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===Reduction===
===Reduction===
[[Digital block]]
''Consider [[digital block]] for pain control''
*Dorsal  
====Dorsal====
**Flex wrist
*Flex wrist
**Hyperextend the joint  
*Hyperextend the joint  
**Apply longitudinal traction followed by dorsal pressure to phalanx base
*Apply longitudinal traction followed by dorsal pressure to phalanx base
**Irreducible cases due to entrapment of avulsion fracture, profundus tendor or volar plate
*Irreducible cases due to entrapment of avulsion fracture, profundus tendor or volar plate
***Without initial hyperextension, can be difficult to disengage from any trapped soft tissue
**Without initial hyperextension, can be difficult to disengage from any trapped soft tissue
**Post reduction, look for central slip rupture, which may lead to [[Boutonniere deformity]]
*Post reduction, look for central slip rupture, which may lead to [[Boutonniere deformity]]
*Volar
 
**Often need open reduction due to volar plate entrapment
====Volar====
**Flex wrist then hyperflex the affected joint
*Often need open reduction due to volar plate entrapment
**Apply gentle traction then extend the joint
*Flex wrist then hyperflex the affected joint
*Apply gentle traction then extend the joint

Revisión del 19:38 25 feb 2018

Reduction

Consider digital block for pain control

Dorsal

  • Flex wrist
  • Hyperextend the joint
  • Apply longitudinal traction followed by dorsal pressure to phalanx base
  • Irreducible cases due to entrapment of avulsion fracture, profundus tendor or volar plate
    • Without initial hyperextension, can be difficult to disengage from any trapped soft tissue
  • Post reduction, look for central slip rupture, which may lead to Boutonniere deformity

Volar

  • Often need open reduction due to volar plate entrapment
  • Flex wrist then hyperflex the affected joint
  • Apply gentle traction then extend the joint