Wrist Fractures. Wrist Defined: Carpal Bones Distal Radius Distal Ulna

Size: px
Start display at page:

Download "Wrist Fractures. Wrist Defined: Carpal Bones Distal Radius Distal Ulna"

Transcription

1 Wrist Fractures

2 Wrist Fractures Wrist Defined: Carpal Bones Distal Radius Distal Ulna

3 Wrist Fractures Wrist Joints: CMC Intercarpal Radiocarpal DRUJ drudge

4 Wrist Fractures Wrist Fractures: (that we are going to discuss) Scaphoid Distal Radius Distal Ulna

5 Wrist Fractures: Scaphoid Scaphoid Fx

6 Wrist Fractures: Scaphoid Fate of Nonunions: Mack Years: Pan Carpal Arthritis Ruby % DJD If Nonunion > 5 Years Duppe 1994 Arthritis Symptomatic United 1/47 3/47 Ununited 4/9 5/9

7 Wrist Fractures: Scaphoid 1 3 2

8 Wrist Fractures: Scaphoid 4 5

9 Wrist Fractures: Scaphoid Suspect Scaphoid Fx s s!!! Hx : Fall on Outstretched Hand Pain : anatomic snuffbox Pain : with scaphoid compression Xray : Normal

10 Wrist Fractures: Scaphoid Suspect Scaphoid Fx s s!!! Over treat : Short Arm Thumb Spica Re Xray : Two Weeks (AP, Lat, Scaphoid Oblique)

11 Wrist Fractures: Scaphoid Suspect Scaphoid Fx s s!!! I I gotta know and money is no object MR Scan will be positive within hours Bone Scan will be positive within days

12 Wrist Fractures: Scaphoid Scaphoid Fx : Fx line visible, No displacement Rx: long vs short arm thumb spica

13 Wrist Fractures: Scaphoid Scaphoid Fx : Fx line visible & Fx displaced Rx: Consider ORIF Need for fixation is relative to Fx location

14 Wrist Fractures: Scaphoid

15 Wrist Fractures: Scaphoid

16 Wrist Fractures: Scaphoid 1. Tubercle Fx Rx: Splint 2. Waist Fx 1 Rx: >1mm Displaced ORIF Proximal Pole Rx: You see it You fix it

17 Wrist Fractures: Scaphoid 36 weeks

18 Wrist Fractures: Scaphoid Another weeks?

19 Wrist Fractures: Scaphoid 2 weeks in splint 10% motion loss, no strength loss 6 wks post

20 Wrist Fractures: Scaphoid Non union: A Simple Problem Made Difficult

21 Wrist Fractures: Scaphoid Bone Graft Technically demanding

22 Wrist Fractures: Scaphoid Bone Graft 1 year of wrist protection 1 year limited use 30% motion loss 30% strength loss

23 Wrist Fractures: Scaphoid Conclusions: In most cases Non Op Rx is truly radical & Op Rx is conservative

24 Wrist Fractures: Scaphoid Refer Early!

25 Wrist Fractures: Distal Radius after a period time.all do well Abraham Colles

26 Wrist Fractures: Distal Radius after a period time.all do well Abraham Colles

27 Wrist Fractures: Distal Radius Distal radius fx s s differ in: Mechanism of injury Energy of injury Articular involvement Associated Injuries

28 Wrist Fractures: Distal Radius Simple Bending

29 Wrist Fractures: Distal Radius Compression: Most Common Low & high Energy

30 Wrist Fractures: Distal Radius Shearing: Inherently Unstable

31 Wrist Fractures: Distal Radius Fx Dislocation: Deceptively Simple

32 Wrist Fractures: Distal Radius Combined Complex: High Energy Comminuted Open

33 Wrist Fractures: Distal Radius Treatment Goals Begin with the end in mind! David Covey

34 Wrist Fractures: Distal Radius Treatment Goals Radial incl > 5 5 Tilt neutral + Length neutral Gaps < 2 mm Step off < 2 mm Stable DRUJ

35 Wrist Fractures: Distal Radius Treatment Based On: Demand Low Demand: Minimal Treatment High Demand: CRPP vs ORIF

36 Wrist Fractures: Distal Radius Treatment Based On: Three Xray Parameters Metaphyseal Stability Articular Step Off / Gaps DRUJ Stability (after radius fixation)

37 Wrist Fractures: Distal Radius What is stable? 1. Easily Reduced 2. Transverse Fx Pattern 3. Minimal Dorsal Comminution 4. No Articular Step Off 5. Maintains Reduction: > 3 Weeks

38 Wrist Fractures: Distal Radius What is Unstable? 1. Can t t Reduce

39 Wrist Fractures: Distal Radius What is Unstable? 1. Can t t Reduce 2. Lose Reduction

40 Wrist Fractures: Distal Radius What is Unstable? 1. Can t t Reduce 2. Lose Reduction 3. Comminution > 1/3 AP Diameter

41 Wrist Fractures: Distal Radius What is Unstable? 1. Can t t Reduce 2. Lose Reduction 3. Comminution > 1/3 AP Diameter 4. >20 Degrees Dorsal Tilt (prior to reduction)

42 Wrist Fractures: Distal Radius What is Unstable? 1. Can t t Reduce 2. Lose Reduction 3. Comminution > 1/3 AP Diameter 4. >20 Degrees Dorsal Tilt 5. Volar Obliquity

43 Wrist Fractures: Distal Radius What is Displaced? > 2mm Measurable Articular Step Off

44 Wrist Fractures: Distal Radius Treatment? All stable fx s s can be treated in cast / splints All unstable fx s s require interventions Closed reduction ± Percut Pins ± Ex Fx ± Open Reduction ± Plates ± Bone Graft

45 Wrist Fractures: Distal Radius Closed Reduction: Longitudinal Txn Palmar Translation Pronation Hand relative to Forearm Ulnar Tilt NO Wrist Flexion!!!! modified from John Agee M.D.

