Hand Fracture
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Introduction
Hand fractures are very common and
The Case of...
Signs and Symptoms
- history
- physical exam
History
Paresthesias can follow nerve laceration
Physical Exam
shortening
dropped knuckle (bony prominence in palm)
extensor lap
Investigations
- lab investigations
- diagnostic imaging
Lab Investigations
Diagnostic Imaging
Describing fractures
location
open/closed
angulation (degrees or percentage; describe direction of apex pointing)
displacement
communted?
articulation involved
rotation
Boxer's Fracture
The 5th metacarpal neck, and potentially the 4th; almost always angulated dorsally.
Swelling soreness
attempt reduction when:
- angulation is greater than 30-45% on X-ray
- scissoring (implies rotational fracture)
Reduction
The Jahss maneuver:
Second line: axial traction to digit to release soft tissues (5 minutes).
Bennett's fracture
intraarticular fracture across thumb CMC joint; fracture in
APL pulls base of metacarpal out extend, abduct, supinated
needs to be reduced to restore function and predispose to OA
reduction: pronate
Rolando's Fracture
Comminuted fracture at base of thumb.
Fixed surgically with K-wires
Differential Diagnosis
Treatments
Consequences and Course
The Case of...
Additional Resources
Topic Development
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