Distal radius fracture physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]
Overview
Patients with distal radius fracture usually appears well. Physical examination of patients with distal radius fracture is usually remarkable for swelling, tenderness, bruises, ecchymosis, deformity and restricted range of motion of the wrist.
Physical Examination
Physical examination of patients with distal radius fracture is usually remarkable for swelling, tenderness, bruises, ecchymosis, deformity and restricted range of motion of the wrist.
Appearance of the Patient
- Patients with distal radius fracture usually appears well.
Vital Signs
- Weak pulse may be seen when associated with polytrauma.
- Low blood pressure with normal pulse pressure may be present due to compound fracture with blood loss.
Skin
- Skin examination of patients with distal radius fracture includes:
- Bruises
- Ecchymosis
HEENT
- HEENT examination of patients with distal radius fracture is usually normal.
Neck
- Neck examination of patients with distal radius fracture is normal.
Lungs
- Pulmonary examination of patients with distal radius fracture is usually normal.
Heart
- Cardiovascular examination of patients with distal radius fracture is usually normal.
Abdomen
- Abdominal examination of patients with distal radius fracture is usually normal.
Back
- Back examination of patients with distal radius fracture is usually normal.
Genitourinary
- Genitourinary examination of patients with distal radius fracture is usually normal.
Neuromuscular
- Neuromuscular examination of patients with distal radius fracture is usually normal.
- However, some patients may develop neuropraxia of the superficial branch of the radial nerve (Wartenberg's syndrome) and median nerve resulting in decreased sensation of thumb, index and middle finger.
Extremities
- Wrist examination of patients with distal radius fracture include:[1][2][3][4]
- Swelling
- Tenderness
- Dinner fork deformity
- Dinner fork deformity of the wrist is caused by dorsal displacement of the carpal bones (Colle's fracture).
- Reverse deformity is seen in volar angulation (Smith's fracture).
- The wrist may be radially deviated due to shortening of the radius bone.
- Restricted range of motion
- Tingling and decreased sensation of thumb, index and middle finger
- Decreased sensation over the thenar eminence can be due to median nerve injury
- Decreased grip and forearm strength
- Acute carpal tunnel syndrome
References
- ↑ Bienek T, Kusz D, Cielinski L (2006). "Peripheral nerve compression neuropathy after fractures of the distal radius". J Hand Surg Br. 31 (3): 256–60. doi:10.1016/j.jhsb.2005.09.021. PMID 16376003.
- ↑ Kleinman WB (2010). "Distal radius instability and stiffness: common complications of distal radius fractures". Hand Clin. 26 (2): 245–64. doi:10.1016/j.hcl.2010.01.004. PMID 20494751.
- ↑ Walenkamp MM, Goslings JC, Beumer A, Haverlag R, Leenhouts PA, Verleisdonk EJ; et al. (2014). "Surgery versus conservative treatment in patients with type A distal radius fractures, a randomized controlled trial". BMC Musculoskelet Disord. 15: 90. doi:10.1186/1471-2474-15-90. PMC 4234244. PMID 24642190.
- ↑ Hove, Leiv (2014). Distal radius fractures : current concepts. Heidelberg: Springer. ISBN 9783642546037.