Forearm, Wrist, and Hand Common Injuries

Barton Fracture Fracture to the distal radius with dislocation of radiocarpal joint Most common fracture/dislocation of the wrist

Baseball/Mallet Finger Deformity of the DIP due to forceful flexion of the phalanx Occurs when object hits the end of the finger when the extensor tendon is taut Caused when catching a ball The tip of the finger drops and can not actively extend Splinted 6-8 weeks

Bennett Fracture A fracture/dislocation to the proximal end of the 1st metacarpal at the carpalmetacarpal (CMC) joint An articular fracture Due to axial compression (punching with a closed fist) Pain & swelling are localized Thumb spica splint worn for ~ 4 wks

Boutionneirre Deformity “buttonhole” deformity Caused by a rupture on the extensor tendon at the PIP Trauma occurs to the top of the finger which forces the PIP into excessive flexion Severe pain and inability to extend the PIP joint Splint PIP 6-8 wks

Boxer Fracture Fracture of the 5th MC resulting in a flexion deformity due to rotation of the head of the metacarpal over the neck Occurs when one punches an object with a closed fist

Carpal Tunnel Syndrome Most common compression syndrome of wrist & hand Caused by direct trauma or repetitive overuse Compression of median nerve as it passes through the carpal tunnel Pain & tingling in the hand

Colles Fracture Fracture of the distal radius which distal fragments angulate dorsally Mechanism – fall on outstretched hand “dinner-fork” deformity Radius displaces from hyperextension

Felon An abscess located within the fat pad of the fingertips Can lead to osteomyelitis – inflammation or infection of the bone and bone marrow

Fracture (radius, ulna) Caused by axial loading when an individual falls on an outstretched hand Galeazzi Fx Fracture of radius with associated dislocation of ulna Monteggia Fx Fracture of ulna with associated dislocation of radial head

Ganglion A cysts that is normally benign on the dorsal aspect of the wrist Seldom causes pain or loss of function

Navicular Fracture Becomes impinged against the radial styloid during hyperextension Caused by axial loading when an individual falls on an outstretched hand Point tenderness @ radial styloid & anatomical snuffbox Pain increases with wrist extension & radial deviation

Paronychia Infection along the nail fold commonly associated with a hangnail Caused by fungal organism

Profundous Tendon Rupture “jersey finger” Rupture of the flexor digitorum profundus tendon from the distal phalanx due to rapid extension of finger while flexed Occurs when individual grabs opponents’ jersey & they simultaneously twist & turn Ring finger is most common

Smith’s Fracture Distal radius fracture where distal fragments angulate volarly Caused by hyperflexion

Subungual Hematoma A collection of blood under the fingernail caused by direct trauma to nail bed

Volkmann’s Ischemic Contracture Ischemic necrosis of the forearm muscles and tissues caused by damaged blood vessels The hand is cold, numb, & white No pulse = medical emergency

Gamekeeper’s Thumb A sprain to the ulnar collateral ligament of the MCP joint of the thumb. Common to athletes. Signs include pain over the ulnar collateral ligament in addition to a weak and painful pinch. Tenderness and swelling over the medial aspect of the thumb.

Dislocations Have a high incidence in athletics. Can occur to either the PIP or DIP joints. RICE, especially elevation while taking to physician. Once reduce, if not fractured, then you have a sprained finger.