Wrist (RITA) Flashcards Preview

Musculoskeletal Pathophysiology > Wrist (RITA) > Flashcards

Flashcards in Wrist (RITA) Deck (33):
1

What is the name of fx that occurs 1.5" proximal to distal end of radius?

"colles fx"
distal radius fx

2

CRPS is also known as

RSD
reflex sympathetic dystrophy

3

Post colles fx, what complication is most common?

malignment/malunion of fragments resulting in joint incongruity

4

With a smith fx, what type of complication is most common?

median nerve injury

5

What factors influence fx management?

mechanism of injury
anatomical location
relationship of fragments
stable fx - cast immobilization
pintrack infection

6

Goals with colles fx?

maximize pain-free ROM
strength
UE fxn

7

With colles fx, if radius is dorsally angulated, what motions are limited and why?

limited flex/ext because of impaired glide of proximal row of carpals on radius

8

The radius should be slightly _____ tilted.

volarly tilted

9

If the radius is tilted _____, it impairs ROM.

dorsally

10

What is normal and functional wrist flex/ext ROM?

normal 70/80
functional 40/40

11

What is normal and functional wrist RD/UD ROM?

normal 15/30
functional 15/15

12

What is normal and functional wrist Sup/Pron ROM?

normal 80/70
functional 50/50

13

What signifies that fx is stable enough to withstand AROm and case can be removed.

Callus formation

14

What percept of all carpal fxs are scaphoid fxs?

60-70%

15

What percent of scaphoid fxs occur in the middle of the bone?

70%

16

Fx to which pole of the scaphoid heals faster?

proximal pole heals slower than distal

17

What are common clinical findings with scaphoid fractures?

radiologic evidence not always common early on
hx of high force hyperextension injury
pain in snuff box region
decreased pinch grip strength

18

Healing of scaphoid depends on

coaptation of fragments
adequate blood supply
early dx and adequate rx (immobilization from injury until union)

19

For fx at proximal pole of scaphoid, what is healing time?

up to 30 weeks

20

For fx at middle 1/3 of scaphoid, what is healing time?

6-12 weeks

21

For fx at distal 1/3 of scaphoid, what is healing time?

4-8 weeks

22

What intrinsic complications can contribute to non-union of scaphoid fxs?

displacement of fx >1mm
instability b/w prox and distal carpal rows

23

What extrinsic complications can contribute to non-union of scaphoid fxs?

delayed diagnosis
inadequate mobilization

24

Management considerations for scaphoid fxs?

beware of extremes of ROM
beware of excessive loading during ADL/sports

25

Lunate fxs mostly affect ____ pole of the bone.

volar

26

Common complication of lunate fx?

kienbock's disease

27

What does kienbock's disease result in?

AVN of the lunate
(collapse)

28

What are predisposing factors to kienbocks?

pattern of intrinsic blood supply
negative ulnar variance
radial slope

29

Age incidence of lunate fxs?

20-40

30

Gender incidence of lunate fxs?

2:1
Male:Female

31

Lunate avascular necrosis is treated with:

surgery

32

What are some surgical interventions for lunate avascular necrosis?

external fixator
revasculation with pronator flap
silocone arthroplasty
carpal fusion procedures
salvage procedures

33

Describe salvage procedures:

proximal row carpectomy/wrist arthrodesis