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Questions and Answers
What is another name for Smith's fracture?
What is another name for Smith's fracture?
Which mechanism of injury is associated with a Smith's fracture?
Which mechanism of injury is associated with a Smith's fracture?
In Smith's fracture, the distal radial segment displaces in which direction?
In Smith's fracture, the distal radial segment displaces in which direction?
Smith's fracture occurs due to which type of fall?
Smith's fracture occurs due to which type of fall?
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How does Smith's fracture differ from a Colles' fracture?
How does Smith's fracture differ from a Colles' fracture?
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What is the most common fracture of the distal radius?
What is the most common fracture of the distal radius?
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What mechanism of injury typically causes a Colles' fracture?
What mechanism of injury typically causes a Colles' fracture?
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In which direction is the distal segment displaced in a Colles' fracture?
In which direction is the distal segment displaced in a Colles' fracture?
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Which clinical sign is associated with Colles' fracture?
Which clinical sign is associated with Colles' fracture?
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What is the common treatment required for a Colles' fracture?
What is the common treatment required for a Colles' fracture?
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What type of wrist deviation is typically involved in a minor fall on an outstretched palm?
What type of wrist deviation is typically involved in a minor fall on an outstretched palm?
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Pain and swelling in which area is commonly associated with a scaphoid injury?
Pain and swelling in which area is commonly associated with a scaphoid injury?
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What is a common consequence of misdiagnosing a scaphoid fracture as a sprain?
What is a common consequence of misdiagnosing a scaphoid fracture as a sprain?
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Which symptom is NOT typically expected with a scaphoid injury?
Which symptom is NOT typically expected with a scaphoid injury?
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What typically triggers further evaluation in a suspected scaphoid injury?
What typically triggers further evaluation in a suspected scaphoid injury?
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What specific area of the wrist is associated with pain in this clinical presentation?
What specific area of the wrist is associated with pain in this clinical presentation?
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Which activity is most likely to exacerbate pain according to the impairments listed?
Which activity is most likely to exacerbate pain according to the impairments listed?
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Which functional limitation is highlighted in the clinical presentation?
Which functional limitation is highlighted in the clinical presentation?
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What type of motion, in addition to wrist extension, potentially increases pain in this clinical scenario?
What type of motion, in addition to wrist extension, potentially increases pain in this clinical scenario?
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What aspect of hand function is directly affected, leading to decreased use for functional activities?
What aspect of hand function is directly affected, leading to decreased use for functional activities?
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Distal ulnar fractures typically occur in conjunction with which other type of fracture?
Distal ulnar fractures typically occur in conjunction with which other type of fracture?
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Persistent pain with rotation in a patient with a distal ulnar fracture might suggest damage to which structure?
Persistent pain with rotation in a patient with a distal ulnar fracture might suggest damage to which structure?
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What secondary condition should be suspected if pain persists with weight bearing following a distal ulnar fracture?
What secondary condition should be suspected if pain persists with weight bearing following a distal ulnar fracture?
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Which symptom might indicate a complication in a patient with a distal ulnar fracture?
Which symptom might indicate a complication in a patient with a distal ulnar fracture?
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What is a possible complication in distal ulnar fractures if the patient continues to experience rotational pain?
What is a possible complication in distal ulnar fractures if the patient continues to experience rotational pain?
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Which of the following diagnostic imaging methods may reasonably follow an X-ray to assess fracture and potential ligamentous damage?
Which of the following diagnostic imaging methods may reasonably follow an X-ray to assess fracture and potential ligamentous damage?
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Which part of the scaphoid bone significantly affects its healing time due to its blood supply when fractured?
Which part of the scaphoid bone significantly affects its healing time due to its blood supply when fractured?
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What is the typical immobilization period for fractures in the distal part of the scaphoid bone?
What is the typical immobilization period for fractures in the distal part of the scaphoid bone?
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Which type of fracture is commonly caused by punching a hard object?
Which type of fracture is commonly caused by punching a hard object?
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What type of splint is used to immobilize fractures that are not displaced or can be easily reduced?
What type of splint is used to immobilize fractures that are not displaced or can be easily reduced?
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If a patient has a fracture at the palmar base of the proximal first metacarpal, what is the most likely diagnosis?
If a patient has a fracture at the palmar base of the proximal first metacarpal, what is the most likely diagnosis?
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Which of the following is not a typical cause of metacarpal fractures laid out in the content?
Which of the following is not a typical cause of metacarpal fractures laid out in the content?
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What is the recommended treatment for non-reducible fractures of the scaphoid?
What is the recommended treatment for non-reducible fractures of the scaphoid?
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A fracture involving which metacarpal is least likely to be diagnosed as a Boxer's fracture?
A fracture involving which metacarpal is least likely to be diagnosed as a Boxer's fracture?
