Traumatic Pathologies of Wrist, Hand, and Fingers

Colley's Fracture

• Definition: Fracture to the distal radius (or ulna).
• Mechanism of Injury (MOI): Fall on an outstretched hand (FOOSH); radial displacement in posterior direction.
• Appearance: "Dinner fork" deformity.
• Treatment: Splint, ER referral, potential surgical intervention.
• Complications: Non-union fracture, possible ulnar and TFCC involvement.

Smith's Fracture

• Definition: Reverse Colley's fracture.
• MOI: FOOSH with hand in flexed position.
• Appearance: Reverse dinner fork deformity.

Carpal Tunnel Syndrome

• Anatomy: Median nerve compression.
• Symptoms: Sensory deficits, weak pinch grip, thenar eminence atrophy.
• Tests: Phalen's, Durkin's, Tenell's.
• Treatment: Ice, activity modification, night splinting, corticosteroid injections, potential surgical release.

TFCC Injury

• Definition: Injury to the triangular fibrocartilage complex.
• Symptoms: Pain, tenderness, limited motion.
• Tests: Piano key test, TFCC compression test.
• Treatment: Splinting, possible surgical stabilization.

Scaphoid Fracture

• MOI: FOOSH.
• Symptoms: Pain in anatomical snuffbox.
• Complications: Poor healing due to low blood supply.
• Treatment: Immobilization, potential surgical fixation.

Lunate Instability

• Definition: Lunate dislocation due to FOOSH.
• Symptoms: Murphy's sign, possible median nerve compression.
• Treatment: Reduction, splinting, possible surgery.

Hook of the Hamate Fracture

• MOI: FOOSH or chronic force from sports equipment.
• Symptoms: Wrist pain, tenderness.
• Treatment: Splinting, possible surgery.

Finger Pathologies

Gamekeeper's Thumb

• MOI: Forced thumb abduction.
• Symptoms: Pain, instability.
• Treatment: Immobilization, possible surgery.

Bennett's Fracture

• Definition: Fracture at base of thumb.
• MOI: Axial load.
• Treatment: ORIF or arthroscopic fixation.

Finger Dislocations/Fractures

• MOI: Crushing or axial blow.
• Symptoms: Pain, deformity.
• Treatment: Reduction, splinting, possible surgical intervention.

Jersey Finger

• Definition: Rupture of the FDP tendon.
• MOI: Excessive load.
• Symptoms: Inability to flex DIP joint.
• Treatment: Splinting, possible surgery.

Dupuytren's Contracture

• Definition: Fibrosis of palmar fascia.
• Symptoms: Inability to flatten hand.
• Treatment: Surgical release often required.

Trigger Finger

• Definition: Stenosing tenovitis.
• Symptoms: Finger locking, nodules.
• Treatment: Steroid injections, possible surgery.

Boutonniere Deformity

• Definition: Rupture of extensor tendon at PIP joint.
• Symptoms: Flexed PIP, extended DIP.
• Treatment: Splinting.

Boxer's Fracture

• Definition: Fracture of the fifth metacarpal.
• MOI: Punching hard surface.
• Treatment: Splinting, possible surgery.

De Quervain's Syndrome

• Definition: Tenosynovitis.
• Symptoms: Pain near thumb, radial nerve involvement.
• Treatment: NSAIDs, splinting, rehab.

Mallet Finger

• Definition: Extensor tendon rupture at DIP joint.
• MOI: Axial compression.
• Treatment: Splinting.

Swan Neck Deformity

• Definition: Volar plate rupture.
• Symptoms: Hyperextension of PIP, flexion of DIP.

Handlebar Palsy

• Definition: Guyon's canal syndrome.
• MOI: Compression of ulnar nerve.
• Symptoms: Sensory and motor deficits in 4th and 5th fingers.

Wrist Ganglion Cyst

• Definition: Fluid-filled sac in joint space.
• Symptoms: Visible/palpable nodule.
• Treatment: Aspiration or surgical removal.