Common Mistakes in Wrist and Hand Trauma

Frank F. Smithuis; Floor Groepenhoff; Gwendolyn Vuurberg; Mario Maas

doi:10.1055/s-0045-1802974

Seminars in Musculoskeletal Radiology, Table of Contents

Semin Musculoskelet Radiol 2025; 29(05): 682-694
DOI: 10.1055/s-0045-1802974

Review Article

Common Mistakes in Wrist and Hand Trauma

Authors

Frank F. Smithuis

¹Division of Musculoskeletal Radiology, Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands

²Academic Center for Evidence-based Sports medicine (ACES), Amsterdam, The Netherlands

³Amsterdam Collaboration for Health and Safety in Sports (ACHSS), IOC Research Center of Excellence, Amsterdam, The Netherlands
Floor Groepenhoff

¹Division of Musculoskeletal Radiology, Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands

⁴Department of Radiology and Nuclear Medicine, Noordwest Ziekenhuisgroep, Alkmaar, the Netherlands
Gwendolyn Vuurberg

⁵Department of Radiology and Nuclear Medicine, Rijnstate Hospital, Arnhem, the Netherlands

⁶Department of Imaging, Radboud University Medical Centre, Nijmegen, the Netherlands
Mario Maas

¹Division of Musculoskeletal Radiology, Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands

²Academic Center for Evidence-based Sports medicine (ACES), Amsterdam, The Netherlands

³Amsterdam Collaboration for Health and Safety in Sports (ACHSS), IOC Research Center of Excellence, Amsterdam, The Netherlands

⁷Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, The Netherlands

Abstract

The anatomy of the wrist and hand is complex due to small and closely opposed bone and soft tissue structures. The complexity of the wrist and hand anatomy simultaneously allows a wide range of motion yet also makes these joints vulnerable to injury. The large number of potentially involved structures can make adequate evaluation of the traumatized wrist challenging. Injury to the wrist or hand is often significant because of the risk of permanent functional impairment.

Additionally, traumatic injury can be easily overlooked because signs may be subtle on conventional radiology and satisfaction of search poses risk of incomplete assessment. Other potential factors that create risk of errors in wrist assessment are nonstandardized acquisition, overlooking subtle signs of osseous trauma, neglecting soft tissue trauma, not performing additional imaging despite persistent suspicion of traumatic injury, traumatic injury, and misinterpretation of normal variants and trauma mimics.

Thus adequate clinical information on the radiology request is essential to initiate an optimized imaging strategy to detect fractures or dislocations and identify normal variants. This review offers examples of pitfalls when assessing conventional radiographs of the wrist and recommendations on when additional imaging using ultrasound, computed tomography, or magnetic resonance imaging is needed.

Keywords

wrist trauma - hand trauma - fall on an outstretched hand - radiography - trauma mimics

Full Text

References

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