Summary
Definition
History and exam
Key diagnostic factors
- história de trauma ou de osteoporose
- dor no punho
- sensibilidade sobre o rádio distal
- edema
Other diagnostic factors
- deformidade
- sensibilidade na tabaqueira anatômica
- dormência nos dedos
- hipoestesia
- ferida aberta
- ausência de pulso
Risk factors
- trauma
- osteoporose
Diagnostic investigations
1st investigations to order
- radiografias simples do punho
Investigations to consider
- tomografia computadorizada (TC) do punho
- ressonância nuclear magnética (RNM; sem contraste) do punho
- absorciometria por dupla emissão de raios X (DEXA)
Treatment algorithm
fechada
exposta
fratura isolada do rádio distal
fratura isolada do escafoide
fraturas concomitantes do rádio distal e do escafoide
fratura do punho confirmada
Contributors
Authors
Niels W.L. Schep, MD
Trauma, Hand and Wrist Surgeon
Department of Trauma and Hand Surgery
Maasstad Hospital
Rotterdam
Netherlands
Disclosures
NS declares that he has no competing interests.
Acknowledgements
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.
Disclosures
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.
Peer reviewers
Asif Ilyas, MD
Program Director of Hand and Upper Extremity Surgery
Rothman Institute
Associate Professor of Orthopaedic Surgery
Thomas Jefferson University
Philadelphia
PA
Disclosures
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
Disclosures
Not disclosed.
References
Key articles
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.Full text Abstract
American Academy of Orthopaedic Surgeons. Management of distal radius fractures: evidence-based clinical practice guideline. Dec 2020 [internet publication].Full text
American Academy of Orthopaedic Surgeons. Prevention of surgical site infections after major extremity trauma: evidence-based clinical practice guideline. Mar 2022 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Torção do punho
- Lesão ligamentar do carpo
- Ruptura do complexo da fibrocartilagem triangular (CFCT)
More DifferentialsGuidelines
- ACR appropriateness criteria: chronic hand and wrist pain
- Prevention of surgical site infections after major extremity trauma
More GuidelinesPatient information
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