Anatomy clinical correlates: Wrist and hand
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Anatomy clinical correlates: Wrist and hand
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Anatomy clinical correlates: Clavicle and shoulder
Anatomy clinical correlates: Axilla
Anatomy clinical correlates: Arm, elbow and forearm
Anatomy clinical correlates: Wrist and hand
Anatomy clinical correlates: Median, ulnar and radial nerves
Anatomy clinical correlates: Bones, joints and muscles of the back
Anatomy clinical correlates: Hip, gluteal region and thigh
Anatomy clinical correlates: Knee
Anatomy clinical correlates: Leg and ankle
Anatomy clinical correlates: Foot
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Anatomy clinical correlates: Wrist and hand
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Transcript
In everyday life, we rely on our hands for a variety of reasons, from vigorously typing out notes while watching an Osmosis video to playing musical instruments or participating in sports.
Unfortunately, since we use them so much, the hands are quite prone to injury.
Alright, let's start by looking at distal forearm fractures.
There’s two kinds: Colles fracture, which are a direct result of falling on an extended wrist, and Smith fracture, which results from falling on a flexed wrist, or a direct blow to the posterior forearm.
With Colles fractures, the displaced radial fragment moves posteriorly, or dorsally, and the ulnar styloid process can also become fractured.
Clinically, when the distal radial segment moves dorsally this is called a “dinner fork deformity” because when viewed laterally, the hand and wrist are slightly curved anteriorly making it look like a fork.
With Smith fractures, on the other hand, the displaced distal radial fragment moves anteriorly, or ventrally, which clinically translates as a “garden spade” deformity.
Next, let’s look at carpal bone fractures, of which the most common are scaphoid fractures.
Scaphoid fractures occur as a result of falling on the lateral side of an outstretched hand in abduction.
Clinically, this results in pain and tenderness on the lateral side of the wrist and hand, in a location called the anatomical snuffbox, which is where you can palpate the scaphoid bone between the tendons of extensor pollicis longus on the medial side and extensor pollicis brevis and abductor pollicis longus on the lateral side.
The big problem with these fractures is that because the blood vessels supply the distal part of the scaphoid first then come back and supply the proximal part, a fracture in the middle of this bone disrupts the blood supply.
This can cause avascular necrosis and non union of the proximal fragment of the scaphoid, which is basically when the bone dies off because of lack of blood, and degenerative wrist joint disease.
Sources
- "Raj's Practical Management of Pain" Elsevier Health Sciences (2008)
- "Synergy" Oxford University Press (2008)
- "Human Anatomy and Physiology" Pearson Education (2003)
- "Human Anatomy and Physiology" Pearson Education (2003)
- "Stabilization and treatment of Colles’ fractures in elderly patients" Clinical Interventions in Aging (2010)
- "Scaphoid Fracture - Overview and Conservative Treatment" Hand Surgery (2015)
- "The Wrist: Clinical Anatomy and Physical Examination—an Update" Primary Care: Clinics in Office Practice (2005)
- "Diagnosing and managing carpal tunnel syndrome in primary care" British Journal of General Practice (2014)
- "Clinical associations of Dupuytren's disease" Postgraduate Medical Journal (2005)
- "Stabilization and treatment of Colles’ fractures in elderly patients" Clin Interv Aging (2010)
- "Carpal tunnel syndrome in pregnancy" Orthop Clin North Am (2012)
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