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Orthopaedics

Wrist and Hand

Built from Orthopedic Trauma Essentials

The first 25 slides of Wrist and Hand
The first 25 slides, exactly as they appear. The full deck has 109 content slides.

What’s inside

5 sections · 109 slides

  1. 01

    Overview

    • What this topic is about
    • Joints of the hand and wrist on X-ray
    • Reading that X-ray
    • Cut-through view of the wrist joint
    • Two structures worth naming now
    • The three injury families
    • Words you will meet
    • More words you will meet

    8 slides

  2. 02

    Distal Radius Fractures

    Instability, reduction targets, and who actually needs an operation

    • A broken distal radius on two views
    • Why instability is the key idea
    • How instability used to be defined
    • The AAOS post-reduction criteria
    • The 2025 guideline is blunter
    • What actually predicts instability
    • A prediction model rather than a rule
    • What the post-reduction picture adds
    • Instability builds up over time
    • A continuum, not a yes-or-no
    • Straighter bone, better hand?
    • Instability: what to take away
    • Perfect bone or good enough bone?
    • Two ways to judge a reduction
    • Functional reduction: the verdict
    • Should older patients be operated on?
    • What the trials found in older adults
    • Adding up the reviews
    • Older patients: the bottom line
    • When surgery is not optional
    • The three ways to hold it
    • Plate versus wires: the DRAFFT-2 trial
    • Wires holding a distal radius fracture
    • A plate on the palm side of the radius
    • Where external fixation sits
    • Choosing a fixation method
    • When the bone is shattered
    • The dorsal spanning plate
    • Frame or spanning plate?
    • Complex fractures: the verdict
    • Does looking inside the joint help?
    • What arthroscopy actually delivers
    • The ulnar side of the wrist
    • What the ulnar-side evidence shows
    • Treating the ulnar side
    • Three questions after the fracture is fixed
    • Carpal tunnel release: not routinely
    • Move it early, under supervision
    • The fracture as a warning shot
    • Adjuncts: the principle
    • Distal radius fractures in one screen

    41 slides

  3. 03

    Perilunate Injuries

    Rare, easy to miss, and unforgiving of delay

    • What a perilunate injury is
    • How they happen
    • Carpus displaced off the lunate, seen from the side
    • The same injury viewed from the front
    • Missed at the front door
    • The old argument about timing
    • What the follow-up studies show
    • Why delay costs so much
    • Timing: the recommendation
    • Is putting the bones back enough?
    • What ligament studies show
    • The two ligaments that matter most
    • The case against repairing everything
    • Ligament repair: where practice has landed
    • The nerve in a dislocated wrist
    • Carpal tunnel release in perilunate injury
    • Front door or back door?
    • Which approach wins?
    • Keyhole surgery for perilunate injuries
    • Why open surgery is still standard
    • Perilunate injuries in one screen

    21 slides

  4. 04

    Scaphoid and Metacarpal Fractures

    The carpal bone that hides its fracture, and the palm bones that forgive deformity

    • Why the scaphoid gets special attention
    • A thin dark line across the scaphoid
    • The diagnostic problem
    • What MRI gives you
    • What CT gives you
    • Which scan, when
    • Imaging: the verdict
    • Waist fractures: operate or plaster?
    • What the randomized trials found
    • What each option costs the patient
    • Waist fractures: the verdict
    • Why the proximal pole is different
    • Proximal pole: what the studies say
    • How far up the arm should the cast go?
    • A below-elbow plaster cast from four sides
    • Does the thumb need to be in the cast?
    • Casting: the two rules
    • Screw or wire, when you do operate?
    • What wires cost you
    • Metacarpal fractures: the forgiving ones
    • A break at the neck of the little-finger metacarpal
    • Why most of them do not need surgery
    • Rotation is the line you cannot cross
    • Four ways to fix a metacarpal
    • The same fracture held by a wire down the bone
    • What each implant trades away
    • Metacarpal fixation: the verdict
    • Scaphoid and metacarpal in one screen

    28 slides

  5. 05

    Pulling It Together

    The habits of thought this topic keeps rewarding

    • Four themes that repeat
    • Numbers worth remembering
    • Decisions worth remembering
    • Where the evidence is still thin
    • References
    • References (continued)
    • References (continued)
    • References (continued)
    • References (continued)
    • References (continued)
    • Orthopedic Trauma Essentials 2026

    11 slides