Presentation on theme: "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."— Presentation 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