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Dr. Hammad Haider extensively elaborates wrist injuries in this sqadia.com medical video lecture. Initially, light is shed on carpal injuries. Then fractured scaphoid along with carpal bones fracture and ulnar sided wrist injury comes under debate. Moreover, carpal dislocations and subluxation are conclusively discussed.
In carpal injuries, entire carpus suffers and vary greatly in type and severity. Commonest carpal injuries encompass fracture of carpal bone, dislocations of lunate or bones around it, self-limiting sprains of joint capsule. Among imaging techniques, X-rays are key to diagnosis. In case of unavailability of MRI, repeated X-rays are needed. Moreover, wrist arthroscopy is also discussed.
Fractured scaphoid is rare in elderly and in children. Anatomically, scaphoid lies obliquely across two rows of carpal bones. Subsequently, mechanism of injury and pathological anatomy also comes under consideration. Clinical features include pain in axial compression, ulnar distraction, and tenderness. Treatment modality of undisplaced waist fractures, displaced fractures, and proximal pole fractures is also discussed.
Carpal Bones Fracture
Hamate is one of the fractures of other carpal bones which is not seen on routine X-rays, CT scan or MRI is needed. After that trapezium comes under consideration. Body of trapezium can be fractured which settles through open reduction and internal fixation. Ridge is fractured by direct blow. Likewise, capitate is elaborated. Fractures of lunate are categorized into undisplaced and displaced fractures. However, fractures of lunate are rare.
Ulnar Sided Wrist Injury
Ulnar-side wrist injuries are damaged in isolation. Some of the clinical features of ulnar-side wrist injuries comprise pain and often clinking, tenderness over injured site, piano-key sign, and pain on rotation of forearm. Arthrography, CT, MRI, and arthroscopy are needed to conﬁrm diagnosis. Treatment of chronic instability may require reconstructive surgery. Treatment option of other acute conditions is also discussed.
Carpal Dislocations and Subluxation
Primarily, lunate and perilunate dislocations are elaborated. Clinical features include painful and swollen wrist. AP view of X-rays demonstrates carpus is diminished in height and bone shadows overlap abnormally. Treatment options follows closed reduction and open reduction. Clinical features of scapholunate dissociation are highlighted later on along with the lunotriquetral dissociation.