Diagnostic Imaging 2- Exam 2- Triquetral to Hand Notes

What is the 2nd most common carpal fractured

Triquetral

What is usually an avulsion from the dorsal surface at the site of attachment of the radiotriquetral and ulnotriquetral ligament

Triquetral fracture

Triquetral fracture has also been called

Fishers fracture

Mechanism of injury for Triquetral fracture

Hyperflexion

People with a Triquetral fracture will have pain where

Posterior ulnar side of the wrist

Avulsion fracture of triquetrum

Triquetral fracture

Another Triquetral fracture

What is the sign called for noticing a Triquetral fracture

Pooping duck sign

What is the 3rd most common carpal fracture

Hamate

Hamate fractures usually involve

The hook

Hamate fractures can be from

Direct blow to hypothenar eminence or sports holding onto clubs, bats, etc

Hamate fracture

Slight indistinctness of the hamate hook suggests

Trauma of hook of hamate

Avulsion hamate fracture

Pisiform fracture

Pisiform fracture again

What is the most common carpal dislocation

Perilunate dislocation

Perilunate dislocations are usually which direction

Posterior

What are the different types of carpal dislocations

Perilunate dislocation

Lunate dislocation

Rotatory subluxation of scaphoid

Lunate dislocations are usually which direction

Anterior

What is the most common carpal dislocation

Positerior Perilunate dislocation

Describe what a posterior Perilunate dislocation looks like

Lunate stated with the radius but capitate has gone backwards

Posterior Perilunate dislocation

Another posterior perinlute dislocation

One more posterior periliunate dislocation

Last posterior Perilunate dislocation

What is the second most common carpal dislocation

Lunate dislocation

Lunate dislocation results from

Hyperextension injury

Lunate dislocation typically goes which direction

Volvarly and tilts anteriorly

What do you see with a lunate dislocation on PA wrist view

Pie sign

Describe what you'd see on X ray with an anterior lunate dislocation

Pie sign and the lunate doesn't articulate with radius anymore

Anterior lunate dislocation with pie sign

Another anterior lunate dislocation with pie sign

What is the most common type of carpal instability patterns

Rotatory subluxation of the scaphoid

What do you see on X ray with rotatory subluxation of the scaphoid

Terry Thomas sign >4mm gap

Shortened appearance of scaphoid

ring sign

Example of rotatory subluxation of scaphoid with the ring side, terry thomas sign and shortened scaphoid appearance

Rotatory subluxation of the scaphoid

Another example of rotatory subluxation of the scaphoid

Example of scapholunate instability

- explain why it is not rotatory subluxation of scaphoid

Cause it doesn't have ring sign or shortened scaphoid appearance

Showing difference between scapholunate instability and rotatory scaphoid subluxation

Fracture of the neck of the firth or sometimes forth metacarpal

Boxers fracture

Boxers fracture the distal fragment is angled

Volarly

Boxers fracture

Another boxers fracture

Another name for baseball finger

Mallet finger

An avulsion of the extensor tendon at its insertion on the dorsal surface of the base of the distal phalanx

Baseball or mallet finger

What results from a blow to the end of the finger causing hyperflexion to a forcibly extended finger

Baseball or mallet finger

Baseball or mallet finger

Another mallet finger

Volar plate fracture, explain why its not a mallet finger

Just a small Avulsion fracture and not a mallet finger because a mallet finger is on the dorsal surface and this Avulsion fracture is on the volar (palmar) surface

Volar plate fracture

Oblique fracture of the midshaft of the 2nd digit proximal phalange

What are the intra articular injuries that can occur in the thumb

Bennett

Rolandos (comminuted)

What are the extra-articular injuries that can occur in the thumb

Transverse

Oblique

Epiphyseal separation

Most of the fractures of the first metacarpal involve which portion

Proximal portion

Fractures of the first metacarpal are from

Direct blow along the longitudinal axis or fall

Hyper abduction or hyperextension

Oblique fracture of the base of the first metacarpal, associated with dorsal subluxation of the first metacarpal

Bennett fracture

What is the most common injury to the first metacarpal

Bennett fracture

Displacement of a Bennett fracture is due to

Abductor policies longus muscles

Bennett fracture

Another example of Bennett fracture

Comminuted Bennett fracture is known as

Rolando`s fracture

Intrarticular comminuted fracture at the base of the 1st metacarpal with radial displacement

Rolando`s fracture

Rolandos fracture

Another Rolando's fracture

Difference between a Bennett fracture, Rolando's fracture and just a regular transverse oblique fracture at the base of the 1st metacarpal

Partial or complete disruption of the ulnar collateral ligament of the 1st MCP articulation

Gamekeepers (skiers) thumb

Gamekeepers is what type of injury

Vagus injury form repeated stress

-may have small Avulsion framing typically form the base of the proximal phalanx

Gamekeepers thumb

Another gamekeepers (skiers) thumb

What is the most common dislocation of the hand

Dorsal

Dislocations of the and result from

Rotatory twisting forces

Dislocations are most often

Single joint involvement

Dorsal dislocation at the PIP

Dorsal discoloration at the PIP again

Positive or dislocation of the PIP and posterior dislocation of the DIP