Upper Extremity Common Hand/Wrist Pathologies

What body part is injured in a Colle’s or Smith’s fracture?

distal radius

What is the MOI for Colle’s fracture?

FOOSH + hyperextension

What is the etiology of Colle’s fracture?

dorsal displacement

What is the MOI for Smith’s fracture?

FOOSH + hyperflexion

What is the etiology of Smith’s fracture?

palmar displacement

What is the MOI for a scaphoid fracture?

FOOSH

What are the S/Sx of a scaphoid fracture?

pain in anatomical snuff box

What is the MOI for metacarpal fractures?

compression or shear force (possible avulsions)

What are the S/Sx for metacarpal fractures?

“snap”, crepitus, depressed knuckle, may not be able to make a fist

What is Boxer’s fracture?

5th metacarpal fracture

What is Bennet’s fracture?

1st metacarpal fracture

What is the MOI for a phalanx fracture?

direct blow, rotational force

What are the S/Sx for a phalanx fracture?

“snap”, crepitus

What is the MOI for a lunate dislocation?

forceful hyperextension (FOOSH)

What does it mean if the lunate was dislocated ventrally?

lunate dislocation

What does it mean if the lunate was dislocated dorsally?

perilunate dislocation

What are the S/Sx of a lunate dislocation?

deformity of the 3rd knuckle, pain at the wrist & along radius

What is the MOI for a finger dislocation?

direct trauma

What are the S/Sx of a finger dislocation?

obvious deformity, often with fracture

What is the MOI for a wrist sprain

FOOSH + hyperextension/hyperflexion

What does a positive valgus stress test indicate?

UCL sprain

What does a positive varus stress test indicate?

RCL sprain

What other injuries should you rule out for a wrist sprain?

carpal fracture, TFCC tear

What is the MOI for a hand sprain (joint)?

hyperabduction, hyperextension

What does hyperabduction/hyperextension of MCP indicate?

UCL sprain

What is Gamekeeper’s thumb?

avulsion fracture of thumb and UCL tears

What is a S/Sx of Gamekeeper’s thumb?

loss of grip strength in opposition

What is the MOI for TFCC injury?

acute: hyperextension + ulnar deviation

chronic: degeneration of the TFCC (repeated overload) *refer if suspected

What are the S/Sx of a TFCC injury?

pain with forced hyperextension & palpation, “clicking” or “catching” sensations

What is the MOI for carpal tunnel syndrome?

compression of median nerve from direct trauma or repetitive overload

What are the S/Sx of carpal tunnel syndrome?

sensory & motor deficits, symptoms INCREASE at night and DECREASE by shaking

What is the MOI for ganglions?

herniation fills with synovial fluid, hardens and becomes “cyst” like

What are S/Sx of ganglions?

*normally NOT symptomatic, if it becomes symptomatic REFER → pain with motion, TTP