We All Fall Down

This guy fell down the stairs, but it happened so fast that he didn't know what exactly happened to injure his wrist. Clearly, it is messed up. What kind of information might the orthopedist want to know?       Distal radius fractures are not uncommon injuries in the emergency department. Many happen after a FOOSH — a fall on an outstretched (usually hyper-extended) hand — resulting in a dorsally displaced radial fracture called a Colles' fracture. This man's injury, however, cannot be a Colles' because the fracture is volarly displaced. It is a Smith's fracture.   I don't like eponyms, though. It is too easy to miscommunicate with others. I believe it is far better to describe the fracture specifically to the consultant.   In this case, the fracture: is volarly angulated. is comminuted. is intra-articular into the radiocarpal joint. is significantly radially shortened, and loss of the radial angle is such that the radial and ulnar styloid are at the same level and the lunate now sits adjacent to the ulna. includes an additional fracture of the ulnar styloid as well as disruption of the radio-ulnar joint.   It is important to know what normal looks like to truly convey what is abnormal. Two points to consider in every distal radius evaluation:   Distal Radial Length: The distal radial length is measured from a point the level of the radioulnar joint to the distal end of the radial styloid. The radial styloid usually extends 11-13 mm beyond th...
Source: Lions and Tigers and Bears - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs