Wrist and Hand Pathology Flashcards
What does a PA view of the wrist/hand show?
PA of hand, wrist, and distal forearm and oblique view of the thumb
What does an oblique view of the wrist/hand show?
- phalanages, metacarpals, and carpals
What does the lateral view of the wrist/hand show?
True PA projection of the thumb
What is a carpal tunnel view good for determining?
If fx at the hook of hamate
What is a clenched-fist view
To see gaps between the carpal bones and show hand instability
What is a CT scan of the wrist good for?
Determine bone healing after a fx
What is an MRI of the wrist/hand good for?
Viewing avascular necrosis
What is an ultrasound of the hand good for?
Fx and ST injuries + shows real time movement
When would you do a nerve conduction velocity test?
To differentiate a nerve disorder from a mm disorder when nerve involvement is suspected
How long does calcification and remodeling of bone take in primary fx healing?
6 weeks
What do you do for MGT of primary healing
- motion/ST gliding
- edema control
- NO strengthening until week 6 or later
List the 3 stages of bone fx healing
- Inflammatory Stage: tissues weakest
- Repair Stage: soft callus formation
- Remodeling: passive ROM and stretching
When can you begin strengthening post fx?
6-8 weeks later
_% of all Fx are fx of the wrist and hand
15%
What is the most common distal radius fx
Colles Fx
What is a colles fx?
An extra-articular fx that has a dorsal angulation of the distal segment of the radius
What is a Barton’s fx?
A fx at the articular surface that is displaced and unstable w/subluxation of the distal radius (+ dorsal angulation of the distal segment)
What is Smith’s fx
Reverse Colles - palmar displacement of the distal radisu
What is the MOI for a smith fx?
Fall bkwd on an outstretched arm that was supinated w/wrist flexed
What is…
a. Type I Smith Fx
b. Type II Smith Fx
c. Type III Smith Fx
a. Extra-articular
b. volar intra-articular
c. oblique justa-articular
What ligament is a chauffeur’s fx associated w?
Scapholunate ligament injuries
What is a chauffeur’s fx?
Intra-articular radio styolid fx that usually begins at the lunate/scaphoid fossa and then extends laterally
What is the MOI of chauffeur’s fx?
Direct blow to the wrist
What are markers of instability w/a radial fx?
- radial shortening
- dorsal angulation > 20 deg
- Dorsal comminution
- intra-articular radiocarpal fx
- associated ulnar fx
What is the sx goal of radial fx treatment
To obtain and maintain anatomical reduction
