Avulsion Injuries of the Hand and Wrist

A review of the common and uncommon avulsions of the hand and wrist, with a focus on the underlying anatomy and expected radiologic appearance.

Course ID: Q00633 Category:
Modality:

2.5

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Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Computed Tomography: 1.50
Procedures: 1.50
Head, Spine, and Musculoskeletal: 1.50

Magnetic Resonance Imaging: 1.50
Procedures: 1.50
Musculoskeletal: 1.50

Radiography: 1.75
Procedures: 1.75
Extremity Procedures: 1.75

Registered Radiologist Assistant: 2.25
Procedures: 2.25
Musculoskeletal and Endocrine Sections: 2.25

Sonography: 1.50
Procedures: 1.50
Superficial Structures and Other Sonographic Procedures: 1.50

Outline

  1. Introduction
  2. Trapeziometacarpal Joint Avulsion and Bennett Fracture
  3. Fifth Metacarpal Bone Fracture: Reverse or Mirrored Bennett Fracture
  4. UCL Avulsion
  5. Radial Collateral Ligament Avulsion
  6. Radial Styloid Process Avulsion
  7. Ulnar Styloid Process Avulsion
  8. Mallet Finger
  9. Central Slip Avulsion
  10. Jersey Finger
  11. Ring Avulsion
  12. Acute Volar Plate Avulsion
  13. Chronic Volar Plate Avulsion
  14. Scapholunate Ligament Avulsion
  15. Triquetral Avulsion Fractures
  16. Avulsions of the Extensor Carpi Radialis Longus and Brevis
  17. Related Disorders
    1. Hydroxyapatite Deposition Disease
    2. Accessory Ossicles of the Wrist
    3. Posttraumatic or Reactive Bone Lesions
  18. Conclusion

Objectives

Upon completion of this course, students will:

  1. state the prevalence of visits to the emergency department for hand and wrist injuries
  2. list the mechanisms of injury for hand and wrist injuries
  3. list the osseous structures of the wrist
  4. number the joint spaces of the wrist
  5. describe the primary imaging modality for evaluating healing of hand and wrist injuries
  6. locate the most common site for a Bennett fracture
  7. list irreversible sequelae of injuries to the hand and wrist
  8. discuss how much hand function is provided by the thumb
  9. state the joint type for the trapeziometacarpal joint
  10. state the carpal bone most often associated with Bennett fracture
  11. describe a Robert view of the thumb
  12. state the treatment options for reverse or mirrored Bennett fracture
  13. describe the cause of an acute ulnar collateral ligament injury
  14. state the most common site of ulnar collateral ligament injury
  15. state the prevalence of radial collateral ligament injuries of the thumb
  16. list indications for surgical repair of radial collateral ligament injuries of the thumb
  17. describe the location of the radial styloid process
  18. list all structures that attach to the ulnar styloid process
  19. state the most common closed tendon injury seen in athletes
  20. describe how to radiographically evaluate Mallet finger
  21. list the long-term complications associated with mallet injuries
  22. describe how traumatic avulsion of the central slip occurs
  23. explain how patients present with traumatic avulsion of the central slip
  24. choose which finger is involved in the majority of jersey finger injuries
  25. state how imaging modalities assist with assessment of jersey finger
  26. list the chronic complications of jersey finger
  27. explain the role of the volar plate
  28. state the causes of volar plate injuries
  29. describe the shape of the scapholunate ligament
  30. list the components of the scapholunate ligament
  31. describe how scapholunate ligament injuries occur
  32. state the second most commonly fractured carpal bone
  33. choose the radiographic projection the demonstrates triquetral fractures as small crescentic or linear bone fragments projecting dorsal to the carpus
  34. state how many variant ossicles have been described in the wrist
  35. state the most common symptomatic ossicle of the wrist