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Which of the following descriptions best fits a Bennett fracture?
Which of the following descriptions best fits a Bennett fracture?
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What is the recommended duration for immobilizing a Boxer's fracture if the fracture is unstable?
What is the recommended duration for immobilizing a Boxer's fracture if the fracture is unstable?
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Which motion is the focus of AROM exercises following a Boxer's fracture?
Which motion is the focus of AROM exercises following a Boxer's fracture?
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When is PROM and strengthening typically initiated in the treatment of a Boxer's fracture?
When is PROM and strengthening typically initiated in the treatment of a Boxer's fracture?
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Which of the following is suggested for edema management in a Boxer's fracture?
Which of the following is suggested for edema management in a Boxer's fracture?
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What is the purpose of interossei strengthening in the rehabilitation of a Boxer's fracture?
What is the purpose of interossei strengthening in the rehabilitation of a Boxer's fracture?
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Which activity is recommended to increase tendon gliding after immobilization?
Which activity is recommended to increase tendon gliding after immobilization?
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What type of splint will a patient initially have after immobilization?
What type of splint will a patient initially have after immobilization?
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Which of the following principles is emphasized during the immobilization phase?
Which of the following principles is emphasized during the immobilization phase?
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Which method may be used if a patient has difficulty regaining full ROM?
Which method may be used if a patient has difficulty regaining full ROM?
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Which is not a strengthening exercise recommended post immobilization?
Which is not a strengthening exercise recommended post immobilization?
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Which of the following is essential before beginning active motion in the management of a Bennett fracture?
Which of the following is essential before beginning active motion in the management of a Bennett fracture?
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Which guideline should therapy for a Bennett fracture follow?
Which guideline should therapy for a Bennett fracture follow?
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What is emphasized during rehabilitation to regain function in a Bennett fracture?
What is emphasized during rehabilitation to regain function in a Bennett fracture?
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Which exercise progression is recommended for a Bennett fracture?
Which exercise progression is recommended for a Bennett fracture?
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Why is it crucial to confirm union at the fracture site with an X-ray before starting active motion in Bennett fracture?
Why is it crucial to confirm union at the fracture site with an X-ray before starting active motion in Bennett fracture?
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Study Notes
Fractures of the Distal Radius
- Most common fracture of the distal radius is Colles' fracture
- Mechanism of injury: fall on the palm of an outstretched arm/hand
- Distal segment is displaced dorsally, resulting in "dinner fork deformity"
- Usually requires reduction
Smith's Fracture
- Also known as reverse Colles' fracture
- Mechanism of injury: fall on the dorsal (posterior) side of an outstretched hand
- Distal radial segment displaces in the palmar direction
Distal Ulnar Fractures
- Usually occur with distal radius fractures
- May be associated with a tear to the soft tissue (triangular fibrocartilage complex)
Pathophysiology/Pathomechanics/MO
- Minor fall on an outstretched palm can cause fracture
- Wrist extended and radially deviated at time of injury
- Often dismissed as a sprain, leading to delayed diagnosis and treatment
- Patient may experience continued pain and swelling in the "anatomic snuff box"
Clinical Presentation
- Pain on the radial side of the wrist at the "anatomical snuff box"
- Pain with wrist extension and gripping
- Decreased grip strength
Impairments
- Pain on the radial side of the wrist
- Pain with wrist extension and gripping
Activity Limitations and Participation Restrictions
- Decreased use of the hand for functional activities
Medical Management
- Diagnostic imaging: X-ray, possible MRI and CT follow-up
- Pharmacological interventions: pain management as needed
- Surgical procedures: determined by location of the fracture
Conservative Management
- Rehab begins during immobilization
- Focus on decreasing swelling, ROM of uninvolved joints, and wrist exercises
- After immobilization, patient will have spica splint initially
- Further treatment includes strengthening, stretching, and ROM exercises
Metacarpal Fractures
- Caused by falls, jammed fingers, or direct trauma
- Can fracture the base, shaft, or head of the metacarpal
- Boxer's fracture: fracture of the 4th or 5th metacarpal
- Bennett fracture: fracture of the palmar base of the proximal first metacarpal
Boxer's Fracture
- Immobilized 3-4 weeks, with additional 2 weeks in a sling splint
- Proximal interphalangeal joints (PIP) can flex and extend within 24 hours
- Edema management: isotoner gloves, massage, elevation
- AROM focuses on extensor digitorum communis motion, MCP flexion, and composite flexion
Bennett Fracture
- X-ray must confirm union at the fracture site before active motion begins
- Therapy follows same guidelines as Boxer's fracture
- Emphasizes regaining web space of the thumb, opposition, and composite flexion and extension movements
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Description
Learn about the most common fracture of the distal radius, its mechanism of injury, and characteristics. Identify the 'dinner fork deformity' and understand the treatment requirements.