46 Wrist Fractures: Distal Radius Longitudinal Txn

47 Wrist Fractures: Distal Radius Palmar Translation Pronation Hand Relative to Forearm Ulnar Tilt

48 Wrist Fractures: Distal Radius Treatment? All stable fx s s can be treated in cast / splints All unstable fx s s require interventions Closed reduction ± Percut Pins ± Ex Fx ± Open Reduction ± Plates ± Bone Graft

49 Wrist Fractures: Distal Radius Treatment?

50 Wrist Fractures: Distal Radius Treatment

51 Wrist Fractures: Distal Radius Treatment

52 Wrist Fractures: Distal Radius Treatment

53 Wrist Fractures: Distal Radius Treatment?

54 Wrist Fractures: Distal Radius Treatment

55 Wrist Fractures: DRUJ

56 Wrist Fractures: DRUJ Treatment of Unstable DRUJ: Address Radius First Then Assess DRUJ Fix if Necessary

57 Wrist Fractures Caveats: 1. R/O Carpal Tunnel Syndrome 2. Excessive Pain = RSD 3. Most Common Cause of RSD Undiagnosed CTS & A Flexed Wrist

58 Wrist Fractures Caveats: Post Injury Care 1. Keep those fingers moving Full extension to full flexion 2. Keep the hand elevated above heart until swelling subsides 3. If you immobilize above the elbow do so with the forearm in supination

59 Wrist Fractures Caveats: Post Injury Care If you can t t do the above with a cast then your patient is best served with Fx fixation.

60 Wrist Fractures Caveats: Post Injury Expectations Following the above guidelines DRUJ pain 8 mo s Maximum Improvement 18 mo s ROM 80% Grip 80%

61 Wrist Fractures Thank You

Fractures around wrist

Fractures around wrist Fractures around wrist Colles Fracture Smiths fracture Barton s fracture Chauffer s fracture Scaphoid fracture Lunate dislocation Vivek Pandey Colles fracture Definition: Fracture of the distal end radius

More information

The 10 Most Common Hand Pathologies In Adults. 1. Carpal Tunnel and Cubital Tunnel

The 10 Most Common Hand Pathologies In Adults. 1. Carpal Tunnel and Cubital Tunnel The 10 Most Common Hand Pathologies In Adults Bobbi Jacobsen PA C 1. Carpal Tunnel and Cubital Tunnel CARPAL TUNNEL (median nerve) ( ) Pain and numbness Distal, proximal radiating Sensory disturbance Distribution

More information

Distal Radius Fractures. Lee W Hash, MD Affinity Orthopedics and Sports Medicine

Distal Radius Fractures. Lee W Hash, MD Affinity Orthopedics and Sports Medicine Distal Radius Fractures Lee W Hash, MD Affinity Orthopedics and Sports Medicine The Problem of Distal Radius Fractures Common injury: >450,000/yr. in USA High potential for functional impairment and frequent

More information

Most active and intricate part of the upper extremity Especially vulnerable to injury Do not respond well to serious trauma. Magee, 2008. pg.

Most active and intricate part of the upper extremity Especially vulnerable to injury Do not respond well to serious trauma. Magee, 2008. pg. PTA 216 Most active and intricate part of the upper extremity Especially vulnerable to injury Do not respond well to serious trauma Magee, 2008. pg. 396 28 bones Numerous articulations 19 intrinsic muscles

More information

WRIST EXAMINATION. Look. Feel. Move. Special Tests

WRIST EXAMINATION. Look. Feel. Move. Special Tests WRIST EXAMINATION Look o Dorsum, side, palmar- palmar flex wrist to exacerbate dorsal swellings o Deformity e.g. radial deviation after colles, prominent ulna o Swellings e.g. ganglion o Scars, muscle

More information

Common wrist injuries in sport. Chris Milne Sports Physician Hamilton,NZ

Common wrist injuries in sport. Chris Milne Sports Physician Hamilton,NZ Common wrist injuries in sport Chris Milne Sports Physician Hamilton,NZ Overview / Classification Acute injuries Simple - wrist sprain Not so simple 1 - Fracture of distal radius/ulna 2 - Scaphoid fracture

More information

RADIOGRAPHIC EVALUATION

RADIOGRAPHIC EVALUATION Jeff Husband MD Objectives Evaluate, diagnose and manage common wrist injuries due to high energy trauma in athletes Appropriately use radiographs, CT scans and MRI Know when to refer patients for additional

More information

INJURIES OF THE HAND AND WRIST By Derya Dincer, M.D.

INJURIES OF THE HAND AND WRIST By Derya Dincer, M.D. 05/05/2007 INJURIES OF THE HAND AND WRIST By Derya Dincer, M.D. Hand injuries, especially the fractures of metacarpals and phalanges, are the most common fractures in the skeletal system. Hand injuries

More information

Wrist and Hand. Patient Information Guide to Bone Fracture, Bone Reconstruction and Bone Fusion: Fractures of the Wrist and Hand: Carpal bones

Wrist and Hand. Patient Information Guide to Bone Fracture, Bone Reconstruction and Bone Fusion: Fractures of the Wrist and Hand: Carpal bones Patient Information Guide to Bone Fracture, Bone Reconstruction and Bone Fusion: Wrist and Hand Fractures of the Wrist and Hand: Fractures of the wrist The wrist joint is made up of the two bones in your

More information

Radial Head Fracture Repair and Rehabilitation

Radial Head Fracture Repair and Rehabilitation 1 Radial Head Fracture Repair and Rehabilitation Surgical Indications and Considerations Anatomical Considerations: The elbow is a complex joint due to its intricate functional anatomy. The ulna, radius

More information

DIAGNOSING SCAPHOID FRACTURES. Anthony Hewitt

DIAGNOSING SCAPHOID FRACTURES. Anthony Hewitt DIAGNOSING SCAPHOID FRACTURES Anthony Hewitt Introduction Anatomy of the scaphoid Resembles a deformed peanut Articular cartilage covers 80% of the surface It rests in a plane 45 degrees to the longitudinal

