2. 51 male working at T 98.3 P 88 BP 160/94 O2
construction site when he 99%
slipped and fell Gen: Age appropriate
backwards, breaking his male, obvious pain, NAD
call with his outstretched MSK- Pt with swelling to
arm behind him, palm
down. Pt states with right wrist, obvious
instant pain to right deformity to ventral
wrist/forearm, with no surface but no laceration.
other injuries. Radial pulse 1+ on right
Neuro: pt with limited
extension/flexion at right
wrist secondary to pain; no
sensory abnormalities
5. Pain control
Closed reduction by reversing fx deformity w/
longitudinal traction
Ortho consult, as many will require Operative
reduction/fixation
If immediate consult not available, may place in long
arm splint with forearm supinated, wrist in neutral or
slightly extended, with follow up in next 48 hours
6. Extra-articular palmarly displaced distal radius fx
Volar angulation of fx is referred to as "Garden Spade"
deformity (reversed Colles Fracture)
Mechanism:
- backward fall on the palm of an outstretched hand
causing pronation of upper extremity while the hand
is fixed to the ground
Classification:
- Type I: extra articular;
- Type II: crosses into the dorsal articlar
surface;
- Type III: enters radiocarpal joint
- Volar Barton's Fracture = Smith's type III