Lunate fracture: Difference between revisions
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*Isolated lunate injuries are rare | *Isolated lunate injuries are rare | ||
*Occurs via FOOSH mechanism | *Occurs via FOOSH mechanism | ||
*Blood supply enters distal end | *Blood supply enters distal end - proximal fracture fragment at risk of [[avascular necrosis]] (Kienbock’s disease) | ||
==Clinical Features== | ==Clinical Features== | ||
* | *Tenderness elicited by axial compression applied along 3rd metacarpal | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Carpal fractures}} | {{Carpal fractures}} | ||
==Evaluation== | |||
*Hand x-ray (PA and lateral views) | |||
*MRI/CT may be required to identify occult fractures | |||
==Management== | ==Management== | ||
* | {{General Fracture Management}} | ||
===Immobilization=== | |||
*[[Thumb spica splint]] | |||
==Disposition== | ==Disposition== | ||
* | *Discharge with referral to orthopedic surgery | ||
==See Also== | ==See Also== | ||
[[ | *[[Carpal fractures]] | ||
==References== | ==References== | ||
<references/> | |||
[[Category:Orthopedics]] | [[Category:Orthopedics]] | ||
Latest revision as of 04:46, 18 September 2019
Background
- Isolated lunate injuries are rare
- Occurs via FOOSH mechanism
- Blood supply enters distal end - proximal fracture fragment at risk of avascular necrosis (Kienbock’s disease)
Clinical Features
- Tenderness elicited by axial compression applied along 3rd metacarpal
Differential Diagnosis
Carpal fractures
- Scaphoid fracture
- Lunate fracture
- Triquetrum fracture
- Pisiform fracture
- Trapezium fracture
- Trapezoid fracture
- Capitate fracture
- Hamate fracture
Evaluation
- Hand x-ray (PA and lateral views)
- MRI/CT may be required to identify occult fractures
Management
General Fracture Management
- Acute pain management
- Open fractures require immediate IV antibiotics and urgent surgical washout
- Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
- Consider risk for compartment syndrome
Immobilization
Disposition
- Discharge with referral to orthopedic surgery