Hand and wrist - Hand and wrist This note covers hand and...

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Hand and wrist This note covers hand and wrist pain Nerves injuries ULNAR NERVE INJURY Weakness of finger ab/adduction (interossei) and claw hand (FDP 3+4) Froment's sign – tests adductor pollicis. Ask pt to grip paper between index finger and thumb. Positive = Bend thumb to hold onto paper by using FPL (supplied by median nerve) RADIAL NERVE INJURY Loss of extension: supplies sensation to dorsum of hand Fractured shaft of humerus (sits in spiral groove) – wrist drop/loss of sensation Saturday night palsy – arm hungover chair leads to symptoms above but also tricep paralysis as lesion is higher up For carpal tunnel injury see carpal tunnel syndrome notes in the orthopaedics section. Fractures Colle's fracture Distal fracture of radius with dorsal displacement of distal fragment Common FOOSH (fall on outstretched hand) On examination: dinner fork deformity Management: Non-displaced cast. Displaced - MUA/ORIF Smith's fracture Distal fracture of radius with ventral displacement of distal fragment Less common
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