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Images

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Wrist fractures

CT scans of the wrist provide excellent detail to assess fracture geometry, articular involvement, as well as degree of comminution

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3

Wrist fractures

Type C (complex) intra-articular fracture of the distal radius: lateral view

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7

Wrist fractures

Labelled version of previous figure. (a) 1=scaphoid; 2=lunate; 3=triquetral; 4-- =pisiform; 5a=body of hamate; 5b=hook of hamate; 6=capitate; 7=trapezoid; 8=trapezium; 1st→5th=respective metacarpal bases; r=radial styloid; u=ulnar styloid; (b) 1--=scaphoid; 2--=lunate; 6--=capitate; dr--=distal radius (note the distal ulna projected through this); t=dorsal tubercle of the radius; (c) as for a, except 5=hamate. *You can use the mnemonic “so long to pinky, here comes the thumb.” -- Object labelled within the dashed line

BMJ 2014;349:g5758; used with permission

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2

Wrist fractures

Type B (simple) intra-articular fracture of the distal radius: lateral view

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4

Wrist fractures

Fernández classification (I: bending of the metaphysis; II: shearing fractures of the joint surface; III: compression of the joint surface; IV: avulsion or radiocarpal fracture dislocations; V: combined fractures with high velocity injuries)

Shehovych A et al. Ann R Coll Surg Engl 2016 Nov;98(8):525-31; used with permission

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9

Wrist fractures

Cast treatment of a distal radius fracture

From the collection of Dr Chaitanya S. Mudgal

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1

Wrist fractures

Type A extra-articular fracture of the distal radius: lateral view

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5

Wrist fractures

Frykman’s 1967 classification (I: extra-articular; II: as I with fracture of the distal ulna; III: radiocarpal joint involved; IV: as III with fracture of the distal ulna; V: distal radioulnar joint involved; VI: as V with fracture of the distal ulna; VII: radiocarpal and distal radioulnar joints both involved; VIII: as VII with fracture of the distal ulna)

Shehovych A et al. Ann R Coll Surg Engl 2016 Nov;98(8):525-31; used with permission

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6

Wrist fractures

(a) Posteroanterior view, (b) lateral view, and (c) posteroanterior oblique view of a normal right wrist

BMJ 2014;349:g5758; used with permission

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10

Wrist fractures

Plate fixation after open reduction with a volarly placed plate and screws

From the collection of Dr Chaitanya S. Mudgal

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11

Wrist fractures

Posteroanterior x-ray showing malunion of the distal radius with significant shortening of the radius and relative lengthening of the ulna

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