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Foundations III-Musculoskeletal/Rheum > Forearm/Wrist > Flashcards

Flashcards in Forearm/Wrist Deck (56)
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1

What are the different types of adult forearm fractures?

UNSTABLE:
-Both bone forearm fracture
-Galiazzi fracture
-Monteggia fracture

STABLE
Nightstick fracture

2

What is a both bone fx?

Radial shaft fracture
Ulnar shaft fracture

3

What is a glaiazzi fx?

Mid to distal radial shaft

Assoc. carpoulnar dislocation

4

What is a monteggia fx?

Mid to proximal ulnar shaft

Assocradial head dislocation

5

What is a nightstick fracture?

Mid to distal ulnar shaft fracture

stable fx

6

What are some common distal radial fxs in adults?

Colle's (MC)

Smith's

Barton

7

What is a Colle's fracture?

MC

Distal radius fracture fragment is tilted dorsally

+/- involvement of articular surface of radius

+/- ulnar styloid fracture

MOA: FOOSH

8

What is a smith's fx?

Distal radius fracture fragment is tilted ventrally

MOA: wrist down when pt falls

9

What is a barton fx?

Intra-articular fracture associated with dislocation of the carpus

10

What x-ray view should you use to dx a colle's or smiths fx?

lateral view

11

What are colle's fractures reduced?

by closed manipulation

wrist first dorsiflexed, traction initiated as distal and volar thumb pressure applied over distal fragment

12

What is a radial torus "buckle" fx? Who is it MCly seen in?

Distal metaphysis

Buckling of cortex due to compression failure

MC in children <10

13

What is a greenstick fracture?

Complete fx of the tension side of the cortex with buckling of the compression side

On x-ray complete disruption on one side with buckle on opposite side

14

Tx of radial torus "buckle" fracture?

Immobilization x 4-6 weeks (cast or brace)

15

What is the MCly scaphoid fx?

Scaphoid Fractures

16

MOA of scaphoid fx?

FOOSH

Limited blood supply leads to high incidence of nonunion and osteonecrosis

17

Who usually gets scaphoid fx from FOOSH? What about radial fx?

kids/younger pts

older pts

18

Clinical findings of scaphoid fx?

Snuffbox pain / TTP

ROM limitations

19

Management of scaphoid fractures?

Long-arm thumb spica cast x 6-12
weeks

If clinical exam is indicative of fracture but x-rays are negative, cast and repeat x-rays in 10-14 days**

If follow up x-rays still negative but clinical concern persists order MRI

20

What are some complications of scaphoid fxs?

Avascular necrosis or failure to union

tx: internal fixation
or bone graph with anastomosis

21

Describe fractures of the metacarpals and phalanges

Displaced transverse and oblique fractures tend to angulate

Spiral fractures tend to rotate

Displaced*, spiral, comminuted and intra-articular fractures should be referred to specialist for further evaluation

22

What is the MC fx of the hand?

boxer's fracture

23

Describe a boxer's fracture

Distal metaphysis of

5th metacarpal
Results from closed fist striking an object

24

Management of a boxer's fracture?

Ulnar gutter splint <15 degrees (transverse, oblique, base & head)

Surgconsult:
-Intra-articular
-> 15 degrees -angulation
-Comminuted
-Spiral

25

What is DeQuervain’s tenosynovitis?

Inflammation of the sheath that surrounds the abductor pollicus longus and extensor pollicus brevis tendons

Tendon sheath thickens and constricts the tendons

26

Presentation of DeQuervain’s tenosynovitis?

Pain + tenderness in the first dorsal extensor compartment (anatomic snuffbox) aggravated by attempts to move thumb or make a fist

+/-Swelling

Crepitation as patient flexes and extends thumb may be noted

27

What test can be used to eval for DeQuervain’s tenosynovitis?

Finklestein Test: Pain with passive stretching of the tendons

-Direct the patient to place the thumb in their palm.
-Have them cover the thumb with the fingers of the same hand, forming a fist.
-Gently deviate the wrist towards the ulna. This stretches the inflamed tendons over the radial styloid, reproducing the patient's pain.

28

Tx of DeQuervain’s tenosynovitis?

NSAIDs

Thumb spica splint

Avoid offending activity

Steroid injection

29

What is an ulnar collateral ligament sprain?

"Gamekeeper’s thumb” or “Skier’s thumb”

UCL injury at 1st MCP joint
Acute or chronic valgus stress

30

How can you dif. DeQuervain’s tenosynovitis v. scaphoid fx?

hx of traumatic fall with scaphoid fx