Non-thumb metacarpal fracture (base): Difference between revisions
Neil.m.young (talk | contribs) (Text replacement - "==Treatment==" to "==Management==") |
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==Examination== | ==Examination== | ||
* Movement at the wrist elicits pain | *Movement at the wrist elicits pain | ||
* Assess for ulnar deficits (finger abduction/adduction) | *Assess for ulnar deficits (finger abduction/adduction) | ||
* Assess for rotational alignment | *Assess for rotational alignment | ||
==Imaging== | ==Imaging== | ||
* 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 fracture despite "negative" plain films | *Consider CT if index of suspicion high for occult fracture despite "negative" plain films | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Management== | ==Management== | ||
* Dorsal and [[Forearm Volar Splint]] with the wrist in 30 deg of extension and MCP joints free | *Dorsal and [[Forearm Volar Splint]] with the wrist in 30 deg of extension and MCP joints free | ||
==Disposition== | ==Disposition== | ||
* Refer for: | *Refer for: | ||
** Intraarticular fx | **Intraarticular fx | ||
** Extraarticular fracture with malrotation | **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 fracture (typically require sx) | **5th metacarpal base fracture (typically require sx) | ||
==See Also== | ==See Also== | ||
Revision as of 09:44, 8 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
Management
- 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)