Fractures & Dislocations of the Hand & Wrist Injuries, Part 2 Fractures & Dislocations of the Hand & Wrist

“Before & After” BELLWORK On a piece of notebook paper, draw two columns. Label the first column ‘Before’ and the second column ‘After.’ Then answer the following questions under the ‘Before’ column. Put the paper aside until the end of class. 1. How does a finger fracture occur? 2. How does a finger dislocation occur? 3. What are the signs of a finger fracture? 4. What are the signs of a finger dislocation?

Objectives Differentiate between common injuries and their mechanisms, signs, symptoms and treatments.

Terminology Anatomical snuffbox: a depression over the wrist that can be seen when the fingers are extended Avascular necrosis: tissue death due to lack of blood supply Boxer’s fracture: injury of the 5th metacarpal Colles’ fracture: fracture of the distal radius

PROPERTY OF PIMA COUNTY JTED, 2010 Idea Wave List 3 ideas about the injuries that we discussed yesterday. Be ready to share with the class. After the “Idea Wave,” rank your top three ideas from the class. 33. Idea Wave each student lists 3 to 5 ideas about the assigned topic the teacher calls on a non-volunteer to begin the "idea wave" by sharing one idea the student to the right of the first non-volunteer shares one idea; then the student to the non-volunteer’s right shares one idea the teacher directs the flow of the "idea wave" until all different ideas have been shared by asking each student at the end of the formal "idea wave," students will rank their top 3 ideas PROPERTY OF PIMA COUNTY JTED, 2010 5

Fractures/Dislocations Radial / ulnar fracture Carpal fracture Carpal dislocation Metacarpal fracture Phalynx fracture Phalynx dislocation

Radial/Ulnar Fracture Colles’ fracture = fracture of the distal radius Mechanism: Falling on an outstretched hand Direct blow to the area Signs & Symptoms: Severe pain Swelling Deformity Possible crack heard/felt Loss of function in wrist & hand Treatment: Follow RICE Splint Refer for x-ray

Carpal Fracture Scaphoid – most commonly fractured carpal bone Mechanism: Fall on an outstretched hand (compression) Forceful wrist hyperextension Signs & Symptoms: Pain Point tenderness (possibly in anatomical snuffbox for scaphoid) Swelling Numbness Loss of wrist and finger flexion Treatment: Follow RICE Refer for x-ray Possible complication: avascular necrosis

Carpal Dislocation Lunate – most commonly dislocated carpal bone Mechanism: Falling on an extended hand Hyperextension Signs & Symptoms: Pain Swelling Numbness Loss of ROM Treatment: Follow RICE Refer for x-ray / reduction

Metacarpal Fracture Mechanism: Signs & Symptoms: Treatment: Direct blow, compression force or twisting Signs & Symptoms: Pain Swelling Depressed MCP joint Loss of ROM and grip strength Treatment: Follow RICE Splint in flexion Refer for x-ray

Phalynx Fracture Mechanism: Signs & Symptoms: Treatment: Axial blow to tip of finger or sudden twisting force Signs & Symptoms: Pain Rapid swelling Loss of motion, grip strength Discoloration possible Treatment: Follow RICE Splint in flexion Refer for x-ray

Phalynx Dislocation Mechanism: Signs & Symptoms: Treatment: Forceful impact causes one bone to move forward and another bone to move back Signs & Symptoms: Pain Deformity Loss of ROM Treatment: Reduction by ATC or physician Ice Splint / buddy taping Complications: possible fracture or ligament injury

5th PIP Dislocation

“What’s My Injury?” With a partner, choose an injury from today’s lesson. Create a scenario for that injury including the mechanism, signs & symptoms, and treatment. Write the scenario down. Be prepared to share your injury with the class.

“Before & After” CLOSURE On your bellwork sheet, answer the following questions in the ‘after’ column. This will assess your new learning for the day! 1. How does a carpal fracture happen? 2. How does a carpal dislocation happen? 3. What are the signs of a carpal fracture? 4. What are the signs of a carpal dislocation?