It’s #fracturefriday! Bet you were hoping for firework injuries after July 4th

NOPE! Just a nuanced distal radius fracture to make ya think

@megancontimica @Congenitalhand @NuelleHandMD @AndrewSobelMD @robgraymd @DrMoghtaderi @RayRavenMD @SandyGebhartMD @NinaSuh9 @JRHandSurg
24y/o healthy RHD F who works in an office job fell roller skating.

Nothing surprising on exam

@DKennedyHands @DrewAlbertMD @handz98 @maximhorwitz @hunter_alistair @TJQPNI @HolliePowerMD @Orthofacts @JuncturaTheorum @CY_Hand @hand_specialist @elveymichael @m_lane19 @ChrisDyMD
24y/o healthy RHD F who works in an office job fell roller skating.Nothing surprising on exam @DKennedyHands @DrewAlbertMD @handz98 @maximhorwitz @hunter_alistair @TJQPNI @HolliePowerMD @Orthofacts @JuncturaTheorum @CY_Hand @hand_specialist @elveymichael @m_lane19 @ChrisDyMD
24y/o healthy RHD F who works in an office job fell roller skating.Nothing surprising on exam @DKennedyHands @DrewAlbertMD @handz98 @maximhorwitz @hunter_alistair @TJQPNI @HolliePowerMD @Orthofacts @JuncturaTheorum @CY_Hand @hand_specialist @elveymichael @m_lane19 @ChrisDyMD
Given frx pattern and risk for concomitant SL injury (and ?SL widening), started scratching the ole’ noggin.

Couldn’t do dynamic (grip) view for injured side so we went for a contralateral comparison. Subtle differences if any…

Now what? Some voting for CT or MRI...
Given frx pattern and risk for concomitant SL injury (and ?SL widening), started scratching the ole’ noggin.Couldn’t do dynamic (grip) view for injured side so we went for a contralateral comparison. Subtle differences if any…Now what? Some voting for CT or MRI...
Given frx pattern and risk for concomitant SL injury (and ?SL widening), started scratching the ole’ noggin.Couldn’t do dynamic (grip) view for injured side so we went for a contralateral comparison. Subtle differences if any…Now what? Some voting for CT or MRI...
Given the dominant-sided injury, radial and intemediate column injury, joint diastasis, possible SL injury, patient's age, we discussed surgery.

We decided that there was no better way to identify the SL injury other than with our eyeballs. So, scope/fix bone/address ligament.
Of course, the scope tower saved whichever images it felt like. Membranous SL tear, no drive through, no shuck.
Scope assisted reduction of the articular surface was pretty cool, but radiographs honestly showed the same story

Ordinarily, I’d change that long/distal screw out, but since I was scoping the joint and didn’t see penetration, I felt ok leaving it

Debrided and pinned the SL
Scope assisted reduction of the articular surface was pretty cool, but radiographs honestly showed the same storyOrdinarily, I’d change that long/distal screw out, but since I was scoping the joint and didn’t see penetration, I felt ok leaving itDebrided and pinned the SL
Scope assisted reduction of the articular surface was pretty cool, but radiographs honestly showed the same storyOrdinarily, I’d change that long/distal screw out, but since I was scoping the joint and didn’t see penetration, I felt ok leaving itDebrided and pinned the SL
Pulled pins 6 weeks later and started motion. Bit of stiffness but overcoming that. Did we do too much? Was there #value and #quality in what we did? The early follow up is ok, but how would you have done it differently?
Pulled pins 6 weeks later and started motion. Bit of stiffness but overcoming that. Did we do too much? Was there #value and #quality in what we did? The early follow up is ok, but how would you have done it differently?
Pulled pins 6 weeks later and started motion. Bit of stiffness but overcoming that. Did we do too much? Was there #value and #quality in what we did? The early follow up is ok, but how would you have done it differently?
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