wrist and hand injuries. quick review: radius is on the thumb side make sure you can locate and name...
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![Page 1: Wrist and Hand injuries. Quick Review: Radius is on the Thumb Side Make sure you can locate AND NAME THE JOINTS OF THE HAND](https://reader030.vdocuments.site/reader030/viewer/2022032518/56649cc55503460f9498ec97/html5/thumbnails/1.jpg)
Wrist and Hand Wrist and Hand injuriesinjuries
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Quick Review:Radius is on the Thumb Side
Make sure you can locate AND NAME THE JOINTS OF THE HAND.
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MetacarpalsMetacarpals
• 5 bones5 bones• Numbered 1 through 5 Numbered 1 through 5 • Thumb is #1Thumb is #1• Pinky is #5Pinky is #5
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INJURIESINJURIES
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ColleColle’’s Fractures Fracture
Involves the distal end of radiusInvolves the distal end of radius
Silver fork deformitySilver fork deformity
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Mechanism of Injury – Mechanism of Injury – Colle’sColle’s
• Fall on an outstretched handFall on an outstretched hand• Run into wall, etc, with wrist Run into wall, etc, with wrist
hyperextendedhyperextended
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Signs and SymptomsSigns and Symptoms
• Visible deformity—Visible deformity—””silver forksilver fork””• SwellingSwelling• PainPain• POTPOT
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ComplicationsComplications
• Tendons may be torn away from Tendons may be torn away from attachment siteattachment site
• Median nerve damageMedian nerve damage
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CareCare
• Splint in position you find it before Splint in position you find it before going to the ERgoing to the ER
• IceIce• ER ER • 1-2 month recovery time1-2 month recovery time
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Signs and Symptoms
• Pain with active motion• Pain with passive stretching• POT over either flexor or extensor
tendons• Swelling
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Treatment
• Ice• Heat• Analgesics• Modify activity • NSAIDS• Splint• Strengthening and ROM exercises
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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
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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
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Ganglion CystGanglion Cyst
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Ganglion cystGanglion cyst
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Ganglion cystGanglion cyst
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Treatment
• Break down swelling with digital pressure and padding
• Aspiration and chemical cauterization followed by pressure padding
• Will usually come back• Surgical removal
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Dislocation of Lunate
• MOI:• Forced hyperextension of wrist
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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
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Lunate dislocationLunate dislocation
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Lunate DislocationLunate Dislocation
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Treatment
• Splint• Ice• Physician referral for reduction• 1-2 month recovery time
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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
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BoxerBoxer’’s fractures fracture
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Signs and Symptoms
• Swelling• Discloration• Pain with movement
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BoxerBoxer’’s fractures fracture
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Treatment
• Ice• Splint • Physician referral for x-ray• Reduction and casting (3-4 weeks)