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64 Cards in this Set
- Front
- Back
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At the junction of the carpal bones with the radius and ulna what is the bone which is larger and lateral
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radius (thumb side)
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What side is the 5th finger located
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medial (ulna side)
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What is another name for the scaphoid
What is a cause of a scaphoid lunate disassociation |
navicular
this a tear of the scaphoid-lunate ligament (widened scaphoid lunate joint space and the scaphoid rotates down and cause a ring sign) |
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What is the normal distance between the scaphoid and the lunate
What are the 3 arcs on an AP xray of the wrist |
less than 3mm
arcs of guliua |
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What does the triquetrum overly
Where are the 3 arcs of gulila |
the pisiform
the proximal row, the articular surface of the proximal row, capitate and hamate articular surface |
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What is the order of the first line of bone
What should be analyzed when looking at an AP wrist x ray |
scaphoid, lunate, triquetrum (dorsal), pisiform
the 3 arcs of gulila and the joint space between the scaphoid and lunate + lunate and triquetrrum are roughly rectangular in shape |
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What is bigger the triquetrum or the pisiform
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the triquetrum (these overly eachother and the triquetrum is the bigger one more dorsal)
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What is the first bone in the distal carpal row
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the trapezium (by the thumb)
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Does part of the thumb normally extend past the trapezium
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yes
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What is next to the trapezium
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the trapezoid
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What distal carpal bone lines up with the lunate
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the capitate
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What is the bone that is next to the 5th digit in the distal carpal row
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the hamate
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Which carpal bone has a hook
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the hammate
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What bones line up on the lateral view
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the capitate, lunate and distal radius
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What carpal bone is next to the capitate but more palmar
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the navicular
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What bone is seen on the lateral view on the dorsum
How many major wrist fractures are there |
the triquetrum
5 |
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What is a colles fracture
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this is an extra-articular fracture of the distal radius. Note the dorsally displace of fractured segment
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What is the mechanism of cause of a colles fracture
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fall on outstretched hand (also navicular)
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Do colles fractures extend into the joint space
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no
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What is the angulation of fracture that results from a colles fracture
How do you determine which bone is the ulnar and radius on a lateral wrist |
doral angulation and posterior displacement of the distal fracture fragment
the radius is higher up. |
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What is a colles fracture associated with
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a fracture of the ulnar styloid
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What is the mechanism of a smith fractue
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fall on a flexed wrist
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What is the reverse of a colles fracture
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smith fracture
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Are both a smith fracture and a colle fracture extra articular
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no, Colles fracture is always extra-articular and Smith may be intra-articular or extra-articular. The differences is Colle is always dorsal and Smith is always volar. Basically, if Colles and Barton fracture where the same name then they could be opposites of eachother.
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If a smith fracture is intraarticular what is it called
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a reverse barton (or a type 3 smith fracture)
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How is the distal fragment displaced in a smith fracture
What is the rule for joints spaces of the wrist |
palmar angulation and displacement
They should be approxiametely the same width in the proximal row (scaphoid-lunate = lunate-triquetral joint space) |
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What is a barton fracture
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this is incorrect according to primer. Dorsal intra-articular is a type 3 smith fracture (or a reverse barton) and volar intraarticular fracture of the dorsal margin of the distal radius (on right) is a barton.
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Does a barton fracture extend into the radiocarpal joint
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yes
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How is a fracture displaced in a barton fracture
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dorsally
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What is a bennet fracture
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this is an intra-articular fracture and dislocation of the base of the 1st metacarpal
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What is the most common mechanism of a bennet fracture
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fist fight
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What is the most common fracture of the thumb
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a bennet fracture
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What is the palmar beak fragment
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this occurs during a bennet fracture and is when a small fragment of the 1st metacarpal continues to articulate with the trapezium
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What are 2 fractures that involve the base of the thumb
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a rolando and bennet fracture
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What is a rolando fracture
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a comminuted intraarticular fracture
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What force cause a fracture of the radial styloid
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ulnar deviation and supination
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What is a fracture of the radial styloid associated with
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lunate dislocation
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What is a chauffers fracture or a hutchinson fracture
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an oblique fracture of the radial styloid
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What is the most common fracture of the carpal bones
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a scaphoid fracture
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What is a cause of a scaphoid fracture
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fall on outstretched hand (colles fractue too)
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Where is the pain in a scaphoid fractures
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snuff box
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What percent of pt with scaphoid fractures have AVN
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30%
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What is the treatment for a scaphoid fracture
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early immobilization
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Why is early detection important for scaphoid fracture
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AVN and non-union
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What is larger at the carpal joint; radius or ulna
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radius
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What does AVN of the scaphoid look like on plain film
What is the best exam to look for a scaphoid lunate dislocation (rupture of the scaphoid-lunate ligament resulting in increase joint space and scaphoid ring sign) |
increased density/sclerotic change of the proximal portion of the scaphoid
clenched fist frontal of both wrist. If there is > 1mm difference from the contralateral side is indicative of a scaphoid-lunate disassociation |
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What is the 2nd most common fracture of the carpal bones
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triquetral fracture
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What is the mechanism of injury of a triquetral fracture
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forced hyperflexion
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How does the triquetral fracture appear on lateral film
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a dorsal chip fracture
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What is the mechanism of injury for a lunate dislocation
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fall on outstretched hand
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What is the mc dislocated carpal bone
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lunate
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What is considered the most severe carpal dislocation
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lunate
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What is the direction of the dislocation of the lunate
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volar (palmar) dislocation and forward rotation
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What happens to the capitate during a lunate dislocation
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collapses toward the radius
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What are lunate dislocations associated with
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trans-scaphoid fractures
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What is a clue that there is a lunate dislocation on frontal wrist film
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the lunate will have a triangular shape instead of a quadralateral shape
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What is a clue that there is a lunate dislocation on lateral wrist view
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the lunate is displace more towards the palmar aspect of the wrist and the capitate is behind it. The capitate has now collapsed toward the radius
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What is a perilunate dislocation
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this is when the lunate maintains its normal position but all the other carpal bones dislocate posteriorly
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What is more common a perilunate or lunate dislocation
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lunate
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Are perilunate dislocations associated with scaphoid fractures
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yes
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What is the mechanism of a perilunate dislocation
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fall on outstretched hyperextended hand
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What are the 12 injuries of the wrist/hand
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Finger: gameskeeper, mallet, bouteniorres, volar plate,
Thumb: bennet, rolando Wrist: scaphoid, triquetral, Radius/Ulnar: radial/ulnar styloid, smith and colles (extratraarticular), barton, lunate, perilunate |
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What are the two dislocation of the wrist
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lunate, perilunate
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What is a classical finding on lateral view of a colles fracture
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radial fracture with dorsal angulation
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