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Hand Injury

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Hand Injury - July 22, 2005 2:43:00 AM    Alex Brenner PT MPT OCS   Posts: 1057 Joined: March 1, 2004 From: Kentucky Status: offline 13 year old male was climbing over a chain linked fence. His shirt was caught and he flipped over while his hand was stuck in the fence. He felt a pop and had immediate pain and swelling. What are the findings? < Message edited by Randy J Moore -- July 22, 2007 11:26:01 PM > _____________________________ Alex Brenner, PT, MPT, OCS Post #: 1

Re: Hand Injury - July 22, 2005 8:36:00 AM    ehanso   Posts: 392 Joined: September 15, 2004 From: Minnesota Status: offline From a very amateur view there is a fracture of the ulnar styloid and dislocation or rupture of the ulnar colateral ligament. The space is obviously excessive. (in reply to Alex Brenner PT MPT OCS) Post #: 2

Re: Hand Injury - July 22, 2005 2:02:00 PM    gerry   Posts: 271 Joined: July 7, 1999 From: Montgomery, AL, USA Status: offline Non-displaced fracture fifth metacarpal. (in reply to Alex Brenner PT MPT OCS) Post #: 3

Re: Hand Injury - July 22, 2005 4:16:00 PM    chiroortho   Posts: 691 Joined: February 19, 2004 Status: offline TFCC tear. Next step: MRI. _____________________________ Greg Priest, DC, DABCO (in reply to Alex Brenner PT MPT OCS) Post #: 4

Re: Hand Injury - July 22, 2005 7:38:00 PM    jma   Posts: 2639 Joined: August 25, 2000 From: NY Status: offline I'm guessing Triangular Fibrocartilagenous Cartilage Complex (TFCC) tear or triangular cartilage tear. What is going on at the base of the fifth metacarpal on the first picture? (in reply to Alex Brenner PT MPT OCS) Post #: 5

Re: Hand Injury - July 23, 2005 1:47:00 AM    pablo w   Posts: 88 Joined: November 14, 2002 From: Canberra Status: offline Fifth metacarpal fracture, midshaft, undisplaced (in reply to Alex Brenner PT MPT OCS) Post #: 6

Re: Hand Injury - July 23, 2005 1:00:00 PM    chiroortho   Posts: 691 Joined: February 19, 2004 Status: offline I see what you're looking at, you might be right Pablo. Usually with a MC fx you'll see displacement, but in a 13 year old it might be more of a greenstick. _____________________________ Greg Priest, DC, DABCO (in reply to Alex Brenner PT MPT OCS) Post #: 7

Re: Hand Injury - July 24, 2005 6:14:00 PM    jma   Posts: 2639 Joined: August 25, 2000 From: NY Status: offline Hmm, what are the findings Alex? (in reply to Alex Brenner PT MPT OCS) Post #: 8

Re: Hand Injury - July 25, 2005 12:39:00 PM    UTDC   Posts: 222 Joined: December 22, 2003 Status: offline Once again, Pablo's on fire. Jeff (in reply to Alex Brenner PT MPT OCS) Post #: 9

Re: Hand Injury - July 25, 2005 1:05:00 PM    JLS_PT_OCS   Posts: 1684 Joined: January 31, 2005 From: USA Status: offline YOU CANNOT STOP PABLO.... J _____________________________ Jason Silvernail DPT Board-Certified in Orthopedic Physical Therapy Certified Strength and Conditioning Specialist www.silvernailstudios.com jasonsilvernail@gmail.com (in reply to Alex Brenner PT MPT OCS) Post #: 10

Re: Hand Injury - July 25, 2005 2:07:00 PM    Synergy   Posts: 619 Joined: March 12, 2004 From: Texas Status: offline While Pablo may be 'en fuego', Gerry nailed it a few posts prior to Pablo. :) _____________________________ Chris Adams, PT, MPT (in reply to Alex Brenner PT MPT OCS) Post #: 11

Re: Hand Injury - July 25, 2005 2:47:00 PM    chiroortho   Posts: 691 Joined: February 19, 2004 Status: offline Okay. Well, if it is a midshaft fracture, and I think it is, then describe the fracture in more detail. Midshaft nondisplaced is not enough. _____________________________ Greg Priest, DC, DABCO (in reply to Alex Brenner PT MPT OCS) Post #: 12

Re: Hand Injury - July 25, 2005 10:53:00 PM    pablo w   Posts: 88 Joined: November 14, 2002 From: Canberra Status: offline Undisplaced spiral fracture midshaft 5th metacarpal, right hand. I think that's right. Pablo (in reply to Alex Brenner PT MPT OCS) Post #: 13

Re: Hand Injury - July 26, 2005 12:42:00 AM    UTDC   Posts: 222 Joined: December 22, 2003 Status: offline oops. Gerry, you rock as well. Personally, I think midshaft, nondisplaced is fine. Jeff (in reply to Alex Brenner PT MPT OCS) Post #: 14

Re: Hand Injury - July 26, 2005 8:57:00 AM    chiroortho   Posts: 691 Joined: February 19, 2004 Status: offline Jeff you're right. Just gilding the lilly a little. Spiral it is. _____________________________ Greg Priest, DC, DABCO (in reply to Alex Brenner PT MPT OCS) Post #: 15

Re: Hand Injury - July 28, 2005 6:40:00 AM    Alex Brenner PT MPT OCS   Posts: 1057 Joined: March 1, 2004 From: Kentucky Status: offline There is a non-displaced fracture of the 5th metacarpal. Nice job Gerry. < Message edited by Randy J Moore -- July 22, 2007 11:26:46 PM > _____________________________ Alex Brenner, PT, MPT, OCS (in reply to Alex Brenner PT MPT OCS) Post #: 16

Re: Hand Injury - July 28, 2005 7:03:00 AM    Sebastian Asselbergs   Posts: 2293 Joined: September 30, 1999 From: Barrie, Canada Status: offline 5th, right? _____________________________ Mundi vult decipi (in reply to Alex Brenner PT MPT OCS) Post #: 17

Re: Hand Injury - July 28, 2005 8:28:00 AM    gerry   Posts: 271 Joined: July 7, 1999 From: Montgomery, AL, USA Status: offline Thanks! I have to credit my son for this one, though. He had this injury several years ago. His was more straight-planed, and not spiral. I still have that x-ray around somewhere... I'll not ever be allowed to forget it because it took several days for me to take him to the orthopedist. Whenever he gets hurt now, and I say it's nothing serious, he reminds us all how I would not take him to the doctor when his hand was broken. Sigh. Thank goodness for teenagers who keep us humble. Thanks Alex for these great case studies. They are always fun and challenging, and I really appreciate the effort you take to post them. Usually, when I check in on the board, the X-ray has been up a while and there are many responses. Just happened to check in at the opportune time this time! Oh, and Pablo definantly rocks! (in reply to Alex Brenner PT MPT OCS) Post #: 18

Re: Hand Injury - July 28, 2005 9:49:00 AM    Alex Brenner PT MPT OCS   Posts: 1057 Joined: March 1, 2004 From: Kentucky Status: offline Yes. 5th. Sorry about the typo. Good catch Sebastian. _____________________________ Alex Brenner, PT, MPT, OCS (in reply to Alex Brenner PT MPT OCS) Post #: 19

Re: Hand Injury - July 28, 2005 5:56:00 PM    pablo w   Posts: 88 Joined: November 14, 2002 From: Canberra Status: offline Gerry, Thanks, but you did have it right before I did! Pablo (in reply to Alex Brenner PT MPT OCS) Post #: 20

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