Wrist and Fingers Flashcards
What is the most common carpal injury?
Scaphoid
What is the second most common carpal injury?
Triquetral chip fracture
What is the third most common carpal injury?
Hamate
The majority of scaphoid fractures (70%) occur where?
Waist (middle 1/3)
Where would a patient with a scaphoid fracture point to an area of pain?
Snuffbox
There is a higher likelihood of complications when a scaphoid fracture is in which direction?
More posterior
What is the best view to assess a scaphoid fracture?
P-A with ulnar deviation (flexion)
How does an area of scaphoid AVN occur on plain film?
Area of white density
What is the name of the sign where a large gap is seen between the lunate and scaphoid?
Terry Thomas sign
What X-ray view is used for a triquetral fracture?
Only lateral
What usually causes a triquetral fracture?
Avulsion from ligaments
What is a big sign on X-ray for a hamate fracture?
No hook present
What is the most common carpal dislocation?
Perilunate dislocation
What is the second most common carpal dislocation?
Lunate dislocation (anterior)
In what type of carpal dislocation does everything move relative to the lunate?
Perilunate
What is the normal amount of joint space between the carpal bones?
1-2 mm
What is the mechanism of injury for a perilunate dislocation?
FOOSH
What is a common fracture to be associated with a perilunate dislocation?
Scaphoid (75%)
With a perilunate dislocation, in which direction does everything go except the lunate?
Posterior
The “pie sign” is associated with what injury?
Anterior lunate dislocation
What is the mechanism of injury for an anterior lunate dislocation?
Hyperextension
What is the most common carpal instability pattern?
Rotatory subluxation of the scaphoid
A Terry Thomas sign greater than 4mm is associated with what carpal instability pattern?
Rotatory subluxation of scaphoid
What is the X-ray sign associated with a rotatory subluxation of scaphoid?
Ring sign
What is the “ring sign”?
The scaphoid appears round in shape instead of kidney bean
What is the diagnosis if both a ring sign and Terry Thomas sign are present?
Rotatory subluxation of the scaphoid
What is the name of the fracture occurring at the neck of the metacarpals?
Boxer’s/Bar Room
What causes a Bar Room fracture?
Direct blow with the fist
What is unique about the visibility of a Boxer’s fracture on X-ray?
Visible on all views of the hand
What is the most common location for a Boxer’s fracture?
5th digit
What is the term for the condition of an avulsion of the extensor tendon at its insertion on the dorsal surface of the base of the distal phalanx?
Baseball/Mallet finger
What is the appearance of a baseball or mallet finger?
Forced hyper flexion at distal phalanx
What specific tendon is involved with baseball/mallet finger?
EXTENSOR tendon (leading to hyper flexion appearance)
What are the two injuries to the thumb that are intraarticular?
Bennett’s and Rolando’s
Fractures of the first metacarpal usually involve what part?
Proximal portion (75%)
What is the most common injury to the first metacarpal?
Bennett’s fracture
What is a Bennett’s fracture?
Oblique fracture at the base of the first metacarpal associated with dorsal subluxation of the first metacarpal
What causes the displacement seen with a Bennett’s fracture?
Abductor pollicis longus muscles
Which is a simple fracture: Bennett’s or Rolando’s?
Bennett’s
Which is a comminuted fracture: Bennett’s or Rolando’s?
Rolando’s
What valgus injury is a partial or complete disruption of the ulnar collateral ligament and may have an avulsed fragment?
Gamekeeper’s thumb
The avulsion involved with Gamekeeper’s thumb comes off of what bone?
Proximal phalanx
What kind of stress causes a Gamekeeper’s thumb?
Valgus
It’s important to not get the fragment seen with Gamekeeper’s thumb confused with what piece of anatomy?
Sesamoid bone seen by the head of the first metacarpal
What is another name for Gamekeeper’s thumb?
Skier’s thumb
What is the most common direction of dislocation of the hand?
Dorsal
