Flashcards in Forearm/Wrist Deck (56)
What are the different types of adult forearm fractures?
-Both bone forearm 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
What are some common distal radial fxs in adults?
What is a Colle's fracture?
Distal radius fracture fragment is tilted dorsally
+/- involvement of articular surface of radius
+/- ulnar styloid fracture
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?
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?
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?
MOA of scaphoid fx?
Limited blood supply leads to high incidence of nonunion and osteonecrosis
Who usually gets scaphoid fx from FOOSH? What about radial fx?
Clinical findings of scaphoid fx?
Snuffbox pain / TTP
Management of scaphoid fractures?
Long-arm thumb spica cast x 6-12
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?
Describe a boxer's fracture
Distal metaphysis of
Results from closed fist striking an object
Management of a boxer's fracture?
Ulnar gutter splint <15 degrees (transverse, oblique, base & head)
-> 15 degrees -angulation
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
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
Crepitation as patient flexes and extends thumb may be noted
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.
Tx of DeQuervain’s tenosynovitis?
Thumb spica splint
Avoid offending activity
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