all things wrist mi zucker, md. a dr z lecture injuries of the wrist fractures and ligament injuries...
TRANSCRIPT
ALL THINGS WRIST
MI Zucker, MD
A dr Z Lecture
INJURIES of the WRIST
• Fractures and ligament injuries of the distal radius and ulna and the carpal bones.
NORMAL AP
• Three smooth carpal arcs
• Inter-carpal spaces of 0-2 mm
NORMAL LATERAL
• Straight line bisecting radius-lunate-capitate
• Dorsal border-triquetrum
• Smooth dorsal and volar borders of radius and ulna
The RADIUS
The most commonly fractured wrist bone in all age groups
COLLES Fracture
Fall on outstretched hand fractures distal radius with dorsal angulation;
associated ulna styloid fracture in 2/3
SMITH Fracture
Fall on back of hand, much less common than Colles. “ Reverse
Colles”
TORUS Fracture
Most common kid fracture of the wrist. Fall on outstretched hand.
SALTER-HARRIS Injuries
SH II of the radius is most common of the wrist SH’s
SCAPHOID FRACTURES
Second most common wrist fracture, most common carpal fracture.
70 % of carpal fractures.
Watch out for additional fractures!
TRIQUETRUM Fracture
Second most common carpal fracture, but only 15 %
HAMATE HOOK Fracture
From twisting ulnar side of wrist as in golf swing
LIGAMENT INJURIES
A spectrum of injuries caused by fall on outstretched hand
SCAPHO-LUNATE DISSOCIATION
Most common, takes the least force.
Scapho-lunate distance exceeds 4 mm
PERILUNATE DISLOCATION
Interruption of three arcs on AP, loss of radius-lunate-capitate relationship
on lateral
LUNATE DISLOCATION
5 X less common than perilunate. On AP, lunate becomes triangle shaped and on lateral, radius-lunate-capitate
relationship is lost
GOODBYE
• Copyright 2004
MI Zucker, MD