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Wrist Injuries Emergency Imaging And Management

November 2001

Abstract

While wrist injuries are common, they can hardly be described as routine. True, most of us can identify a radius fracture when we see one, and we can usually recognize a carpal fracture. We also know that navicular tenderness suggests an occult fracture, which requires follow-up with an orthopedist.

However, wrist injuries are often quite complex. They comprise a continuum of bony, muscle, and ligamentous damage. Physical exam and radiographic findings are rarely conclusive. Moreover, both recognized and occult injuries can lead to significant long-term sequelae. Because patients rely on their hands for careers and day-to-day activities of all kinds, complete recoveries are usually a must. It is little wonder that wrist injuries (especially missed or delayed diagnoses as well as inadequate treatment) are common causes of malpractice suits against emergency physicians.1

The literature on wrist injuries can be confusing. The emergency literature is sparse, while studies in the orthopedic, hand, and radiologic journals focus on retrospective, operative, and often theoretic concerns. Short of splinting everything, the emergency physician is often left without a comprehensive guide for the evaluation and management of wrist injuries. This issue of Emergency Medicine Practice aims to fill this void by describing the state of the art ED management of wrist injuries.
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