More information

August 1st, 2006. Scaphoid Fractures. Dr. Christine Walton, PGY 2 Orthopedics

August 1st, 2006. Scaphoid Fractures. Dr. Christine Walton, PGY 2 Orthopedics August 1st, 2006 Scaphoid Fractures Dr. Christine Walton, PGY 2 Orthopedics Injury Patterns to the Carpal Bones 1) Perilunate pattern injuries 2) Axial pattern injuries 3) Local impaction/avulsion injuries

More information

NERVE COMPRESSION DISORDERS

NERVE COMPRESSION DISORDERS Common Disorders of the Hand and Wrist Ryan Klinefelter, MD Associate Professor of Orthopaedics Department of Orthopaedics The Ohio State University Medical Center NERVE COMPRESSION DISORDERS 1 Carpal

More information

Splinting and Casting for the Primary Care Provider

Splinting and Casting for the Primary Care Provider Splinting and Casting for the Primary Care Provider Postgraduate Seminar 4/22/2016 Stephanie Bailey, MD Asad Siddiqi, DO G H S C l i n i c a l U n i v e r s i t y P a r t n e r s Objectives Manage common

More information

11/18/2009. day 1. 6 weeks

11/18/2009. day 1. 6 weeks 11/18/2009 from Fractures of the Distal Radius : a practical approach to management DL Fernandez and JB Jupiter, Springer, New York, 1995 SGH, Biel, 2009 FRACTURES OF THE DISTAL RADIUS: do we still indicate

More information

THE WRIST. At a glance. 1. Introduction

THE WRIST. At a glance. 1. Introduction THE WRIST At a glance The wrist is possibly the most important of all joints in everyday and professional life. It is under strain not only in many blue collar trades, but also in sports and is therefore

More information

ASOP Exams PO Box 7440 Seminole, FL 33775. The Manual of Fracture Casting & Bracing Exam 80% Passing ID # Name Title. Address. City State Zip.

ASOP Exams PO Box 7440 Seminole, FL 33775. The Manual of Fracture Casting & Bracing Exam 80% Passing ID # Name Title. Address. City State Zip. The Manual of Fracture Casting & Bracing Exam 80% Passing ID # Name Title Address City State Zip Tel# Email Certification Organization Cert# Mail a copy of your completed exam to: ASOP Exams PO Box 7440

More information

Sports Related Injuries of the Hand, Wrist and Elbow. Melissa Nayak, M.D. Department of Orthopaedics Division of Sports Medicine

Sports Related Injuries of the Hand, Wrist and Elbow. Melissa Nayak, M.D. Department of Orthopaedics Division of Sports Medicine Sports Related Injuries of the Hand, Wrist and Elbow Melissa Nayak, M.D. Department of Orthopaedics Division of Sports Medicine Injury triage History, mechanism of injury (MOI) Assess extent of swelling,

More information

Splinting & Bracing Chris Guyer, MD

Splinting & Bracing Chris Guyer, MD Splinting & Bracing Chris Guyer, MD Hey Kids, As Seen On TV!! Learn How to Splint in 10 Easy Lessons!!!! Amaze Your Friends!!! WOW!!! Be the First on your Block!!! Introduction Evidence of rudimentary

More information

Hand and Wrist Injuries in The Baseball Athlete

Hand and Wrist Injuries in The Baseball Athlete Hand and Wrist Injuries in The Baseball Athlete Brian A. Schofield M.D. Clinical Assistant Professor Florida State University College of Medicine Hand and Wrist Injuries in The Baseball Athlete Participants

More information

Scaphoid Fracture of the Wrist

Scaphoid Fracture of the Wrist Page 1 of 6 Scaphoid Fracture of the Wrist Doctors commonly diagnose a sprained wrist after a patient falls on an outstretched hand. However, if pain and swelling don't go away, doctors become suspicious

More information

3.1. Presenting signs and symptoms; may include some of the following;

3.1. Presenting signs and symptoms; may include some of the following; Title: Clinical Protocol for the management of Forearm and Wrist injuries. Document Owner: Deirdre Molloy Document Author: Deirdre Molloy Presented to: Care & Clinical Policies Date: August 2015 Ratified

More information

The Wrist I. Anatomy. III. Wrist Radiography Typical wrist series: Lateral Oblique

The Wrist I. Anatomy. III. Wrist Radiography Typical wrist series: Lateral Oblique monteleoneg@wvuh.com The Wrist I. Anatomy The wrist is a complex system of articulations comprising 27 articular surfaces among the radius, ulna, carpus, and metacarpals. It is generally agreed that the

More information

.org. Distal Radius Fracture (Broken Wrist) Description. Cause

.org. Distal Radius Fracture (Broken Wrist) Description. Cause Distal Radius Fracture (Broken Wrist) Page ( 1 ) The radius is the larger of the two bones of the forearm. The end toward the wrist is called the distal end. A fracture of the distal radius occurs when

More information

Non Operative Management of Common Fractures

Non Operative Management of Common Fractures Non Operative Management of Common Fractures Mr Duy Thai Orthopaedic Surgeon MBBS, FRACS (Ortho), Dip Surg Anat NOT ALL FRACTURES NEED TO BE FIXED FRACTURE CLINIC EMERGENCY DEPARTMENTS GENERAL PRACTITIONERS

More information

Management of common upper limb fractures in Adults and Children. Dr Matthew Sherlock Shoulder and Elbow Orthopaedic Surgeon

Management of common upper limb fractures in Adults and Children. Dr Matthew Sherlock Shoulder and Elbow Orthopaedic Surgeon Management of common upper limb fractures in Adults and Children Dr Matthew Sherlock Shoulder and Elbow Orthopaedic Surgeon Outline Immobilisation choices Adults Clavicle Fractures Proximal Humeral Fractures

