Non-thumb metacarpal fracture (base): Difference between revisions
Neil.m.young (talk | contribs) (Text replacement - "==Source== <references/>" to "==References== <references/>") |
Neil.m.young (talk | contribs) (Text replacement - "fx " to "fracture ") |
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* AP, lateral, oblique | * AP, lateral, oblique | ||
* 30 deg obliques pronated and supinated if usual films unable to visualize the MC bases | * 30 deg obliques pronated and supinated if usual films unable to visualize the MC bases | ||
* Consider CT if index of suspicion high for occult | * Consider CT if index of suspicion high for occult fracture despite "negative" plain films | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
| Line 18: | Line 18: | ||
* Refer for: | * Refer for: | ||
** Intraarticular fx | ** Intraarticular fx | ||
** Extraarticular | ** Extraarticular fracture with malrotation | ||
** Dislocation of metacarpal base CMC joint; | ** Dislocation of metacarpal base CMC joint; | ||
** Ulnar nerve injury | ** Ulnar nerve injury | ||
** 5th metacarpal base | ** 5th metacarpal base fracture (typically require sx) | ||
==See Also== | ==See Also== | ||
Revision as of 01:01, 3 July 2016
Examination
- Movement at the wrist elicits pain
- Assess for ulnar deficits (finger abduction/adduction)
- Assess for rotational alignment
Imaging
- AP, lateral, oblique
- 30 deg obliques pronated and supinated if usual films unable to visualize the MC bases
- Consider CT if index of suspicion high for occult fracture despite "negative" plain films
Differential Diagnosis
Hand and Finger Fracture Types
Treatment
- Dorsal and Forearm Volar Splint with the wrist in 30 deg of extension and MCP joints free
Disposition
- Refer for:
- Intraarticular fx
- Extraarticular fracture with malrotation
- Dislocation of metacarpal base CMC joint;
- Ulnar nerve injury
- 5th metacarpal base fracture (typically require sx)