Wrist injury and management

Home

Get App

Create

What is a colles fracture
- Transverse fracture of the distal radius
- Dorsal angulation
- Radial shortening
- Dinner fork deformity
What is the management of a colles fracture
- Refer to orthos
- Manipulation
- Back slab
When do colles fractures need manipulating
- >10deg angulation
- Significant shortening
What is the MOI of a colles fracture

FOOSH
What is a smiths fracture
- Reverse colles fracture
- Distal radius fracture
- Volar angulation
What is the MOI of a smiths fracture
- Direct blow to back of hand
- Fall onto flexed wrist
Which is least stable, a colles or smiths fracture

Smiths
What is the management of a smiths fracture

Always refer to orthos
Which age group are most likely to suffer from a colles fracture

Elderly
With a colles fracture, which nerve is likely to show symptoms of parathesia
- Median
- Thumb, index, middle and radial border of ring finger, dorsal and palmar aspect
What is a bartons fracture
- Type of smiths fracture
- Fracture through the articular surface and volar part of distal radius
What is the management of a bartons fracture
- Refer to orthos
- Needs fixation
What are the clinal features of a scaphoid fracture
- ASB tenderness
- Tenderness to scaphoid tubercle
- Pain on axial compression
What is the management of a ? Scaphoid fracture with clinical signs but normal X-ray
- Splint
- 1/7 fracture clinic
What is the management of a scaphoid fracture seen on X-ray
- Backslab
- 1/7 fracture clinic
Why must all patients with scaphoid views be followed up

Fractures may not be seen on X-ray for 5-10 days
What is a galleazzi fracture
- Fracture if the radius with shortening
- Dislocation of distal ulna
- Dorsal angulation
- Often compound
What is a monteggia fracture
- Fracture of the ulna
- Anterior dislocation of the radial head
- Dorsal angulation
What is the mechanism of a monteggia fracture

Direct blow to the forearm
What is the management of a distal radius fracture with no displacement or angulation
- Backslab
- Elevate
- Analgesia
- Fracture clinic
What is the management of a displaced fracture or fracture involving the articular surface
- Backslab
- Elevate
- Analgesia
- NBM
- refer to orthos
What must be remembered about fractures to the ulna shaft
- Isolated fracture is rare
- Look for an associated radial fracture or dislocation of the radial head
What are common caused of non trauma wrist pain
- Referred pain - cervical spondylosis
- Arthropathies
- Soft tissue disorders
What are possible arthropathies affecting the wrist
- Osteoarthritis
- Rheumatoid arthritis
- Septic arthritis
- Crystal deposition - pseudo gout
- Osteochondritis of the lunate
How does septic arthritis present
- No history of trauma
- Hot swollen painful joint
- Systemic sepsis
What investigations are needed for septic arthritis
- Bloods
- ESR
- CRP
What possible soft tissue disorders affect the wrist
- De Querains tenosynovitis
- Ganglion
- Carpal tunnel syndrome
- Paratendonitis
What is De Querains tenosynovitis
- Washer woman's sprain
- Thickening of the EPB and APL tendons
What are the symptoms of De Querains tenosynovitis
- Pain on gripping and lifting
- Possible swelling over the radial styloid
- Thumb extension and abduction is painful
- Finkelsteins test positive
What is the management if De Querains tenosynovitis
- Futura splint
- GP follow up
What are the symptoms of carpal tunnel syndrome
- Compression of the median nerve and symptoms relating to its distribution
- Pain radiating to the elbow
- Weakness or paralysis of the hand
What is the management of carpal tunnel syndrome
- Futura splint
- GP for possible hydrocortisone Injection / referral to surgeons
What is paratendonitis

Inflammation of a specific tendon sheath
What causes paratendonitis
- Infection
- Overuse
- Rheumatoid disease
What are the symptoms of paratendonitis
- Swelling
- Tenderness over the tendon
- Creaking sensation on flexion and extension of the wrist
- Increased pain on ulnar deviation
What is the management of paratendonitis
- Tubigrip or splint
- NSAID
- GP
What is a greenstick fracture
- A break in the periosteum on one side of the bone
- The fracture doesn't pass through to the other side of the bone
What is the MOI of greenstick / buckle fractures
- An angulation force
- FOOSH
what is the management of an isolated radial buckle fracture
- Splint of 3 weeks
- Notes to fracture clinic
When should a buckle fracture be backslabbed and sent to fracture clinic
- Break through both cortexes
- Fracture is too proximal (distance from the physis is > width of the physis)
- Angulation >15deg
- Ulnar buckle also
What is the MOI of a torus fracture

Axial crush of the bone
How does a torus fracture appear on X-ray
- No gap in the cortex
- Bulge where impaction occurred

Author

AnnaCowlishaw

131963

Card Set

Wrist injury and management

Description

Wrist injury and management

Updated

2012-01-31T17:27:20Z

Show Answers