Wrist fractures

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Last reviewed: 23 Sep 2025
Last updated: 14 Nov 2024

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
完整详情

其他诊断因素

  • deformity
  • tenderness in the anatomic snuff-box
  • numbness in the fingers
  • hypoesthesia
  • open wound
  • absent pulse
完整详情

危险因素

  • trauma
  • osteoporosis
完整详情

诊断性检查

首要检查

  • plain radiographs of the wrist
完整详情

需考虑的检查

  • CT wrist
  • MRI (without contrast) wrist
  • dual-energy x-ray absorptiometry (DXA)
完整详情

治疗流程

初步治疗

closed

open

急症处理

isolated fracture of distal radius

isolated scaphoid fracture

concomitant distal radius and scaphoid or ulnar styloid fractures

持续性治疗

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

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

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.
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