Compound Fracture Case Study
Any pain in the limb of the same side should also be investigated to Fractute associated injuries to the same limb. Reverse deformity is seen in volar angulation Smith's fracture. The wrist may be radially deviated Compound Fracture Case Study to shortening of the radius bone.
Decreased sensation especially at the tips of the radial three and one half digits thumb, index finger, middle finger and radial portion of the ring finger can be due to median nerve injury. Swelling and displacement can cause compression on the median nerve which results in acute carpal tunnel syndrome and requires prompt treatment.
Very rarely, pressure on the muscle components of the hand or forearm is sufficient to create a compartment syndrome which can manifest as severe pain and sensory deficits in the hand. Malunionhowever, is not uncommon, and can lead to residual pain, grip weakness, reduced range of motion especially rotationand persistent deformity. Symptomatic malunion may require additional surgery.
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If the joint surface is damaged and heals with more than 1—2 mm of unevenness, the wrist joint will be prone to post-traumatic osteoarthritis. Half of nonosteoporotic patients will develop post-traumatic arthritis, specifically limited radial deviation and wrist flexion. This arthritis can worsen over time. Tendon injury can occur in people treated both nonoperatively and operatively, most commonly to the extensor pollicis longus tendon.
This can be due to the tendon coming in contact with protruding bone or with hardware placed following surgical procedures. The cause for this condition is unknown. People who fall on the outstretched hand are usually fitter and have better reflexes when compared to those with elbow or humerus fractures.
The characteristics of distal radius fractures are influenced by the position of the hand at the time of impact, Compojnd type of surface at point of contact, the speed of the impact, and Compound Fracture Case Study strength of the bone. Distal radius fractures typically occur with the wrist bent back from 60 to 90 degrees. If the wrist is bent back less, then proximal forearm fracture would occur, but if the bending back is more, then the carpal bones fracture would occur.
With increased bending back, more force is required to produce a fracture. More force is required to produce a fracture in males than females.
Risk of injury increases in those with osteoporosis. There is an increased risk of interosseous intercarpal injury if the ulnar variance the difference in height between the distal end of the ulna and the distal end of the radius Compound Fracture Case Study more than 2mm and there is fracture into the wrist joint. Ulnar styloid process fracture increases the risk of TFCC injury by a factor of However, it is unclear whether intercarpal ligaments and triangular fibrocartilage injuries are associated with long term pain and disability for those who are affected.
Diagnosis may be evident clinically when the distal radius is deformed, but should be confirmed by X-ray. The differential diagnosis includes scaphoid fractures and wrist dislocations, which can also co-exist with a distal radius fracture. Occasionally, fractures may not be seen on X-rays immediately after the injury. X-ray of the affected wrist is required if a fracture is suspected.
Posteroanterior, lateral, and oblique views can be used together to Compound Fracture Case Study the fracture. If the carpal bones are Compounnd, both lines will intersect within the carpal bones. If the carpal bones are not aligned, both lines will intersect outside the carpal bones. Carpal malignment is frequently associated with dorsal or volar tilt of the radius and will have poor grip strength and poor forearm rotation. Tear drop angle less than 45 degrees indicates displacement of lunate facet.]
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