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Which of the following statements is TRUE about force transmission based on wrist position?
neutral wrist position decreases force through the lunate fossa
extended wrist position increases force through the lunate fossa
neutral wrist position increases force through the scaphoid fossa
extended wrist position increases force through the scaphoid fossa
wrist position has no effect on force transmission
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A 35-year-old woman reports wrist pain after a fall onto an outstretched hand. On exam, she has focal tenderness over the wrist snuffbox. A radiograph and CT image are shown in Figures A and B. What is the proper treatment of her injury?
Rest, ice, elevation
Removable splint for comfort
Thumb spica cast
Open reduction, internal fixation
Vascularized bone grafting
A 27-year-old professional cowboy is thrown from a bull during the rodeo and lands on his hand. No deformity is identified and the hand is completely neurovascularly intact. Pain is present upon palpation of the anatomic snuffbox. A radiograph is provided in Figure A. The cowboy wants to return to competitive riding tomorrow. Which of the following is the best next step in management?
Cock-up wrist splint and immediate return to sport as tolerated by pain
Steroid injection of the snuffbox, taping of the wrist and return to sport
Percutaneous screw fixation of the nondisplaced fracture
Scapholunate ligament repair and percutaneous pin fixation
A 20-year-old skateboarder fell 6 months ago and has had radial-sided wrist pain since. His radiograph upon presentation to your office is shown in figure A. What is the most appropriate treatment at this time?
four corner fusion
long arm thumb spica cast
wrist arthroscopy to evaluate intercarpal ligaments
open reduction internal fixation with autologous bone graft
A 22-year-old male snowboarder falls on an outstretched hand and presents with the radiograph shown in Figure A. Which of the following techniques is MOST important in optimizing biomechanical fixation?
Using a longer screw placed in the central axis of the scaphoid
Using a supplementary K-wire transfixing the distal pole of the scaphoid to the capitate
Using a longer screw placed in the dorsal axis of the scaphoid
Using a larger diameter screw placed in the dorsal axis of the scaphoid
Using a larger diameter screw placed in the volar axis of the scaphoid
Percutaneous screw fixation for non-displaced scaphoid waist fractures has been shown to have which of the following differences compared to closed treatment?
Increased direct and indirect cost
Slower return to work
Higher union rates
Reduced time to fracture union
Improved motion and grip strength after 2 years
An open dorsal approach for antegrade screw fixation of a nondisplaced scaphoid waist fracture differs in which of the following ways compared to a percutaneous dorsal approach?
Decreased risk of proximal pole AVN
Increased risk of posterior interosseous nerve injury
Decreased risk of injury to the APL tendon
Increased risk of injury to the EPL tendon
Decreased risk of screw prominence above subchondral bone
HPI - 50 year old, right-handed female patient suffered from trauma one year ago. The patient sought medical advice and was told that she had a scaphoid fracture that required fixation. The patient refused surgery and a cast was applied for two months.
What additional imaging would you order in this patient?
HPI - Neglected trauma to right wrist 15 months ago.
How would you manage this patient?
HPI - 20years ago, slip down injury
--> intermittent pain during exercise
He has no problem ordinary life
What is the optimal treatment at this time?