Pediatric Distal Forearm and Wrist Injury

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:

Radiography: 2.00
Procedures: 2.00
Extremity Procedures: 2.00

Outline

1. Introduction
2. Development, Anatomy, and Radiologic-Anatomic Considerations
3. Distal Forearm Fractures
   1. Buckle Fractures
   2. Greenstick Fractures
   3. Complete or Displaced Fractures
   4. Physeal Injuries
4. Galeazzi and Galeazzi-equivalent Fractures
   1. Bone Contusion
   2. Carpal Fractures
   3. Scaphoid Fractures
5. Other Carpal Bone Fractures
6. Carpal Dislocations
7. Chronic Overuse Injuries
8. Conclusion

Objectives

Upon completion of this course, students will:

1. list differences between the pediatric and adult skeleton
2. list the order of carpal development
3. recite in order both the proximal and distal rows of carpal bones
4. describe ulnar variance
5. list the bones that align longitudinally in a laterally neutral wrist image
6. specify the amount of space between the scaphoid and lunate in a mature carpus
7. explain where buckle fractures most commonly occur in the pediatric wrist
8. list views that are helpful in identifying subtle wrist injuries
9. state radiographic findings that indicate further evaluation of occult type 1 fractures
10. list the Salter-Harris fracture classification types
11. note the prevalence of Galeazzi fractures
12. identify which imaging modality detects bone contusion
13. specify the modalities that best demonstrate pediatric lunate injuries
14. describe how capitate fractures occur
15. verbalize the key finding on lateral wrist radiographs that helps diagnose carpal dislocation
16. describe changes noted in Salter-Harris type 1 fractures of the distal radius