More information

Wrist Fractures: What the Clinician Wants to Know 1

Wrist Fractures: What the Clinician Wants to Know 1 What the Clinician Wants to Know Charles A. Goldfarb, MD Yuming Yin, MD Louis A. Gilula, MD Andrew J. Fisher, MD Martin I. Boyer, MD Index terms: Bones, CT, 43.1211 Wrist, fractures, 43.41 Wrist, MR, 43.12141,

More information

Scaphoid Fractures 1

Scaphoid Fractures 1 1 Scaphoid Fractures Scaphoid Fractures Introduction Anatomy Biomechanics History Clinical examination Radiographic evaluation DDx Classification Treatment Complications 2 Scaphoid fractures Introduction

More information

Wrist and Hand Injuries Keep Your Edge: Hockey Sports Medicine 2015 Toronto, Canada August 28-30

Wrist and Hand Injuries Keep Your Edge: Hockey Sports Medicine 2015 Toronto, Canada August 28-30 Wrist and Hand Injuries Keep Your Edge: Hockey Sports Medicine 2015 Toronto, Canada August 28-30 Steven E. Rokito, MD Division Chief, Sports Medicine, NSLIJ Associate team orthopedist NY Islanders Wrist

More information

IFSSH Scientific Committee on. Wrist Biomechanics and Instability

IFSSH Scientific Committee on. Wrist Biomechanics and Instability IFSSH Scientific Committee on Wrist Biomechanics and Instability Chair: Hisao Moritomo (Japan) Committee: Emmanuel Apergis (Greece) Guillaume Herzberg (France) Scott Wolfe (USA) Jose Maria Rotella (Argentina)

More information

Forearm Fractures 09/18/2013. Mechanism: Usually a fall on an outstretched arm. Incidence. Mechansim

Forearm Fractures 09/18/2013. Mechanism: Usually a fall on an outstretched arm. Incidence. Mechansim September 20, 2013 Amanda Taylor PA-C Children s Orthopaedics of Louisville Forearm Fractures Incidence 40-50% of all pediatric fractures Mechansim Wide range of mechanism Mechanism: Usually a fall on

More information

Wrist Fractures. Wrist Injuries/Pain. Upper Extremity Care in an Aging Population. Objectives. Jon J. Cherney, M.D. Fractures of the Distal Radius

Wrist Fractures. Wrist Injuries/Pain. Upper Extremity Care in an Aging Population. Objectives. Jon J. Cherney, M.D. Fractures of the Distal Radius Upper Extremity Care in an Aging Population Hand and Upper Extremity Center of Northeast Wisconsin, Ltd. Symposium February 24, 2012 1 2 Objectives Wrist Injuries/Pain by Jon J. Cherney, M.D. Anatomy History/Evaluation

More information

Scaphoid Fractures- Anatomy And Diagnosis: A Systemic Review Of Literature

Scaphoid Fractures- Anatomy And Diagnosis: A Systemic Review Of Literature Article ID: WMC001268 ISSN 2046-1690 Scaphoid Fractures- Anatomy And Diagnosis: A Systemic Review Of Literature Corresponding Author: Dr. Dharm Meena, junior resident, orthopaedics, PGIMER, E 402, MDH,PGIMER,CHANDIGARH,

More information

Hand and Wrist Injuries and Conditions

Hand and Wrist Injuries and Conditions Hand and Wrist Injuries and Conditions Julia Wild Hand Therapist www.southernhandtherapy.com.au 02 9553 8597 POSI Position of Safe Immobilisation So everything is balanced Wrist 30⁰ ext MCP 70⁰ flex for

More information

Musculoskeletal Trauma of the Wrist

Musculoskeletal Trauma of the Wrist September 2000 Musculoskeletal Trauma of the Wrist Murat Akalin, Harvard Medical School, Year- IV Gillian Lieberman, MD The Wrist Most common site of injury in entire skeleton Distal radius and ulna fractures

More information

Hand and Upper Extremity Injuries in Outdoor Activities. John A. Schneider, M.D.

Hand and Upper Extremity Injuries in Outdoor Activities. John A. Schneider, M.D. Hand and Upper Extremity Injuries in Outdoor Activities John A. Schneider, M.D. Biographical Sketch Dr. Schneider is an orthopedic surgeon that specializes in the treatment of hand and upper extremity

More information

We compared the long-term outcome in 61

We compared the long-term outcome in 61 Fracture of the carpal scaphoid A PROSPECTIVE, RANDOMISED 12-YEAR FOLLOW-UP COMPARING OPERATIVE AND CONSERVATIVE TREATMENT B. Saedén, H. Törnkvist, S. Ponzer, M. Höglund From Stockholm Söder Hospital,

More information

NOW PLAYING THE WRIST. David Costa, OTR/L October 20, 2007

NOW PLAYING THE WRIST. David Costa, OTR/L October 20, 2007 NOW PLAYING THE WRIST David Costa, OTR/L October 20, 2007 Starring Radius Ulna Scaphoid Lunate Triquetrum Trapezium Trapezoid Capitate Hamate Pisiform TFCC Transverse Carpal Ligament Scapholunate Ligament

More information

Wrist Fracture. Please stick addressograph here

Wrist Fracture. Please stick addressograph here ORTHOPAEDIC UNIT: 01-293 8687 /01-293 6602 UPMC BEACON CENTRE FOR ORTHOPAEDICS: 01-2937575 PHYSIOTHERAPY DEPARTMENT: 01-2936692 GUIDELINES FOR PATIENTS FOLLOWING WRIST FRACTURE Please stick addressograph

More information

Hand and Wrist Injuries. Hmmm... 2/24/2015

Hand and Wrist Injuries. Hmmm... 2/24/2015 Hand and Wrist Injuries John J Shaff, PA-C Hand Surgery Specialists, P.C. Hmmm... The field of hand surgery deals with both surgical and non-surgical treatment of conditions and problems that may take

More information

ESSENTIALPRINCIPLES. Wrist Pain. Radial and Ulnar Collateral Ligament Injuries. By Ben Benjamin

