Chapter 1 - Hand and wrist emergencies

Summary

This chapter presents the key facts, diagnostic testing, treatments, and prognosis of various types of hand and wrist fractures such as distal radius fracture, distal radioulnar joint disruption (DRUJ), carpal bone fractures, metacarpal bone fractures, phalangeal bone fractures, and distal phalanx fracture. Distal radius and ulnar injuries are often associated with median and ulnar neuropathies. A transverse fracture of the distal radial metaphysis with dorsal displacement and angulation, often caused by a fall on an outstretched hand. The lateral radiograph is the best view for revealing an intra-articular fracture of the radius and any associated carpal displacement in Barton fractures. A posteroanterior (PA) radiograph often shows a comminuted fracture of the distal radius. Barton fractures require emergency orthopedic/hand-specialist consultation for early operative management. Non-displaced Hutchinson fractures can be managed with a short-arm splint and routine orthopedic/hand-specialist follow-up.