Wrist and Hand Pathology

Question 1

What does a PA view of the wrist/hand show?

Answer 1

PA of hand, wrist, and distal forearm and oblique view of the thumb

Question 2

What does an oblique view of the wrist/hand show?

Answer 2

• phalanages, metacarpals, and carpals

Question 3

What does the lateral view of the wrist/hand show?

Answer 3

True PA projection of the thumb

Question 4

What is a carpal tunnel view good for determining?

Answer 4

If fx at the hook of hamate

Question 5

What is a clenched-fist view

Answer 5

To see gaps between the carpal bones and show hand instability

Question 6

What is a CT scan of the wrist good for?

Answer 6

Determine bone healing after a fx

Question 7

What is an MRI of the wrist/hand good for?

Answer 7

Viewing avascular necrosis

Question 8

What is an ultrasound of the hand good for?

Answer 8

Fx and ST injuries + shows real time movement

Question 9

When would you do a nerve conduction velocity test?

Answer 9

To differentiate a nerve disorder from a mm disorder when nerve involvement is suspected

Question 10

How long does calcification and remodeling of bone take in primary fx healing?

Answer 10

6 weeks

Question 11

What do you do for MGT of primary healing

Answer 11

• motion/ST gliding
• edema control
• NO strengthening until week 6 or later

Question 12

List the 3 stages of bone fx healing

Answer 12

1. Inflammatory Stage: tissues weakest
2. Repair Stage: soft callus formation
3. Remodeling: passive ROM and stretching

Question 13

When can you begin strengthening post fx?

Answer 13

6-8 weeks later

Question 14

_% of all Fx are fx of the wrist and hand

Answer 14

15%

Question 15

What is the most common distal radius fx

Answer 15

Colles Fx

Question 16

What is a colles fx?

Answer 16

An extra-articular fx that has a dorsal angulation of the distal segment of the radius

Question 17

What is a Barton’s fx?

Answer 17

A fx at the articular surface that is displaced and unstable w/subluxation of the distal radius (+ dorsal angulation of the distal segment)

Question 18

What is Smith’s fx

Answer 18

Reverse Colles - palmar displacement of the distal radisu

Question 19

What is the MOI for a smith fx?

Answer 19

Fall bkwd on an outstretched arm that was supinated w/wrist flexed

Question 20

What is…
a. Type I Smith Fx
b. Type II Smith Fx
c. Type III Smith Fx

Answer 20

a. Extra-articular
b. volar intra-articular
c. oblique justa-articular

Question 21

What ligament is a chauffeur’s fx associated w?

Answer 21

Scapholunate ligament injuries

Question 22

What is a chauffeur’s fx?

Answer 22

Intra-articular radio styolid fx that usually begins at the lunate/scaphoid fossa and then extends laterally

Question 23

What is the MOI of chauffeur’s fx?

Answer 23

Direct blow to the wrist

Question 24

What are markers of instability w/a radial fx?

Answer 24

• radial shortening
• dorsal angulation > 20 deg
• Dorsal comminution
• intra-articular radiocarpal fx
• associated ulnar fx

Question 25

What is the sx goal of radial fx treatment

Answer 25

To obtain and maintain anatomical reduction