Forearm/Wrist Flashcards
What are the different types of adult forearm fractures?
UNSTABLE:
- Both bone forearm fracture
- Galiazzi fracture
- Monteggia fracture
STABLE
Nightstick fracture
What is a both bone fx?
Radial shaft fracture
Ulnar shaft fracture
What is a glaiazzi fx?
Mid to distal radial shaft
Assoc. carpoulnar dislocation
What is a monteggia fx?
Mid to proximal ulnar shaft
Assocradial head dislocation
What is a nightstick fracture?
Mid to distal ulnar shaft fracture
stable fx
What are some common distal radial fxs in adults?
Colle’s (MC)
Smith’s
Barton
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
What is a smith’s fx?
Distal radius fracture fragment is tilted ventrally
MOA: wrist down when pt falls
What is a barton fx?
Intra-articular fracture associated with dislocation of the carpus
What x-ray view should you use to dx a colle’s or smiths fx?
lateral view
What are colle’s fractures reduced?
by closed manipulation
wrist first dorsiflexed, traction initiated as distal and volar thumb pressure applied over distal fragment
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
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
Tx of radial torus “buckle” fracture?
Immobilization x 4-6 weeks (cast or brace)
What is the MCly scaphoid fx?
Scaphoid Fractures
MOA of scaphoid fx?
FOOSH
Limited blood supply leads to high incidence of nonunion and osteonecrosis
Who usually gets scaphoid fx from FOOSH? What about radial fx?
kids/younger pts
older pts
Clinical findings of scaphoid fx?
Snuffbox pain / TTP
ROM limitations
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
What are some complications of scaphoid fxs?
Avascular necrosis or failure to union
tx: internal fixation
or bone graph with anastomosis
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
What is the MC fx of the hand?
boxer’s fracture