Carpal fractures: Difference between revisions
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==Background== | ==Background== | ||
[[File:Carpal bones.png|thumb|Carpal bones]] | |||
[[File:Zone_of_Vulnerability.jpg|thumb|Zone of Vulnerability]] | |||
*[[Scaphoid fracture|Scaphoid fractures]] account for 70% of all carpal fractures | *[[Scaphoid fracture|Scaphoid fractures]] account for 70% of all carpal fractures | ||
*Ulnar nerve damage associated with fractures of hamate or pisiform | *Ulnar nerve damage associated with fractures of hamate or pisiform | ||
*50% of pisiform fracture associated with injury to distal radius or other carpal bone | *50% of pisiform fracture associated with injury to distal radius or other carpal bone | ||
*If bone fragment seen posterior to carpus on lateral, very likely triquetrum fracture | *If bone fragment seen posterior to carpus on lateral, very likely triquetrum fracture | ||
==Fracture Types== | ==Fracture Types== | ||
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==Evaluation== | ==Evaluation== | ||
[[Image:Wrist_-_Lateral.jpg|thumb|Lateral view]] | |||
*Evaluate Zone of Vulnerability (see picture) | *Evaluate Zone of Vulnerability (see picture) | ||
==Management== | |||
{{General Fracture Management}} | |||
==Management== | ===Specific Management=== | ||
*Based on fracture location (see individual fracture page for details) | *Based on fracture location (see individual fracture page for details) | ||
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*[[Fractures (main)]] | *[[Fractures (main)]] | ||
*[[Carpal dislocations]] | *[[Carpal dislocations]] | ||
==References== | ==References== | ||
Latest revision as of 22:12, 27 March 2024
Background
- Scaphoid fractures account for 70% of all carpal fractures
- Ulnar nerve damage associated with fractures of hamate or pisiform
- 50% of pisiform fracture associated with injury to distal radius or other carpal bone
- If bone fragment seen posterior to carpus on lateral, very likely triquetrum fracture
Fracture Types
Carpal fractures
- Scaphoid fracture
- Lunate fracture
- Triquetrum fracture
- Pisiform fracture
- Trapezium fracture
- Trapezoid fracture
- Capitate fracture
- Hamate fracture
Evaluation
- Evaluate Zone of Vulnerability (see picture)
Management
General Fracture Management
- Acute pain management
- Open fractures require immediate IV antibiotics and urgent surgical washout
- Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
- Consider risk for compartment syndrome
Specific Management
- Based on fracture location (see individual fracture page for details)