Summary
定义
病史和体格检查
关键诊断因素
- history of trauma or osteoporosis
- wrist pain
- tenderness over the distal radius
- swelling
其他诊断因素
- deformity
- tenderness in the anatomic snuff-box
- numbness in the fingers
- hypoesthesia
- open wound
- absent pulse
危险因素
- trauma
- osteoporosis
诊断性检查
首要检查
- plain radiographs of the wrist
需考虑的检查
- CT wrist
- MRI (without contrast) wrist
- dual-energy x-ray absorptiometry (DXA)
治疗流程
closed
open
isolated fracture of distal radius
isolated scaphoid fracture
concomitant distal radius and scaphoid or ulnar styloid fractures
confirmed wrist fracture
撰稿人
专家顾问
Niels W.L. Schep, MD
Trauma, Hand and Wrist Surgeon
Department of Trauma and Hand Surgery
Maasstad Hospital
Rotterdam
Netherlands
利益声明
NS declares that he has no competing interests.
鸣谢
Dr Niels W.L. Schep would like to gratefully acknowledge Dr Jeffrey N. Lawton, Dr John R. Lien, Dr Gregory D. Byrda, Dr Tamara D. Rozental, and Dr Chaitanya S. Mudgal, previous contributors to this topic.
利益声明
JNL is a consultant for Innomed Inc, has received honoraria from The AO Foundation for teaching courses, and has been sponsored for research by DePuy Synthes. JRL and GDB declare that they have no competing interests. TDR is an author of several references cited in this topic. CSM has been reimbursed by AO North America and Asia Pacific for being a faculty member during educational conferences.
同行评议者
Asif Ilyas, MD
Program Director of Hand and Upper Extremity Surgery
Rothman Institute
Associate Professor of Orthopaedic Surgery
Thomas Jefferson University
Philadelphia
PA
利益声明
AI declares that he has no competing interests.
Isam Atroshi, MD, PhD
Associate Professor of Orthopaedics
Lund University
Chief
Hand Surgery Section
Department of Orthopaedics
Hässleholm and Kristianstad Hospitals
Sweden
利益声明
Not disclosed.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
Torabi M, Lenchik L, Beaman FD, et al; Expert Panel on Musculoskeletal Imaging. ACR appropriateness criteria: acute hand and wrist trauma. J Am Coll Radiol. 2019 May;16(5s):S7-17.全文 摘要
American Academy of Orthopaedic Surgeons. Management of distal radius fractures: evidence-based clinical practice guideline. Dec 2020 [internet publication].全文
American Academy of Orthopaedic Surgeons. Prevention of surgical site infections after major extremity trauma: evidence-based clinical practice guideline. Mar 2022 [internet publication].全文
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Wrist strain
- Ligamentous carpal injury
- Triangular fibrocartilage complex (TFCC) tear
更多 鉴别诊断指南
- ACR appropriateness criteria: chronic hand and wrist pain
- Prevention of surgical site infections after major extremity trauma: evidence-based clinical practice guideline
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