Wrist Pathologies

Question 1

Distal Radius Fx: MOI

Answer 1

FOOSH

Question 2

Distal Radius Fx: populations

Answer 2

Younger (skateboard, rollerskating, etc.)

Question 3

Distal Radius Fx: indications for reduction

Answer 3

Displaced
Intra-articular, minimally-displaced

Question 4

Distal Radius Fx: indications for surgery

Answer 4

Extra-articular, comminuted
Reduction failed

Question 5

Colle’s Fx: radius moves ____ due to what MOI?

Answer 5

posterior
FOOSH

Question 6

Smith’s Fx: radius moves ____ due to what MOI?

Answer 6

anterior
fall on back of hand

Question 7

Distal Radius Fx: post-op rehab (3 phases)

Answer 7

Wk 1-2: pain, stiffness.
Wk 2-8: ROM.
Wk 8+: function, strength.

Question 8

TFCC function

Answer 8

Stabilize DRUJ
Taut during forearm rotation
Transmit force thru wrist

Question 9

DRUJ function

Answer 9

Forearm rotation

Question 10

Ulnar head moves ___ with pronation

Answer 10

dorsal

Question 11

Ulnar head moves ___ with supination

Answer 11

volar

Question 12

DRUJ instability causes

Answer 12

Hx of trauma (FOOSH in pronation; traction injuries).

Question 13

DRUJ instability treatment

Answer 13

Custom orthosis
Surgical tendon graft if highly unstable

Question 14

Most commonly involved structure with RA

Answer 14

DRUJ

Question 15

TFCC tears causes

Answer 15

Distal radius &/or ulna fx

Question 16

ECU instability cause

Answer 16

Lax dorsal extensor compartment

Question 17

ECU instability treatment

Answer 17

Ulnar Gutter Orthosis - limits UD

Question 18

FCR/FCU tendonitis symptoms

Answer 18

edema
crepitus
pain w/ isometrics

Question 19

Traumatic TFCC Disc tear MOI

Answer 19

Forearm rotation + force transmitted thru ulnar side (forcibly twisted while gripping or FOOSH)

Question 20

TFCC Disc vascularity

Answer 20

Central: avascular, poor healing.
Periphery: vascular, can be surgically repaired.

Question 21

Degenerative TFCC Disc tear occurs in what part of the disc?

Answer 21

Central - avascular, cannot be repaired surgically.

Question 22

TFCC Disc tear symptoms

Answer 22

Pain with UD
Pain with grip
Clicking
TTP

Question 23

TFCC Disc tear treatment

Answer 23

Ulnar gutter orthosis

Question 24

Ulnar N compression treatment

Answer 24

Neutral wrist orthosis

Question 25

Carpal Fx (generally): vascularity & healing potential

Answer 25

Not good blood supply, difficult to heal

Question 26

Carpal Fx (generally): complications

Answer 26

Neuropathy
Carpal Tunnel Syndrome
Dorsal radial sensory N irritation

Question 27

Most common carpal Fx

Answer 27

Scaphoid

Question 28

Scaphoid Fx: populations

Answer 28

M > F
Age 15-30

Question 29

Scaphoid Fx: MOI

Answer 29

Hyperext + RD (FOOSH)

Question 30

Scaphoid Fx: most commonly occurs on which part?

Answer 30

Waist (70%)

Question 31

Scaphoid Fx: which part has the highest risk of AVN?

Answer 31

Proximal pole

Question 32

Lunate Fx: MOI

Answer 32

FOOSH

Question 33

Lunate Fx: major complication

Answer 33

Kienbock’s Disease - AVN of lunate

Question 34

Hammate Fx: MOI

Answer 34

Force thru palm + forceful gripping (golf, tennis)

Question 35

Hammate Fx: often combo with…

Answer 35

Ulnar Neuropathy
Flexor Tendon Rupture

Question 36

Carpal Fx - general rehab

Answer 36

Long term immobilization.
Acute: once cast off, control edema, thumb/finger ROM.
Strengthen once bone/lig healed (3mo).

Question 37

Carpal Instabilities (DISI/VISI) causes

Answer 37

tumor
necrosis

Question 38

Carpal Instabilities (DISI/VISI) best outcomes if…

Answer 38

diagnosed within 6 weeks

Question 39

DISI

Answer 39

Lunate abnormally extends.
Causes scapho-lunate dissociation.
SL ligament may tear.

Question 40

VISI

Answer 40

Lunate abnormally extends.
Causes lunate-triquetrum dissociation.
SL ligament may tear.

Question 41

Carpal Instabilities (DISI/VISI) rehab

Answer 41

Re-train FCR for stability