1. Wrist and Hand injuries

2. Quick Review: Radius is on the Thumb Side Make sure you can locate AND NAME THE JOINTS OF THE HAND.

3. Metacarpals 5 bones5 bones Numbered 1 through 5Numbered 1 through 5 Thumb is #1Thumb is #1 Pinky is #5Pinky is #5

4. INJURIES

5. Colle’s Fracture Involves the distal end of radius Silver fork deformity

7. Mechanism of Injury – Colle’s Fall on an outstretched handFall on an outstretched hand Run into wall, etc, with wrist hyperextendedRun into wall, etc, with wrist hyperextended

8. Signs and Symptoms Visible deformity—”silver fork”Visible deformity—”silver fork” SwellingSwelling PainPain POTPOT

9. Complications Tendons may be torn away from attachment siteTendons may be torn away from attachment site Median nerve damageMedian nerve damage

10. Care Splint in position you find it before going to the ERSplint in position you find it before going to the ER IceIce ERER 1-2 month recovery time1-2 month recovery time

11. Signs and Symptoms Pain with active motion Pain with passive stretching POT over either flexor or extensor tendons Swelling

12. Treatment Ice Heat Analgesics Modify activity NSAIDS Splint Strengthening and ROM exercises

13. 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

14. 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

15. Ganglion Cyst

16. Ganglion cyst

18. Treatment Break down swelling with digital pressure and padding Aspiration and chemical cauterization followed by pressure padding Will usually come back Surgical removal

19. Dislocation of Lunate MOI: Forced hyperextension of wrist

20. 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

21. Lunate dislocation

22. Lunate Dislocation

23. Treatment Splint Ice Physician referral for reduction 1-2 month recovery time

24. Metacarpal (Boxer’s) 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

25. Boxer’s fracture

26. Signs and Symptoms Swelling Discloration Pain with movement

27. Boxer’s fracture

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