Upper Extremity WRISTANATOMY REVIEWPowerPoint PresentationSlide 4TEST YOURSELFSlide 6www.rad.washington.eduSlide 8WRIST (5)Slide 10PA WRISTSlide 12Slide 13Slide 14PA OBLIQUE WRISTPA OBLIQUESlide 17AP OBLIQUE WRISTSlide 19Alternate positioning for obliquesTHESE ARE THE SAME POSITION ON THE IMAGEWhich Oblique & What is seen?OBLIQUE WRIST PA OBL (LAT ROT) / AP OBLIQ (MED ROT)PA Oblique / AP ObliqueSlide 25Slide 26“true” LateralSlide 28Slide 29Slide 30Slide 31Slide 32SCAPHOIDWhen the hand is turned toward the ulnar side, it is termed:Slide 35ADDITONAL VIEWS - WRISTSlide 37Slide 38Slide 39Slide 40CRITIQUESlide 42Slide 43PATHOLOGY FOR UPPER EXTREMITY 1Slide 45Slide 46Fracture type?Problem/ Path?greenstickTorus or BuckleThis fracture is most common in children between the ages of 5 and 11. Typically, the child reports having fallen onto his or her outstretched hand.impactedscaphoidScaphoid fx new 3 wks laterSCAPHOID FXSlide 56Slide 57Slide 58Colles’ FractureColles' fractureSlide 61Slide 62Slide 63Slide 64Smith's fractureSMITH’S FXSmith’s FXBARTON’S fxColles vs Barton’sColles' fracture?Slide 71Slide 72Slide 731Upper ExtremityWRIST RTEC 123 # 1B LECTUREContributions by:MOSBY – MERRILLS & BONTAGERXRAY2000.CO.UK rev 10/10/112ANATOMY REVIEWWRIST34SLTPTTCH5TEST YOURSELF67www.rad.washington.edu8•Use a FULL SHIELD•PROTECT THE BREAST & THYROID•HAVE PATIENT TURN THEIR HEADPOSITIONING9WRIST (5)•PA•OBLIQUE (MEDIAL)- PA OBLIQUE•LATERAL•OBLIQUE (LATERAL) AP OBLIQUE•ULNAR DEVIATION (SCAPHOID “view”)1011Note incorrect position of patient ! ↑PA WRIST121314PA vs AP WRIST15PA OBLIQUE WRIST16PA OBLIQUE17PA OBLIQUE18AP OBLIQUE WRIST1920Alternate positioning for obliques21THESE ARETHE SAME POSITIONON THE IMAGEPA OBLIQ / AP OBLIQ : LAT ROTATION22Which Oblique & What is seen?23OBLIQUE WRISTPA OBL (LAT ROT) / AP OBLIQ (MED ROT)24PA Oblique / AP Oblique252627“true” Lateral2829303132MOST COMMONLY FX CARPAL BONE33SCAPHOID34When the hand is turned toward the ulnar side, it is termed:•A. adduction•B. abduction•C. ulnar deviation•D. radial deviation35When the hand is turned toward the ulnar side, it is termed:•A. adduction•B. abduction•C. ulnar deviation•D. radial deviation36ADDITONAL VIEWS - WRIST•CARPAL CANAL •LECTURE ONLY – •NOT FOR LAB PRACTICE3738394041CRITIQUEWRISTDigital “issues”42434344PATHOLOGYFOR UPPER EXTREMITY 1SEE CHART PG ______Avulsion fxBone cystBursitisfracturesJoint effusionOsteoporosisRheumatoid Arthritis45AP/LAT wrist showing complete dislocation of the lunate46Fracture type?Fracture type?47What else should be done?Problem/ Path?4849greenstick50Torus or BuckleImpacted fracture with bulging of the periosteum.5051This fracture is most common in children between the ages of 5 and 11. Typically, the child reports having fallen onto his or her outstretched hand. 51impacted525253scaphoid•If the fracture is not recognized early, it may not heal properly. This can lead to problems later. 5354Scaphoid fxnew 3 wks later55SCAPHOID FX5657575859Colles’ Fracture Extension-Compression Fracture of Distal Radius FX WITH POSTERIORDISPLACEMENT60Colles' fracture•of the distal radius and ulnar styloid •with posterior displacement•(of the hand)61Colle's fractures usually occur when an adult falls on a hyperextended, outstretched hand. There is frequently an associated fracture of the ulnar styloid. 62•Smith's fracture is caused by a fall on a hyperflexed, outstretched hand. •It is sometimes referred to as a "reverse Colle's fracture."636465Smith's fracture•of the distal radius and ulnar styloid •with anterior displacement.66SMITH’S FXFlexion-Compression FX WITH ANTERIORDISPLACEMENT67Smith’s FXBARTON’S fx68FX/DISLOCATIONOF POSTERIOR LIP OF DISTAL RADIUSunstable intra-articular fracture of the dorsal lip of the radius with dorsal subluxation of the carpus along with the dorsal radius fragmentColles vs Barton’s6970Colles' fracture? 707172www.rad.washington.edu73QUESTIONS ?OPEN LABS SIGN UP? Days TBANOTE: NO OPEN LABS BEFORE I DO
View Full Document