ESSENTIALPRINCIPLES. Wrist Pain. Radial and Ulnar Collateral Ligament Injuries. By Ben Benjamin ESSENTIALPRINCIPLES Wrist Pain Radial and Ulnar Collateral Ligament Injuries By Ben Benjamin 92 MASSAGE & BODYWORK FEBRUARY/MARCH 2005 Ulnar Collateral Ligament Radial Collateral Ligament Right wrist,

More information

Common Injuries of the Hand, Wrist, & Elbow. Terry M. Messer, MD October 25, 2007

Common Injuries of the Hand, Wrist, & Elbow. Terry M. Messer, MD October 25, 2007 Common Injuries of the Hand, Wrist, & Elbow Terry M. Messer, MD October 25, 2007 Introduction! Hand, Wrist, & Elbow Injuries are common! Increase in intensity/frequency of sports training! Sedentary lifestyle

More information

Chpter 2 Nonoperative Management of Non-displaced Acute Scaphoid Fracture

Chpter 2 Nonoperative Management of Non-displaced Acute Scaphoid Fracture Chpter 2 Nonoperative Management of Non-displaced Acute Scaphoid Fracture Megan Tomaino and Thomas B. Hughes Case Presentation The patient is a 15-year-old male with a history of left wrist pain following

More information

CoNGRUENT RADIAL HEAD PLATE

CoNGRUENT RADIAL HEAD PLATE Mayo Clinic CoNGRUENT RADIAL HEAD PLATE Since 1988 Acumed has been designing solutions to the demanding situations facing orthopedic surgeons, hospitals and their patients. Our strategy has been to know

More information

Name them. Clenched Fist A-P

Name them. Clenched Fist A-P Sports Injuries Not To Misdiagnose LtCol Fred H. Brennan, Jr., DO, FAOASM, FAAFP, FACSM Head Team Physician, University of New Hampshire Deputy Commander, 157 th Medical Group, Pease ANGB To improve the

More information

Two-Column Volar Distal Radius Plate. For fragment-specific fracture fixation with variable angle locking technology.

Two-Column Volar Distal Radius Plate. For fragment-specific fracture fixation with variable angle locking technology. 2.4 mm Variable Angle LCP Two-Column Volar Distal Radius Plate. For fragment-specific fracture fixation with variable angle locking technology. Tips and Tricks This material was created in cooperation

More information

Elbow, Forearm, Wrist, & Hand. Bony Anatomy. Objectives. Bones. Bones. Bones

Elbow, Forearm, Wrist, & Hand. Bony Anatomy. Objectives. Bones. Bones. Bones Objectives Elbow, Forearm, Wrist, & Hand Chapter 19 Identify and discuss the functional anatomy of the elbow and forearm Discuss the common injuries associated with these anatomical structures Bones Humerus

More information

Colles Fractures: Functional Treatment in Supination

Colles Fractures: Functional Treatment in Supination 197/, p. 197 202 Colles Fractures: Functional Treatment in Supination Collesova zlomenina: funkční léčení v supinaci A. Sarmiento, L. L. Latta Department of Orthopedic and Rehabilitation University of

More information

Adult Forearm Fractures

Adult Forearm Fractures Adult Forearm Fractures Your forearm is made up of two bones, the radius and ulna. In most cases of adult forearm fractures, both bones are broken. Fractures of the forearm can occur near the wrist at

More information

Chapter 7 The Wrist and Hand Joints

Chapter 7 The Wrist and Hand Joints Chapter 7 The Wrist and Hand Manual of Structural Kinesiology R.T. Floyd, EdD, ATC, CSCS Many Archery, Relate wrist require sports require precise functioning of flexion, & hand & hand functional combined

More information

Examination of the Elbow. Elbow Examination. Structures to Examine. Active Range of Motion. Active Range of Motion 8/22/2012

Examination of the Elbow. Elbow Examination. Structures to Examine. Active Range of Motion. Active Range of Motion 8/22/2012 Examination of the Elbow The elbow is a complex modified hinge joint The humero-ulnar joint is a hinge joint allowing flexion and extension The radio-ulnar joint allows for pronation and supination of

More information

Common Pediatric Fractures. Quoc-Phong Tran, MD UNSOM Primary Care Sports Medicine Fellow November 6, 2014

Common Pediatric Fractures. Quoc-Phong Tran, MD UNSOM Primary Care Sports Medicine Fellow November 6, 2014 Common Pediatric Fractures Quoc-Phong Tran, MD UNSOM Primary Care Sports Medicine Fellow November 6, 2014 Pediatric fractures 20% of injured kids found to have fracture on evaluation Between birth and

More information

The Elbow, Forearm, Wrist, and Hand

The Elbow, Forearm, Wrist, and Hand Elbow - Bones The Elbow, Forearm, Wrist, and Hand Chapters 23 & 24 Humerus Distal end forms the medial & lateral condyles Lateral: capitulum Medial: trochlea Radius Ulna Sports Medicine II Elbow - Bones

More information

Common Hand and Wrist Conditions: When to Refer? Dr Tim Heath

Common Hand and Wrist Conditions: When to Refer? Dr Tim Heath Common Hand and Wrist Conditions: When to Refer? Dr Tim Heath Difficult Balance Many hand conditions can be managed non-operatively / simply Missed injury or delayed diagnosis not uncommon Common Problems

More information

Common Hand Problems: Things You ll See All Day

Common Hand Problems: Things You ll See All Day Common Hand Problems: Things You ll See All Day Marci Dara Jones, M.D. Associate Professor Department of Orthopedic Surgery and Rehabilitation University of Massachusetts Disclosure I have no actual or

More information

HAND & WRIST REHAB AFTER SPORTS INJURY Jennifer Allen,PT,OCS,CHT. Overview. Why do ATCs Need to Know Hand Injury Info?

