Scaphoid Fractures: A Case Study

There are many specific types of fracture that occur in the thumb and first metacarpal, fractures of the proximal phalange and distal phalange are simpler to manage than the more complex Bennett and Rolando fractures which involve the joint between metacarpal and carpal bones (Day & Stern, 2010). If a fracture occurs in the first metacarpal, or proximal or distal phalange the patient will experience pain to the thumb, the area may appear bruised and will swell; patient also in most cases experience a loss in function and are unable to complete tasks such as pinching motions (The Royal Berkshire NHS Trust, 2013). Anne is not experiencing any loss of function in her arm and there is no swelling of the thumb; consequently, it is unlikely that Anne has fractured her first metacarpal, distal or radial

The first step in the diagnosis is doing laboratory studies to detect any secondary causes. These include serum chemistry levels of calcium, phosphate, vitamin D, magnesium, PTH, and CBC (complete blood count). Detecting secondary causes is important because it will change the treatment plan. Even though there might be some small fractures can’t be seen

In addition Allen could not raise his arms against gravity, had flaccid lower extremities, and was without triceps or wrist extensor reflexes, and other muscle stretch reflexes were absent. If the fracture was at C4-5 Allen would not be able to shrug his shoulders and if the fracture was at C7 he could extend his flexed arms.

PROCEDURE: The patient was placed in the supine position on the operating room table, where her right hand and forearm were prepped with Betadine and draped in a sterile fashion. We infiltrated the thenar crease area with 1% Xylocaine, and once adequate anesthesia had been achieved, we exsanguinated the hand and forearm with an Esmarch bandage. We then created a longitudinal incision just at the ulnar aspect of the thenar crease and carried the dissection down through the subcutaneous tissue. We identified the transverse carpal ligament and incised this

Elbow fractures are often the result of either a fall or a direct blow to the elbow. The fracture type will depend in large part upon how the person falls or gets hit. For example, someone who falls onto an outstretched arm will hurt a different part of the elbow

      The radiographer’s job is to deliverer quality X-rays that have been ordered by the medical staff. Basic radiographs required to exclude a cervical spine fracture include lateral view, anterioposterior view, and an open-mouth odontoid view. The lateral view must include all seven cervical vertebrae as well as the joint space between C7-T1. If this is not possible because of patient size or condition then a swimmers view will be needed. The anterioposterior view should show all cervical vertebrae, while the dens and joint space should be visible on the odontoid view. These exams need to be completed in a timely matter while continuing to maintain cervical immobilization. The importance of obtaining quality X-rays cannot be overemphasized as the most frequent cause of missed cervical fractures is the result of inadequate films.

PROCEDURE: The patient was placed in the supine position on the operating room table, where her right hand and forearm were prepped with Betadine and draped in a sterile fashion. We infiltrated the thenar crease area with 1% Xylocaine, and once adequate anesthesia had been achieved, we exsanguinated the hand and forearm with an Esmarch bandage. We then created a longitudinal incision just at the ulnar aspect of the thenar crease and carried the dissection down through the subcutaneous tissue. We identified the transverse carpal

Raney was experiencing any pain to the area and Mrs. Raney replied that the only pain is in the right shoulder. Mrs. Raney was able to supinate and pronate her right wrist 30-40 degrees. Her skin was dry. Dr. Mendelson replied that at this time Mrs. Raney no longer required to wear the wrist brace and she can use the extremity. Dr. Mendelson obtained x-rays of her right shoulder as Mrs. Rainey has limited range of motion. After reviewing this, Dr. Mendelson replied that Mrs. Rainey as tremendous arthritis in her shoulder. I inquired if it was traumatic arthritis and the result of the accident. Dr. Mendelson replied that it was not related directly to the accident necessarily but her shoulder was aggravated from the accident. Dr. Mendelson continued to state that symptomatically it will get better and at some point Mrs. Raney did have a glenoral crack. Dr. Mendelson inquired about how Mrs. Raney’s shoulder was prior to the accident and she stated that it was fine and she could raise her arm above her shoulder and head but now she can’t and has had limited movement since the accident. Dr. Mendelson assessed and evaluated her lower extremity and replied that Mrs. Raney’s left incision is now healed. Her right ankle is still healing, the wound is dry and her skin is consolidating over the area. Mrs. Raney has an avagus external rotation of her foot.

Some of the injuries that can occur in the hand are Cubital Tunnel Syndrome and Carpal Tunnel Syndrome along with many more. Cubital Tunnel Syndrome causes pain or numbness in the ring and little fingers, but could also go to the arm (Types of RSI, 2010). Occurs when the ulnar nerve is pinched along the elbow’s edge (“funny bone”), and has tingling or painful feeling (Types of RSI, 2010). Cubital Tunnel Syndrome can be treated by avoiding putting pressure on the “funny bone” (Types of RSI, 2010). Cubital could lead to surgery if the nerve needs to be relieved. Carpal Tunnel Syndrome is similar to Cubital but occurs in the three first fingers. A major nerve is compressed which passes over the carpal bones through the front of the wrist (ASSH, 2015). When the nerve is compressed it causes painful, tingling and numbness in the first three fingers (ASSH, 2015). Carpal Tunnel Syndrome can be treated without surgery by changing the patterns of hand use and/or wearing wrist splints at night (ASSH, 2015). If severe then surgery can take place to make the nerve have more

Specificity: The ICD-10 codes allow you to identify etiology, anatomic site, and severity, as well as specify the encounter: initial, subsequent, or sequel of an encounter. In ICD-10 a "fracture of the forearm" can become a "torus fracture of lower end of right radius, initial encounter for closed fracture. That's just

The clinical signs of this fracture are swelling and pain in the scaphoid region, tenderness in the “anatomical snuffbox”, pain on axial compression, pain while pronating the hand, and painful pinch grip2. Radiological diagnosis consists of a scaphoid series of X-rays: Anterior-Posterior, lateral, semipronated and semisupinated views2. In cases of so-called "occult" fractures, the fracture is not visible on the radiographs, if the clinical signs are highly suggestive of fracture a 2 week period of cast immobilization is recommended, followed by a repeat X-ray series2. If further investigation is required, CT and MRI scans can also be implemented.

A unique case I saw Dr. Hart treat was a young bull rider who had a possible broken ankle. Dr. Hart has an X-Ray Technician in the clinic that took pictures of the patient’s ankle. The images are then sent to a local hospital for a radiologist to read. Dr. Hart can also make a preemptive read of the X-ray scans. In this case, the patient’s ankle was determined to be sprained.

Claimant’s family members and colleagues concerning the accused loss of function in daily activities of living.

In order to properly diagnose this type of injury, Dr. Erik Nilssen and his medical staff take several things into consideration, including the patient’s:

A twenty-one year old female, basketball player experienced an ankle sprain by accidentally stepping on another player’s foot. The player was going up to make a shot landed on the opponents foot when she came back down, which made her ankle invert. The head athletic trainer evaluated her then taped her ankle to provide support and keep the swelling to a minimum at that time, so the player could return to play. Immediately after the game, the player’s ankle was iced down to control the swelling and was receiving NSAID’s to help with the pain or discomfort she was feeling. The player was referred to the team physician for x-rays and MRI to help rule out fractures. Treatment was started to help relieving the swelling and pain.