Carpal fractures
Background
Carpal bones
Zone of Vulnerability
- Scaphoid fractures account for 70% of all carpal fractures
- Ulnar nerve damage associated with fractures of hamate or pisiform
- 50% of pisiform fracture associated with injury to distal radius or other carpal bone
- If bone fragment seen posterior to carpus on lateral, very likely triquetrum fracture
Fracture Types
Evaluation
Lateral view
- Evaluate Zone of Vulnerability (see picture)
Management
General Fracture Management
- Acute pain management
- Open fractures require immediate IV antibiotics and urgent surgical washout
- Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
- Consider risk for compartment syndrome
Specific Management
- Based on fracture location (see individual fracture page for details)
See Also
Video
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References
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