or overlapping joints)