Emergency Medicine Reports – October 6, 2013
October 6, 2013
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Five Key Injuries of the Wrist and Hand
Scaphoid fractures are by far the most frequent bony injuries of the wrist in both pediatric and adult patients. The peak incidence is in adolescence, around 15 years of age. Skiers thumb is an acute injury to the ulnar collateral ligament (UCL) caused by forced abduction and hyperextension of the thumb; frequently it is associated with any sport that involves grasping a pole, such as skiing, hockey, lacrosse, or pole vaulting. Bennett fractures are fractures of the first metacarpal, with the fracture line extending from the base of the metacarpal (MC) to the CMC joint. Bennett fractures are the most common thumb MC fractures. Involvement of the CMC makes this fracture unstable. A Rolando fracture is defined as a comminuted fracture of the base of the thumb metacarpal. The mechanism of a Rolando fracture is most often simultaneous hyperextension and hyperabduction. This fracture type is typically unstable and occurs less commonly than a Bennett fracture in the pediatric population.