Diferencia entre revisiones de «Lunate fracture»
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| (No se muestran 15 ediciones intermedias de 6 usuarios) | |||
| Línea 2: | Línea 2: | ||
*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 | ||
==Diagnosis== | ==Differential Diagnosis== | ||
*PA and lateral views | {{Carpal fractures}} | ||
==Evaluation== | |||
*Hand x-ray (PA and lateral views) | |||
*MRI/CT may be required to identify occult fractures | *MRI/CT may be required to identify occult fractures | ||
==Management== | ==Management== | ||
* | {{General Fracture Management}} | ||
* | |||
===Immobilization=== | |||
*[[Thumb spica splint]] | |||
==Disposition== | |||
*Discharge with referral to orthopedic surgery | |||
==See Also== | ==See Also== | ||
[[ | *[[Carpal fractures]] | ||
== | ==References== | ||
<references/> | |||
[[Category: | [[Category:Orthopedics]] | ||
Revisión actual - 04:46 18 sep 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