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

2. “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?

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

4. 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

5. 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

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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 5th PIP Dislocation

14. “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.

15. “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?