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Hand Injury

 
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Hand Injury - July 22, 2005 2:43:00 AM   
Alex Brenner PT MPT OCS

 

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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 >


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Re: Hand Injury - July 22, 2005 8:36:00 AM   
ehanso

 

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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.

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Re: Hand Injury - July 22, 2005 2:02:00 PM   
gerry

 

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Non-displaced fracture fifth metacarpal.

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Re: Hand Injury - July 22, 2005 4:16:00 PM   
chiroortho

 

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TFCC tear. Next step: MRI.

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Greg Priest, DC, DABCO

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Re: Hand Injury - July 22, 2005 7:38:00 PM   
jma

 

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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?

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Re: Hand Injury - July 23, 2005 1:47:00 AM   
pablo w

 

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Fifth metacarpal fracture, midshaft, undisplaced

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Re: Hand Injury - July 23, 2005 1:00:00 PM   
chiroortho

 

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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.

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Re: Hand Injury - July 24, 2005 6:14:00 PM   
jma

 

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Hmm, what are the findings Alex?

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Re: Hand Injury - July 25, 2005 12:39:00 PM   
UTDC

 

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Once again, Pablo's on fire.

Jeff

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Re: Hand Injury - July 25, 2005 1:05:00 PM   
JLS_PT_OCS

 

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YOU CANNOT STOP PABLO....

J

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Re: Hand Injury - July 25, 2005 2:07:00 PM   
Synergy

 

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While Pablo may be 'en fuego', Gerry nailed it a few posts prior to Pablo. :)

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Chris Adams, PT, MPT

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Re: Hand Injury - July 25, 2005 2:47:00 PM   
chiroortho

 

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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.

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Re: Hand Injury - July 25, 2005 10:53:00 PM   
pablo w

 

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Undisplaced spiral fracture midshaft 5th metacarpal, right hand. I think that's right.

Pablo

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Re: Hand Injury - July 26, 2005 12:42:00 AM   
UTDC

 

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oops. Gerry, you rock as well.

Personally, I think midshaft, nondisplaced is fine.


Jeff

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Re: Hand Injury - July 26, 2005 8:57:00 AM   
chiroortho

 

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Jeff you're right. Just gilding the lilly a little. Spiral it is.

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Greg Priest, DC, DABCO

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Re: Hand Injury - July 28, 2005 6:40:00 AM   
Alex Brenner PT MPT OCS

 

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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 >


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Alex Brenner, PT, MPT, OCS

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Re: Hand Injury - July 28, 2005 7:03:00 AM   
Sebastian Asselbergs

 

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5th, right?

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Re: Hand Injury - July 28, 2005 8:28:00 AM   
gerry

 

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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!

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Re: Hand Injury - July 28, 2005 9:49:00 AM   
Alex Brenner PT MPT OCS

 

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Yes. 5th. Sorry about the typo. Good catch Sebastian.

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Re: Hand Injury - July 28, 2005 5:56:00 PM   
pablo w

 

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Gerry,

Thanks, but you did have it right before I did!

Pablo

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