Wrist and Hand injuries

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Wrist and Hand injuries
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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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Metacarpals

• 5 bones
• Numbered 1 through 5
• Thumb is 1
• Pinky is 5

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INJURIES
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Colles Fracture

• Involves the distal end of radius
• Silver fork deformity

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Mechanism of Injury Colles

• Fall on an outstretched hand
• Run into wall, etc, with wrist hyperextended

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Signs and Symptoms

• Visible deformitysilver fork
• Swelling
• Pain
• POT

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Complications

• Tendons may be torn away from attachment site
• Median nerve damage

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Care

• Splint in position you find it before going to
  the ER
• Ice
• ER
• 1-2 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 Cyst
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Ganglion cyst
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Ganglion 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 dislocation
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Lunate Dislocation
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Treatment

• Splint
• Ice
• Physician referral for reduction
• 1-2 month recovery time

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Metacarpal (Boxers) 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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Boxers fracture
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Signs and Symptoms

• Swelling
• Discloration
• Pain with movement

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Boxers fracture
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Treatment

• Ice
• Splint
• Physician referral for x-ray
• Reduction and casting (3-4 weeks)