1 / 18

HAND &WRIST INJURIES

HAND &WRIST INJURIES. Distal Radius Fractures. elderly vs. young intra vs. extra-articular “acceptable reduction” follow-up. Distal Radius Fractures Deformities. Radial Shortening Loss of Radial Tilt (A/P view) “Dorsal Angulation” (lateral view). Distal Radius Fractures Reduction.

beaumont
Download Presentation

HAND &WRIST INJURIES

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. HAND &WRIST INJURIES

  2. Distal Radius Fractures • elderly vs. young • intra vs. extra-articular • “acceptable reduction” • follow-up

  3. Distal Radius FracturesDeformities • Radial Shortening • Loss of Radial Tilt (A/P view) • “Dorsal Angulation” (lateral view)

  4. Distal Radius FracturesReduction • Traction/Correction of Deformity • radius = ulna • radial styloid 1 cm distal • articular surface at least neutral angulation

  5. Distal Radius FracturesWhen to Refer? • unable to acheive reduction • unable to maintain reduction in cast • intra-articular fractures • acute carpal tunnel syndrome • open fractures

  6. Distal Radius FracturesComplications • malunion • compartment syndrome • nerve entrapment • tendon rupture • loss of motion

  7. Distal Radius Fractures • osteotomy to correct malunion • DRUJ reconstruction • tendon reconstruction

  8. Scaphoid Fractures • most commonly fractured carpal bone • 5-12 % nonunion rate • when in doubt;cast • may take 12 weeks to heal

  9. Wrist Dislocations • perilunate fracture - dislocations • beware the displaced scaphoid fracture • require surgical treatment • best seen on lateral view • rarely possible to reduce without GA

  10. Metacarpal Fractures • shaft = rotational deformity • neck = angulation deformity • base = usually intraarticular

  11. Boxer’s Fractures • neck of 5th • controversy re acceptable reduction • palmar prominence • loss of knuckle • cast position

  12. Bennett’s Fracture • base of thumb metacarpal • APL pulls on larger fragment • unstable & frequently require pinning

  13. 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

  14. 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

  15. Phalanx fractures • intraarticular = trouble • oblique condyle fracture often displaces;even after couple of weeks • PCP or ORIF

  16. Phalanx fractures • “chip” fractures • FDP avulsion • Volar plate injuries(PIP joint dislocation) • FDP > 10 days not salvageable

  17. Phalanx fractures • PIP joint sprains may swell > 1year • extension block splint • buddy-tape • rare comminuted fractures require surgery • isolated digit lateral view

More Related