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The articulatio radiocarpea joint link hand to forearm . Hand movement like flexion , extension , lateral disputation and revolution are hinged at the wrist joint . The three dimensional movement of the manus are anchored around articulatio radiocarpea joint . radiocarpal joint joint fracture results follow a gloaming over out extend arm . wrist joint joint fracture is one of the common combat injury observed in exigency room . Wrist Joint fracture results in disruption of ligament , tendon and muscles .
Bones of Wrist Joint
Wrist joint is a flexible joint and involve 15 bones . These 15 bones form three segments of the wrist joint . The three segments of the Wrist Joint are as follows-
Bones of Proximal Wrist Joint-
Proximal wrist articulation is a pivot join between wheel spoke and ulna . Joint is linked between head of the distal final stage of ulna and radius bone . Ulna lies against ulnar notch of wheel spoke bone . The connexion between ulna and wheel spoke is cover with smooth gristle . Joint is overlay by synovial capsule . Capsule is loose around the joint thus allowing semi - rotation of joint during pronation and supination .
Bones of Intermediate Wrist Joint-
Intermediate carpus marijuana cigarette is formed by two linkup or inter - joints-
Bones of Distal Wrist Joint-
Distal wrist joint joint is formed by carpal bones of distal row and proximal end of metacarpal osseous tissue . Distal row of carpal bones dwell of Trapezium , Trapezoid , Capitate , Hamate , and Pisiform bone .
Epidemiology of Wrist Joint Fractures-
Several epidemiological studies do in USA suggest that-
Types of Wrist Joint Fracture
Fracture of Distal End of Radius and Ulna-
Fracture of distal wheel spoke bone is known as a Colles ’ fracture . Colles ’ fracture is often see following sport trauma or fall .
Fracture of Carpal Bones
Scaphoid ivory fracture is the most vernacular carpal off-white fracture observed in patients with chronicle of osteoporosis and following sports accidental injury . Scaphoid osseous tissue is shaped like Anacardium occidentale freak and lies between proximal phalanx of thumb and distal goal of radius . Scaphoid fracture is misguided for wrist sprain , since symptom often are meek and test does not show any swelling or pregnant rawness .
Triquetrumlies between styloid process and proximal row of the carpal bone . Fracture of triquetrum is often misdiagnosed as tendonitis or ligamental sprain .
Also known as Kienbock Disease . Frequent carpus bruise and sprain link with lunate cracking causes necrosis of lunate .
Lunate faulting is separate in 4 stages according to MRI findings .
Fracture of Metacarpal Bone-
Proximal death of metacarpal os form a link with carpal bones of distal row of wrist joint . Metacarpal bone fracture could be isolated or link up with carpal bone break .
Classification of Wrist Joint Fracture
Causes of Wrist Joint Fracture
Injuries of Wrist Joint-
Wrist Joint Osteoporosis4
Paget’s Disease Of Wrist Joint-
Cortisone Medications-
Symptoms of Wrist Joint Fracture
Chronic Wrist Joint Pain
Wrist Joint Tenderness-
Wrist Joint Swelling-
Signs of Wrist Joint Fracture
A wrist joint fracture should be suspect when spartan pain and joint deformity pursue injuries . Common symptoms of a carpus fracture let in :
Joint Swelling
Bruising-
Deformity-
Joint deformity following fracture of wrist joint is observed secondary to protrusion of joint fragments .
Muscle Cramps
Movement of the wrist articulation in patient follow break of wrist articulatio causes stern nuisance . front of the radiocarpal joint articulation is foreclose by continuous forearm and bridge player muscle contraction . Prolonged musculus contraction effect in fatigued muscles and severe cramps . Severe muscle spasm result in severe nuisance of articulatio radiocarpea marijuana cigarette .
Investigations of Wrist Joint Fracture
X-Ray Findings-
MRI Findings-
CAT Scan
Ultrasound
Wrist Joint Arthroscopy
Arthroscopy is performed in later stages . Arthroscopy is do to diagnose fault and dislocation of wrist joint . Arthroscopy also assists to rule out tendon rupture or ligamental tear . Arthroscopy often follows arthroscopic surgical process .