HAND & WRIST REHAB AFTER SPORTS INJURY Jennifer Allen,PT,OCS,CHT. Overview. Why do ATCs Need to Know Hand Injury Info? HAND & WRIST REHAB AFTER SPORTS INJURY Jennifer Allen,PT,OCS,CHT Overview Why do ATCs Need to Know Hand Injury Info? 1 Incidence of Hand Injury in Sports NFL Combine Review 1987-2000 Ankle Sprain 29.1%

More information

The Emergent Evaluation and Treatment of Hand and Wrist Injuries

The Emergent Evaluation and Treatment of Hand and Wrist Injuries The Emergent Evaluation and Treatment of Hand and Wrist Injuries Michael K. Abraham, MD, MS a,b, *, Sara Scott, MD a,c KEYWORDS Hand and wrist injuries Emergency physician Emergent evaluation Treatment

More information

Open Reduction of Chronic Elbow Dislocations

Open Reduction of Chronic Elbow Dislocations Open Reduction of Chronic Elbow Dislocations Duane Anderson, MD Abebe Chala PT Soddo Christian Hospital Samuel Hailu, MD Black Lion Hospital Ethiopia Chronic Elbow Dislocations Very difficult to treat

More information

Pediatric Sports Injuries of the Wrist and Hand. Sunni Alford, OTR/L,CHT Preferred Physical Therapy

Pediatric Sports Injuries of the Wrist and Hand. Sunni Alford, OTR/L,CHT Preferred Physical Therapy Pediatric Sports Injuries of the Wrist and Hand Sunni Alford, OTR/L,CHT Preferred Physical Therapy Wrist injuries TFCC ECU/ FCU tendonitis Instability Growth Plate Fractures Ulnar abutment syndrome Triangular

More information

Scaphoid Non-union. Dr. Mandel Dr. Gyomorey. May 3 rd 2006

Scaphoid Non-union. Dr. Mandel Dr. Gyomorey. May 3 rd 2006 Scaphoid Non-union Dr. Mandel Dr. Gyomorey May 3 rd 2006 Introduction Scaphoid fracture incidence: 8-38/100,000 Non-union 5% (0-22%) Adams and Leonard (1928) first described operative treatment of the

More information

Systemic condition affecting synovial tissue Hypertrohied synovium destroys. Synovectomy. Tenosynovectomy Tendon Surgery Arthroplasty Arthrodesis

Systemic condition affecting synovial tissue Hypertrohied synovium destroys. Synovectomy. Tenosynovectomy Tendon Surgery Arthroplasty Arthrodesis Surgical Options for Rheumatoid Arthritis of the Wrist Raj Bhatia Consultant Hand & Orthopaedic Surgeon Bristol Royal Infirmary & Avon Orthopaedic Centre Rheumatoid Arthritis Systemic condition affecting

More information

ASSOCIATED LESIONS COMPLICATIONS OSTEOARTICULAR COMPLICATIONS

ASSOCIATED LESIONS COMPLICATIONS OSTEOARTICULAR COMPLICATIONS Corrective Osteotomy of Distal Radius Malunion---New Horizons I certify that, to the best of my knowledge, no aspect of my current personal or profession situation might reasonably be expected to affect

More information

Case Series: Radial Head Fractures. Treated with the Acumed Anatomic Radial Head System

Case Series: Radial Head Fractures. Treated with the Acumed Anatomic Radial Head System Treated with the Acumed Anatomic Radial Head System Indication: Acute right radial head fracture, elbow subluxation, small coronoid avulsion, and olecranon fracture. with Acumed Locking Olecranon Plate.

More information

The wrist and hand are constructed of a series of complex, delicately balanced joints whose function is essential to almost every act of daily living.

The wrist and hand are constructed of a series of complex, delicately balanced joints whose function is essential to almost every act of daily living. TOPIC OUTLINE 9- THE WRIST AND HAND. Introduction. The wrist and hand are constructed of a series of complex, delicately balanced joints whose function is essential to almost every act of daily living.

More information

BLUE SKY SCHOOL OF PROFESSIONAL MASSAGE AND THERAPEUTIC BODYWORK Musculoskeletal Anatomy & Kinesiology UPPER EXTREMITY ASSESSMENT

BLUE SKY SCHOOL OF PROFESSIONAL MASSAGE AND THERAPEUTIC BODYWORK Musculoskeletal Anatomy & Kinesiology UPPER EXTREMITY ASSESSMENT BLUE SKY SCHOOL OF PROFESSIONAL MASSAGE AND THERAPEUTIC BODYWORK Musculoskeletal Anatomy & Kinesiology UPPER EXTREMITY ASSESSMENT MSAK201-II Session 8 LEARNING OBJECTIVES: By the end of this session, the

More information

Ulnar sided Wrist Pain

Ulnar sided Wrist Pain Ulnar sided Wrist Pain 1 Susan Cross, 1 Anshul Rastogi, 2 Brian Cohen, 1 Rosy Jalan 1 Dept of Radiology, Barts Health NHS Trust, London, UK 2 London Orthopaedic Centre Contact: susan.cross@bartshealth.nhs.uk

More information

Self-Range of Motion Exercises for Shoulders, Arms, Wrists, Fingers

Self-Range of Motion Exercises for Shoulders, Arms, Wrists, Fingers Self-Range of Motion Exercises for Shoulders, Arms, Wrists, Fingers These exercises will help keep your muscles strong and mobile, and your joints flexible. Other benefits of these exercises include: C

More information

ASSOCIATE PROFESSOR BO POVLSEN Emeritus Consultant Orthopaedic Surgeon Guy s & St Thomas Hospitals NHS Trust GMC no. 3579329

ASSOCIATE PROFESSOR BO POVLSEN Emeritus Consultant Orthopaedic Surgeon Guy s & St Thomas Hospitals NHS Trust GMC no. 3579329 ASSOCIATE PROFESSOR BO POVLSEN Emeritus Consultant Orthopaedic Surgeon Guy s & St Thomas Hospitals NHS Trust GMC no. 3579329 Consultant Orthopaedic Surgeon London Bridge Hospital Medico-Legal Secretary:

