Wrist Injuries

Question 1

Most common fracture in wrist

Answer 1

Scaphoid

Question 2

Mechanism of scaphoid # (2)

Answer 2

1 FOOSH 2 with forced dorsiflexion

Question 3

Visual sign for scaphoid # with effusion

Answer 3

Fullness in anatomical snuffbox

Question 4

Borders of anatomical snuffbox including floor and roof (5)

Answer 4

Proximal, styloid process of radius; Radial, EPB and APL; Ulnar, EPL; Roof, skin; Floor, schaphoid and trapezium

Question 5

Use of anatomical snuffbox tenderness in assessing wrist injury

Answer 5

Suggests scaphoid #

Question 6

Use of scaphoid tubercle tenderness in assessing wrist injury

Answer 6

Suggests scaphoid #

Question 7

Most predictive sign of scaphoid # o/e

Answer 7

Scaphoid tubercle tenderness (volar surface)

Question 8

‘Move’ sign suggesting scaphoid # o/e (2)

Answer 8

1 Pain on pronation 2 followed by ulnar deviation

Question 9

How is ? scaphoid # investigated radiographically

Answer 9

Scaphoid series film

Question 10

False negative rate of scaphoid series films

Answer 10

<5%

Question 11

Usual site of scaphoid #

Answer 11

Waist

Question 12

Treatment of scaphoid # (2)

Answer 12

1 below elbow cast 2 for 8 weeks

Question 13

Time for scaphoid # healing

Answer 13

Up to 12 wk

Question 14

Indications for ORIF in scaphoid # (3)

Answer 14

1 displacement >1mm 2 proximal pole # 3 non union at 12 wk

Question 15

Common complications in scaphoid # (3)

Answer 15

1 non union 2 avascular necrosis 3 degenerative change

Question 16

Treatment in non-union of scaphoid #

Answer 16

ORIF

Question 17

Reason for high rate of complications in scaphoid # (especially proximal pole)

Answer 17

Retrograde blood supply commonly disrupted

Question 18

Treatment in scaphoid # with avascular necrosis (2)

Answer 18

1 Internal fixation 2 with vascularied bone graft

Question 19

Treatment of scaphoid # showing degenerative change

Answer 19

Limited wrist fusion