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Wrist and Hand injuries

Wrist and Hand injuries. Quick Review: Radius is on the Thumb Side Make sure you can locate AND NAME THE JOINTS OF THE HAND. Metacarpals. 5 bones Numbered 1 through 5 Thumb is #1 Pinky is #5. INJURIES. Colle ’ s Fracture. Involves the distal end of radius Silver fork deformity.

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Wrist and Hand injuries

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  1. Wrist and Hand injuries

  2. Quick Review: Radius is on the Thumb Side Make sure you can locate AND NAME THE JOINTS OF THE HAND.

  3. Metacarpals • 5 bones • Numbered 1 through 5 • Thumb is #1 • Pinky is #5

  4. INJURIES

  5. Colle’s Fracture Involves the distal end of radius Silver fork deformity

  6. Mechanism of Injury – Colle’s • Fall on an outstretched hand • Run into wall, etc, with wrist hyperextended

  7. Signs and Symptoms • Visible deformity—”silver fork” • Swelling • Pain • POT

  8. Complications • Tendons may be torn away from attachment site • Median nerve damage

  9. Care • Splint in position you find it before going to the ER • Ice • ER • 1-2 month recovery time

  10. Signs and Symptoms • Pain with active motion • Pain with passive stretching • POT over either flexor or extensor tendons • Swelling

  11. Treatment • Ice • Heat • Analgesics • Modify activity • NSAIDS • Splint • Strengthening and ROM exercises

  12. Ganglion Cyst • herniation of joint capsule, synovial sheath of tendon or cystic structure • MXN: Appears slowly after repeated forced hyperextension of wrist. • Contains clear mucous fluid • Appears most often on dorsum of hand

  13. Ganglion cyst • S/S: • pain on dorsum of hand that increases with wrist extension • May feel soft and rubbery or hard • May appear bigger with flexion of wrist

  14. Ganglion Cyst

  15. Ganglion cyst

  16. Ganglion cyst

  17. Treatment • Break down swelling with digital pressure and padding • Aspiration and chemical cauterization followed by pressure padding • Will usually come back • Surgical removal

  18. Dislocation of Lunate • MOI: • Forced hyperextension of wrist

  19. Signs and Symptoms • Pain • Swelling • Difficulty moving wrist and fingers into flexion • Numbness/paralysis of flexors due to pressure of lunate on median nerve • deformity

  20. Lunate dislocation

  21. Lunate Dislocation

  22. Treatment • Splint • Ice • Physician referral for reduction • 1-2 month recovery time

  23. Metacarpal (Boxer’s) Fracture • Most common of all metacarpal fractures • Associated with martial arts/boxing • MOI: • direct axial force caused by punching another person or object • Direct impact to hand

  24. Boxer’s fracture

  25. Signs and Symptoms • Swelling • Discloration • Pain with movement

  26. Boxer’s fracture

  27. Treatment • Ice • Splint • Physician referral for x-ray • Reduction and casting (3-4 weeks)

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