More information

Median Nerve Injuries in, Fractures in the Region of the Wrist

Median Nerve Injuries in, Fractures in the Region of the Wrist 252 Median Nerve Injuries in, Fractures in the Region of the Wrist N. MEADOFF, M.D., Bakersfield SUMMARY Injuries of the median nerve in fractures in the region of the wrist are not uncommon. Median nerve

More information

Citation International Orthopaedics, 2011, v. 35 n. 3, p. 389-394. Creative Commons: Attribution 3.0 Hong Kong License

Citation International Orthopaedics, 2011, v. 35 n. 3, p. 389-394. Creative Commons: Attribution 3.0 Hong Kong License Title Operative treatment of distal radial fractures with locking plate system - A prospective study Author(s) Kwan, KYH; Lau, TW; Leung, F Citation International Orthopaedics, 2011, v. 35 n. 3, p. 389-394

More information

Elbow Examination. Haroon Majeed

Elbow Examination. Haroon Majeed Elbow Examination Haroon Majeed Key Points Inspection Palpation Movements Neurological Examination Special tests Joints above and below Before Starting Introduce yourself Explain to the patient what the

More information

Whether a physician is

Whether a physician is ILLUSTRATIONS BY SCOT BODELL Hand and Wrist Injuries: Part I. Nonemergent Evaluation JAMES M. DANIELS II, M.D., M.P.H., Southern Illinois University School of Medicine, Quincy, Illinois ELVIN G. ZOOK,

More information

Operative Treatment of Intra-articular Distal Radius Fractures Using the Small AO External Fixation Device

Operative Treatment of Intra-articular Distal Radius Fractures Using the Small AO External Fixation Device ORIGINAL ARTICLE Operative Treatment of Intra-articular Distal Radius Fractures Using the Small AO External Fixation Device Teng-Le Huang 1,2 *, Ching-Kuei Huang 2,3, Jung-Kuang Yu 2,3, Fang-Yao Chiu 2,3,

More information

UVA HAND CENTER - THERAPY

UVA HAND CENTER - THERAPY Post-Op to Week 3: Distal Biceps Re-Insertion Rehabilitation Protocol - Pt is immobilized in 90 degrees of flexion, neutral rotation and wrist in a position of comfort, either a cast or brace/splint may

More information

Proximal Humerus Fractures

Proximal Humerus Fractures Proximal Humerus Fractures - What to do in young active patients? Phani K. Dantuluri, MD Shoulder and Elbow & Upper Extremity Surgery Resurgens Orthopaedics Emory University Midtown Hospital Emory St.Joseph

More information

Wrist Fusion and Back to Work

Wrist Fusion and Back to Work Wrist Fusion and Back to Work Marc J. Richard, M.D. Associate Professor Department of Orthopaedic Surgery Durham, North Carolina 42 yo Ironworker, Failed Scope Debridement FUSION ARTHROPLASTY FUSION ARTHROPLASTY

More information

Postoperative Therapy following Complex Elbow Fractures. Handouts. Physician Orders. Topics for Discussion. Therapy Initiated 5-7 Days Postop

Postoperative Therapy following Complex Elbow Fractures. Handouts. Physician Orders. Topics for Discussion. Therapy Initiated 5-7 Days Postop Postoperative Therapy following s Handouts www.indianahandtoshoulder.com Click on THERAPY APTA Combined Sections Meeting 2015 Nancy M. Cannon, OTR, CHT Hand to Shoulder Therapy Center Email: ncannon@ihtsc.com

More information

213: HUMAN FUNCTIONAL ANATOMY: PRACTICAL CLASS 5: Forearm and Hand. What areas of skin are supplied by the median nerve?

213: HUMAN FUNCTIONAL ANATOMY: PRACTICAL CLASS 5: Forearm and Hand. What areas of skin are supplied by the median nerve? 213: HUMAN FUNCTIONAL ANATOMY: PRACTICAL CLASS 5: Forearm and Hand FOREARM (Anterior compartment) Identify the common flexor origin which is the fibrous extension of the medial collateral ligament of the

More information

ACUTE HAND INJURY PROTOCOLS

ACUTE HAND INJURY PROTOCOLS ACUTE HAND INJURY PROTOCOLS I. FRACTURES OF THE HAND AND DIGITS Digital and hand fractures are seen in workers who use their hands, due to the exposed nature of the hand (in most functions) at work. Most

More information

CLOSED REDUCTION AND PERCUTANEOUS KIRSCHNER WIRE FIXATION OF DISPLACED COLLES FRACTURE IN ADULTS

CLOSED REDUCTION AND PERCUTANEOUS KIRSCHNER WIRE FIXATION OF DISPLACED COLLES FRACTURE IN ADULTS Original Article CLOSED REDUCTION AND PERCUTANEOUS KIRSCHNER WIRE FIXATION OF DISPLACED COLLES FRACTURE IN ADULTS M. AKHTER BAIG, KASHIF AHMED, S. MUJAHID HUMAIL Department of Orthopaedics (Unit I), Dow

More information

The Hand Exam: Tips and Tricks

The Hand Exam: Tips and Tricks The Hand Exam: Tips and Tricks Nikki Strauss Schroeder, MD Assistant Clinical Professor, UCSF Department of Orthopaedic Surgery November 4, 2013 Outline Surface Anatomy Hand Anatomy Exam Management of

More information

Commonly Missed Fractures in the Emergency Department

Commonly Missed Fractures in the Emergency Department Commonly Missed Fractures in the Emergency Department Taylor Sittler MS IV - UMASS Images courtesy of Jim Wu, MD, Sanjay Shetty, MD and Mary Hochman, MD Diagnostic Errors in the ED Taylor Sittler, MS IV

More information

Rigid Internal Fixation of Displaced Distal Radius Fractures

Rigid Internal Fixation of Displaced Distal Radius Fractures n Feature rticle Rigid Internal Fixation of Displaced Distal Radius Fractures Stephen. Gunther, MD; Tennyson L. Lynch, S abstract Full article available online at Healio.com/Orthopedics. Search: 20131219-14

More information

Treatment Guide Understanding Hand and Wrist Pain. Using this Guide. Choosing Your Care

Treatment Guide Understanding Hand and Wrist Pain. Using this Guide. Choosing Your Care Treatment Guide Understanding Hand and Wrist Pain With how much we rely on our hands, there s no wonder hand and wrist pain can be so disabling and frustrating. When this pain interferes with typing on

More information

Arthroscopy of the Hand and Wrist

Arthroscopy of the Hand and Wrist Arthroscopy of the Hand and Wrist Arthroscopy is a minimally invasive procedure whereby a small camera is inserted through small incisions of a few millimeters each around a joint to view the joint directly.

