Wrist fractures Flashcards
What is meant by a Volar tilt?
Angle of the distal radial surface with respect to a line perpendicular to the shaft
- 10°- 25° is considered normal
- angle of zero or less is indicative of dorsal angulation
What is meant by Radial Inclination?
Angle between one line connecting the radial styloid tip and the ulnar aspect of the distal radius… and a second line perpendicular to the longitudinal axis of the radius.
- Normal range is between 21 - 25 degrees
Loss of radial inclination increases load across the lunate
Give 3 examination findings indicative of a wrist fracture
- Pain and restricted movement at the wrist
- Swelling
- Visible deformity
What fracture is shown below and why?
Colles Fracture ➞ dorsally displaced, extra-articular fracture
What fracture is shown below and why?
Smith’s fracture ➞ low energy, volar displaced, extra-articular
What fracture is shown below and why?
Barton’s fracture ➞ fracture-dislocation of radiocarpal joint with intra-articular fracture involving the volar or dorsal lip
What fracture is shown below and why?
Chauffeur’s Fracture ➞ horizontal radial styloid fracture
What fracture is shown below and why?
Die Punch (lunate fossa) fracture
What factors must we consider when deciding a patients need for surgery?
- age
- hand dominance
- occupation
- level of activity
- quality of bone
- general medical condition
Wrist fracture treatments can be ______ or _______
Non-Operative or Operative
Give 3 operative treatments for a wrist fracture and what type of fracture each is best for?
- MUA and K wires ➞ 2 part non-comminuted fractures
- Volar locking plating ➞ best for comminuted, shortened osteoporotic fractures OR Smith’s and volar Barton’s fractures
- External fixation ➞ less used due to versatility of volar locking plate, but good for high energy multifragmentary fractures. Works via ligamentotaxis.
Give 4 complications of operative treatment of fractures
DOUBLE CHECK
