Hand and Wrist Injuries 2

ORTHOPEDIC EMERGENCIES HAND INJURIES PRESENTER DR. DANIEL SQUIRE MUN Grad 1983  Orthopedic Residency/Wrist fellowship University of Ottawa 1984 - 1989  Clinical Assistant Professor Othopedics MUN 1990 - present  Program Director, MUN Orthopedic Residency 1992 - present  CASE # 1 24 year old skier falls at White Hills  c/o pain right thumb  swelling at metacarpophalangeal joint  tender ulnar side of mcp joint  stability tests  CASE # 1 Discussion Skier’s thumb = ulnar collateral ligament injury  +/- fracture at base of phalanx  “Stener” lesion  thumb spica vs. surgery  examine & compare opposite side  CASE # 2 21 year old mountain biker thrown over handlebars on downhill trail  c/o ++ pain in wrist  fusiform swelling left wrist  numbness thumb & index fingers  marked loss of motion  tender all around wrist  CASE # 2 XRAY Interpretation  Diagnosis ?  Initial management ?  Definitive treatment ?  CASE # 2 Discussion classification of perilunate dislocations  anatomy of wrist ligaments  radiographic findings  treatment principles  prognosis  CASE # 3 17 year old basketball player with “jammed finger”  swollen PIP joint  tender all around joint  decreased range of motion  xray  CASE # 3 Discussion Condylar fractures of phalanx  London classification  Beware of “late” displacement  Treatment principles 