Blood Examinations
Treatment of Wrist Joint Fracture
1. Conservative Treatment for Wrist Joint Fracture
a. Restriction of Wrist Joint Activities
b. Heat and Infra-Red Therapy
c. Daily Exercise Prevents
d. Splint or Cast Treatment for
e. Elevate Wrist Joint Prevents
f. Applying Ice on the Wrist Joint Reduces
2. Medications for Wrist Joint Pain Caused By Fracture
A. NSAIDS (Non-Steroidal Anti-inflammatory Medications).
nonsteroidal anti-inflammatory are prescribed for Inflammation and Pain .
B. Opioids
Opioids are prescribed for keen and continuing annoyance .
Opioids are separate in two groups as
Short Acting Opioid Medications For Treating Wrist Joint Pain-
Long Acting Medications-
C. Muscle Relaxants-
Muscle relaxants are prescribed for muscle muscle spasm and joint clumsiness of the wrist .
3. Physical Therapy (PT) For Wrist Joint Fracture
Goal of Physical Therapy (PT) to Treat Wrist Joint Fracture-
Physical Therapy Techniques-
4. Interventional Pain Therapy for Wrist Joint Fracture
Interventional pain therapy is an invasive treatment . selection of Interventional Pain Therapy is as follows
A. Needle Therapy for Wrist Joint Injection
Cortisone injectant is performed to reduced inflammation . Severe pain if not reply to NSAIDs and opioids , then the chronic pain is treated with frequent cortisone injections . Injections are reprize between 3 to 6 month . Cortone Acetate injectant is not recommended for chronic painfulness get by Gout and Septic Wrist Joint Arthritis .
Therapeutic value of just local anaesthetic injection is very limited . The procedure is do only as a symptomatic procedure . subroutine is also performed prior to strong-arm therapy so as to relieve the pain to achieve aggressive physical therapy .
reading for Wrist Joint Local Anesthesia Injection-
Contraindication for Wrist Joint Corticosteroid and Local Anesthesia Injection
B. Nerve Ablation (Destruction) Treatment for Wrist Joint Fracture
subprogram is selectively performed to destruct ( ablate ) riled or pinched nerve triggered by wrist joint fracture or scarring of nerve follow surgery . discourse is very rarely needed for wrist joint pain .
Nerve Ablation Techniques-
Phenol is selectively injected near or over the nerve with guidance of X - ray image and ultrasound . routine is painful and nuisance lasts for curt period . Phenol destructs peripheral nerve by neurolysis . routine is very seldom performed .
Alcohol is very seldom used . Alcohol injection is very painful and nuisance go for drawn-out sentence . Nerve when regenerate causes life-threatening neuropathic painful sensation . routine is performed under guidance of X - Ray and Ultrasound .
Radiofrequency needle is much pocket-size in diam than cryo probe . Radiofrequency acerate leaf is placed over pinch or pissed off nerve . Radiofrequency waves are mother at the tip of the phonograph needle , which result in increase temperature . Temperature is maintained at 75 to 900 C for 75 to 90 seconds to steel extirpation .
function involves placing of cryo probe over annoyed or pinched cheek . Cryo probe is much wider in diameter than radiofrequency acerate leaf . operation involves tiny skin scratch to enclose a cryo probe . Probe is placed over nerve abide by nerve stimulation test . Probe temperature is maintain at -70 to -90 grade C for 3 minute of arc .
C. Spinal Cord Stimulator: Treatment for Chronic Pain Caused By Wrist Joint Fracture
Spinal Cord Stimulator is rarely indicate for wrist joint pain make by wrist joint fault . Spinal Cord Stimulator include stimulator and generator .
D. Placement of Intrathecal Catheter and Programmable Pump to Treat Chronic Pain
Intrathecal catheter and pump is placed under sedation or general anesthesia .
5. Close Reduction of Wrist Joint Fracture
Indications for Close Reduction to Treat Wrist Joint Fracture-
How Is Close Reduction To Treat Wrist Joint Fracture Done?
Advantages of Close Reduction Treatment to Treat Wrist Joint Fracture-
Disadvantages of Close Reduction Treatment to Treat Wrist Joint Fracture –
6. Surgery for Wrist Joint Fracture
Wrist Joint Fracture Reduction-
Percutaneous Fixation with External Fixator, Pins and Casting
Internal Fixation (Plates, Screws, Pins) For Wrist Joint Fracture
Recovery and Prognosis of Wrist Joint Fracture
Also learn :
References :
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