Emergency Medicine Cases Ep 189 Commonly Missed and Mismanaged Wrist Injuries
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Dec 19, 2023 
Experts Dr. Arun Sayal and Dr. Matt DiStefano discuss commonly missed wrist injuries in the ED. They cover topics like DRUJ injuries, x-ray views for diagnosis, and management of fractures including Colles vs Barton's vs Smith's. Key x-ray signs for wrist injuries and TFC tears in distal radius fractures are highlighted.
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History Gathering in Wrist Injuries
- Gather history details like age, comorbidities, occupation, and hand dominance before examining a suspected wrist injury.
- This helps construct a wider differential diagnosis and avoid cognitive bias.
Age and Eponyms in Wrist Injuries
- Age influences tissue quality in orthopedic trauma, affecting the differential diagnosis.
- Eponyms like "Colles' fracture" can be misleading, as they often imply specific mechanisms and bone quality.
Wrist Exam Pearls
- Palpate for point of maximal tenderness to localize pathology, as wrist x-rays can be normal despite injury.
- Remember surface anatomy and palpate key areas like Lister's tubercle, scapholunate ligament, and DRUJ.