Traumatic Hand Injury

Hand Trauma

Hand radiographs obtained after trauma should evaluate for fracture, dislocation and signs of ligamentous injury.

Familiarize yourself with common locations and patterns of injury involving the digits and metacarpals. 

Hand Trauma

Bennet fracture

  • Intra-articular fracture of the base of the thumb metacarpal 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Rolando fracture

  • Comminuted intra-articular fracture of thumb metacarpal base
Hand Trauma

Boxer's fracture

  • 4th or 5th metacarpal neck fracture
  • Usually with slight apex dorsal angulation

 

 

 

 

 

 

 

Volar plate avulsion fracture

  • Small fragment of bone avulsed from the volar base of the middle phalanx.
Hand Trauma

Gamekeeper's thumb/UCL avulsion fracture

  • Small fragment of bone avulsed from the ulnar base of thumb proximal phalanx
Hand Trauma

Mallet finger 

  • Disruption of the extensor tendon at the distal phalanx resulting in fixed flexion of the DIP. (pictured in brace)

Boutonniere deformity

  • Disruption of medial slip of extensor tendon at middle phalanx resulting in hyperflexion of the PIP and hyperextension of the DIP. 


 

Swan-neck deformity

  • Disruption of the extensor tendon at the distal phalanx resulting in fixed flexion of the DIP, then PIP hyperextension as the lateral bands migrate volarly.


 

Hand Trauma
Hand Trauma

Tuft fracture

  • Fracture of the distal aspect of the distal phalanx. 
  • Comminution, soft tissue injury, and crush mechanisms raise the possibility of open fracture.
Hand Trauma

Example report negative for traumatic injury.


FINDINGS: 

  • No acute fracture or dislocation. Joint spaces are preserved.

IMPRESSION: 

  • No acute fracture or traumatic malalignment.

 

Traumatic Finger Injuries: What the Orthopedic Surgeon Wants to Know 
Ged G. Wieschhoff, Scott E. Sheehan, Jeremy R. Wortman, George S. M. Dyer, Aaron D. Sodickson, Ketan I. Patel, and Bharti Khurana. RadioGraphics 2016 36:4, 1106-1128