TRAUMATIC FILM

Ext. Sanrutai Julsuksrisakul 57107010158

■ Case : Thai female patient, 58 years old, No known
underlying disease
■ Chief complaint : Slipped and fell to the ground 10
minutes pta
■ Present Illness : 10 minutes pta. The patient slipped
and fell to the ground.
The only part of the body that hit the ground was
dorsal side of her left wrist and forearm, No fainting,
No amnesia
Her left wrist was swelling, tender with limited
movement. Other part was unremarkable. She was be
able to move her left shoulder and elbow freely with no
tender
■ Physical Examination
– V/S : BP 140/77 mmHg, PR 97 bpm, RR 20 /min
– GA : A Thai female, good consciousness
– HEENT : Not pale conjunctiva, anicteric sclera
– CVS : Normal S1-S2, no murmur
– RS : Equal and normal breath sound both lung
– ABD : Soft, not tender, normoactive bowel sound
■ Physical Examination
– Musculoskeletal
■ Swelling and tender at left wrist
■ No external wound was seen
■ Limited active ROM due to pain (be able to perform
the action of ADM, EPL, EPB, APL, APB, Flexion
of finger)
■ Distal neurovascular was intact
■ Radial pulse 2+
Wrist
Left side

AP Lateral
DISTAL END RADIUS
FRACTURE
Injury Mechanisms

- Fall on the outstretched hand from standing height : most common

- High-energy injury
- Injury to interosseous ligament and triangular fibrocartilage complex
Signs and Symptoms

■ Pain and swelling around the wrist

■ May presented with visible deformity “ Silver fork deformity ”
■ Tenderness
■ +/- Paresthesia or numbness
Imaging
X-rays of wrist
■ PA
■ Lateral
■ Oblique
 PA
Ulnar variance
Radial length

Radial inclination

Radial inclination
Radial length
Ulnar variance
PA

Radial inclination

Radial length
Ulnar variance
 Volar or Dorsal angulation
Lateral
Volar or Dorsal angulation

Teardrop angle

AP distance

Carpal malalignment
Oblique
 Wrist
Left side
(Post reduction)

AP Lateral
Make a Plan

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Set a destination mode of travel, attractions, food
and/or travel theme and find venues, and
accommodations activities
THANK YOU
for your attention