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    Hand and Wrist Injuries 2

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    mateen
    This document discusses various hand and wrist injuries. It covers distal radius fractures, noting differences between elderly vs. young patients and intra-articular vs. extra-articular fractures. Key deformities and how to achieve reduction are outlined. When to refer patients and potential complications are also mentioned. Other topics covered include scaphoid fractures, wrist dislocations, metacarpal fractures including boxer's fractures, Bennett's fracture, and skier's thumb. Phalange fractures of different types are also discussed.

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    Hand and Wrist Injuries 2

    Uploaded by

    mateen
    48 views18 pages
    This document discusses various hand and wrist injuries. It covers distal radius fractures, noting differences between elderly vs. young patients and intra-articular vs. extra-articular fractures. Key deformities and how to achieve reduction are outlined. When to refer patients and potential complications are also mentioned. Other topics covered include scaphoid fractures, wrist dislocations, metacarpal fractures including boxer's fractures, Bennett's fracture, and skier's thumb. Phalange fractures of different types are also discussed.

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    This document discusses various hand and wrist injuries. It covers distal radius fractures, noting differences between elderly vs. young patients and intra-articular vs. extra-articular fractures. Key deformities and how to achieve reduction are outlined. When to refer patients and potential complications are also mentioned. Other topics covered include scaphoid fractures, wrist dislocations, metacarpal fractures including boxer's fractures, Bennett's fracture, and skier's thumb. Phalange fractures of different types are also discussed.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    48 views18 pages

    Hand and Wrist Injuries 2

    Uploaded by

    mateen
    This document discusses various hand and wrist injuries. It covers distal radius fractures, noting differences between elderly vs. young patients and intra-articular vs. extra-articular fractures. Key deformities and how to achieve reduction are outlined. When to refer patients and potential complications are also mentioned. Other topics covered include scaphoid fractures, wrist dislocations, metacarpal fractures including boxer's fractures, Bennett's fracture, and skier's thumb. Phalange fractures of different types are also discussed.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 18

    HAND &WRIST INJURIES

    MUN Orthopedics
    MUN Orthopedics
    Distal Radius Fractures

     elderly vs. young


     intra vs. extra-articular
     “acceptable reduction”
     follow-up

    MUN Orthopedics
    Distal Radius Fractures
    Deformities

     Radial Shortening
     Loss of Radial Tilt (A/P view)
     “Dorsal Angulation” (lateral view)

    MUN Orthopedics
    Distal Radius Fractures
    Reduction

     Traction/Correction of Deformity
     radius = ulna
     radial styloid 1 cm distal
     articular surface at least neutral
    angulation

    MUN Orthopedics
    Distal Radius Fractures
    When to Refer?

     unable to acheive reduction


     unable to maintain reduction in cast
     intra-articular fractures
     acute carpal tunnel syndrome
     open fractures

    MUN Orthopedics
    Distal Radius Fractures
    Complications

     malunion
     compartment syndrome
     nerve entrapment
     tendon rupture
     loss of motion

    MUN Orthopedics
    Distal Radius Fractures

     osteotomy to correct malunion


     DRUJ reconstruction
     tendon reconstruction

    MUN Orthopedics
    Scaphoid Fractures

     most commonly fractured carpal bone


     5-12 % nonunion rate
     when in doubt;cast
     may take 12 weeks to heal

    MUN Orthopedics
    Wrist Dislocations

     perilunate fracture - dislocations


     beware the displaced scaphoid fracture
     require surgical treatment
     best seen on lateral view
     rarely possible to reduce without GA

    MUN Orthopedics
    Metacarpal Fractures

     shaft = rotational deformity


     neck = angulation deformity
     base = usually intraarticular

    MUN Orthopedics
    Boxer’s Fractures

     neck of 5th
     controversy re acceptable reduction
     palmar prominence
     loss of knuckle
     cast position

    MUN Orthopedics
    Bennett’s Fracture

     base of thumb metacarpal


     APL pulls on larger fragment
     unstable & frequently require pinning

    MUN Orthopedics
    Skier’s Thumb

     ulnar collateral ligament avulsion


     with or without bone fragment
     ?? stability
     compare to other side
     less pain often more unstable
     stable 6 weeks cast immobilisation

    MUN Orthopedics
    Phalanx fractures

     shaft = rotation
     base of fifth often hard to see on Xray
     clinical examination critical
     check nail bed orientation
     Xray healing later than clinical

    MUN Orthopedics
    Phalanx fractures

     intraarticular = trouble
     oblique condyle fracture often
    displaces;even after couple of weeks
     PCP or ORIF

    MUN Orthopedics
    Phalanx fractures

     “chip” fractures
     FDP avulsion
     Volar plate injuries(PIP joint dislocation)
     FDP > 10 days not salvageable

    MUN Orthopedics
    Phalanx fractures

     PIP joint sprains may swell > 1year


     extension block splint
     buddy-tape
     rare comminuted fractures require
    surgery
     isolated digit lateral view

    MUN Orthopedics

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