Emergency Medicine Cases Ep 190 Carpal Bone Injuries – The Big 4
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Jan 2, 2024 Learn about commonly missed carpal bone injuries - the 'Big 4'. Discover key historical, physical exam, and x-ray findings, along with management strategies. Explore high-energy carpal injuries in young individuals and the importance of prompt reduction. Dive into the diagnosis and treatment of carpal bone injuries, with a focus on hook of hamate fractures. Uncover the debate on diagnostic tests for wrist injuries and the introduction of a donation button for supporting free access content.
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Age and Wrist Injury
- Consider age-related prevalence in wrist injuries.
- Younger and older patients are more prone to distal radius fractures, while those in between are more susceptible to carpal bone or ligament injuries.
Carpal Bone Injury Frequency
- Scaphoid fractures are the most common carpal bone injury (66%).
- Triquetral chip fractures are the second most common (20%), followed by lunate (10%), and hook of hamate (few %).
Triquetral Chip Fracture Assessment
- For triquetral chip fractures, palpate the dorsal wrist proximal to the fourth metacarpal.
- Look for a small flake on the lateral X-ray; immobilize with a removable splint.