More information

Hand Injuries and Disorders

Hand Injuries and Disorders Hand Injuries and Disorders Introduction Each of your hands has 27 bones, 15 joints and approximately 20 muscles. There are many common problems that can affect your hands. Hand problems can be caused

More information

QUICK REFERENCE GUIDE. One-step fracture fixation. The Fragment Fixation System

QUICK REFERENCE GUIDE. One-step fracture fixation. The Fragment Fixation System 16 One-step fracture fixation The Fragment Fixation System GENERAL PRINCIPLES Thread Diameter Shaft Diameter Small 1.2 mm 1.5 mm Medium 1.6 mm 2.0 mm Large 2.2 mm 3.0 mm Three shaft diameter/thread diameter

More information

9 DISTAL RADIUS AND ULNA FRACTURES

9 DISTAL RADIUS AND ULNA FRACTURES 9: DISTAL RADIUS AND ULNA FRACTURES Rockwood and Wilkins Fractures in Children 9 DISTAL RADIUS AND ULNA FRACTURES PETER M. WATERS Classification Anatomy Physeal Injuries Diagnosis Treatment Options Complications

More information

ELBOW EXAMINATION. What s the problem Instability Stiffness Disability. Which hand? How old? Occupation Any history of injury

ELBOW EXAMINATION. What s the problem Instability Stiffness Disability. Which hand? How old? Occupation Any history of injury ELBOW EXAMINATION What s the problem Pain Instability Stiffness Disability Which hand? How old? Occupation Any history of injury Assess disability Work and ADL 1. Can you lift heavy weights? 2. Can you

More information

3. Be able to perform a detailed clinical examination of the forearm and wrist.

3. Be able to perform a detailed clinical examination of the forearm and wrist. Patient Care: 1. Demonstrate appropriate evaluation and treatment of patients with hand/wrist surgery problems in the emergency room and as part of the inpatient consultation service, including application

More information

Total Elbow Arthroplasty and Rehabilitation

Total Elbow Arthroplasty and Rehabilitation Total Elbow Arthroplasty and Rehabilitation Surgical Indications and Considerations Anatomical Considerations: There are three bones and four joint articulations that have a high degree of congruence in

More information

National Joint Replacement Registry. Demographics and Outcome of Elbow & Wrist Arthroplasty

National Joint Replacement Registry. Demographics and Outcome of Elbow & Wrist Arthroplasty National Joint Replacement Registry Demographics and Outcome of Elbow & Wrist Arthroplasty SUPPLEMENTARY REPORT 2015 CONTENTS INTRODUCTION... 1 ELBOW REPLACEMENT... 2 Categories of Elbow Replacement...

More information

Wrist Plating System

Wrist Plating System Wrist Plating System Acu-Loc Wrist Plating System Acumed is a global leader of innovative orthopaedic and medical solutions. We are dedicated to developing products, service methods and approaches that

More information

Stretch Beyond Your Expectations.

Stretch Beyond Your Expectations. CLINICIAN INSTRUCTIONS Dynasplint Supination/Pronation Forearm System Corporate Headquarters: 800.638.6771 toll-free 800.380.3784 fax Canada: 800.668.9139 toll-free 905.851.3494 fax Europe: 00131.455 230

More information

Westmount UCC 751 Victoria Street South, Kitchener, ON N2M 5N4 519-745-2273 Fairway UCC 385 Fairway Road South, Kitchener, ON N2C 2N9 519-748-2327

Westmount UCC 751 Victoria Street South, Kitchener, ON N2M 5N4 519-745-2273 Fairway UCC 385 Fairway Road South, Kitchener, ON N2C 2N9 519-748-2327 K-W URGENT CARE CLINICS INC. Westmount UCC 751 Victoria Street South, Kitchener, ON N2M 5N4 519-745-2273 Fairway UCC 385 Fairway Road South, Kitchener, ON N2C 2N9 519-748-2327 OPEN Mon-Fri 8am-5pm, Sa

More information

Synopsis of Causation. Fractures Long Bones, Upper Limb (includes hand)

Synopsis of Causation. Fractures Long Bones, Upper Limb (includes hand) Ministry of Defence Synopsis of Causation Fractures Long Bones, Upper Limb (includes hand) Author: Mr John A Dent, Ninewells Hospital and Medical School, Dundee Validator: Mr Sheo Tibrewal, Queen Elizabeth

More information

Wrist-Hand Intervention. Ed Mulligan, PT, DPT, OCS, SCS, ATC Clinical Orthopedic Rehabilitation Education

Wrist-Hand Intervention. Ed Mulligan, PT, DPT, OCS, SCS, ATC Clinical Orthopedic Rehabilitation Education Wrist-Hand Intervention Ed Mulligan, PT, DPT, OCS, SCS, ATC Clinical Orthopedic Rehabilitation Education Rehabilitation Interventions for Consideration Modalities Manual Therapy joint and soft tissue mobilization

More information

Integrated Manual Therapy & Orthopedic Massage For Complicated Forearm, Wrist & Hand Conditions

Integrated Manual Therapy & Orthopedic Massage For Complicated Forearm, Wrist & Hand Conditions Integrated Manual Therapy & Orthopedic Massage For Complicated Forearm, Wrist & Hand Conditions Assessment Protocols Treatment Protocols Treatment Protocols Corrective Exercises Artwork and slides taken

More information