HPI: Adult male presents after being involved in a motor vehicle collision with right wrist pain and obvious distal deformity.
PE: Obvious deformity of the right wrist. No abrasions or ecchymosis. Full thumb abduction, able to flex at DIP and PIP joint of all 5 fingers, full abduction of all 4 palmar fingers, 5/5 strength to finger grip. Slightly limited range of motion to flexion or extension wrist secondary to pain. Significant pain with pronation and supination. Normal sensation to pinprick and two point discrimination of all five fingers. 2+ radial pulse with normal cap refill.
How to Diagnosis:
Radial shaft fracture and concurrent distal radioulnar joint. Most commonly seen in fractures of the distal 1/3 of the radius. Termed a Galeazzi fracture. Typically occurs secondary to direct wrist trauma (most classically dorsolateral) or with fall onto outstretched hand with forearm in pronation.
CMC ER Residents
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