Abstract
Acute bony injuries to the hand and wrist are very common after a fall on an outstretched
hand. In the wrist, distal radius fractures are the most common; isolated distal ulna
fractures are uncommon. More serious injuries to the wrist include complicated fracture-dislocation
injuries such as perilunate dislocations. At the carpal level, scaphoid fractures
are the most common followed by fractures of the dorsal side of the triquetrum. The
metacarpals often fracture, most commonly the base of the thumb and the subcapital
region of the fifth metacarpal. In the fingers, we encounter many different types
of fractures, often avulsions reflecting underlying soft tissue pathology (e.g., mallet
finger). Dislocations are common in the fingers, predominantly in the distal interphalangeal
joints. From an imaging standpoint, conventional radiography is always the initial
examination. Complex (intra-articular) fractures, fracture-dislocation injuries, and
a strong clinical suspicion of radiographically occult fractures need to be further
evaluated for decision making regarding treatment. Computed tomography is the primary
imaging modality of choice for the first two. In the latter, magnetic resonance imaging
can be preferable, depending on clinical suspicion and the local situation in the
associated hospital.
Keywords
Wrist - Hand - Fractures - Dislocation - Imaging
