Special Skills for Reducing Distal Radius Fractures, Part II: Finger Traps.

15 Apr

wrist1

Colles’ Fractures, wrist fractures with dorsal and lateral dislocation of the radius, often have an element of
radial shortening”. This refers to the length of the radius comparing the carpal articular surface of the ulna and the lunate fossa of the radius.

If the radius is proximal to a line drawn across the end of the ulna the radius is shortened (yellow arrow).  

 

What to do????wrist2

 

Finger traps are meant to elongate a shortnened radius.

 

 

 

 

  • Place the patient supine, with the HOB flatwrist3
  • Flex the elbow to 90 degrees
  • The goal is to achieve radial tilt, so include no more than the first three digits (1&2 or 1-3)
  • Hang 15lb weight from the upper arm (distal humerus)
  • Adequate fracture reduction is considered with

o   <2mm articular step off

o   <20 degree of volar angulation

o   <3mm radial shortening

 

References: Text & Picture 1-2 ERcast.org; Picture 3

 

Submitted by K Estes.

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