Vessel divisions Compartment syndrome Following crush injuries and the fractures of the forearm and hand, pressure within the facial compartments rises, Occlude the microcirculation
Carpal instability Damage to the ligaments interconnecting intercalated segment Following outstretched hand Rx- early repair and stabilization with wires Thumb ulnar collateral ligament Can be torn when thumb is wrenched radially or with chronic over use Rx – relatively stable injury is splinted for 3 weeks Unstable- need repair
Triangular fibro cartilage complex attach ulnar styloid to the ulnar side of the distal radius and stabilize distal radio ulnar joint Can be torn leading to instability of the distal radio ulnar joint and ulnar sided wrist pain Rx- repair
Dislocation of the lunate bone Following fall on to the hand Lunate bone lies at the front of the wrist rotated 90 degrees Rx- early-manipulation under anesthesia Late- open reduction Complications Avascular necrosis Osteoarthritis Median nerve injury
Sudden passive flexion of the distal interphalangeal joint may rupture the extensor tendon at the point of its insertion into the base of the distal phalanx Clinically the distal IP joint rests in moderate flexion and can not be actively extended. Management : Tendon avulsion without a bone fragment is treated by uninterrupted splintage in the fully straight position for 6 weeks.