PageSourceSearch

https://www.imageinterpretation.co.uk/wrist.php

html imageinterpretation.co.uk collected 2026-10-05 00:56:41 UTC 35,328 bytes, 682 lines download raw bytes

1<!DOCTYPE html>
2<html lang="en">
3<head>
4 <meta charset="utf-8">
5 <meta name="viewport" content="width=device-width, initial-scale=1, shrink-to-fit=no">
6<meta content="radiology,X ray,radiograph,image interpertation, red dot" name="keywords">
7<title>The Wrist</title> <link rel="canonical" href="https://www.imageinterpretation.co.uk/wrist.php" />
8<link type="text/css" rel="stylesheet" href="magiczoomplus/magiczoomplus.css?v=5_3_7_updated"/>
9<script src="magiczoomplus/magiczoomplus.js"></script>
9
10
11<script>
12var mzOptions = {
13zoomWidth: '400px',
14zoomHeight: '400px',
15zoomCaption: 'bottom',
16
17};
18
19
20
21var mzOptionsx = {
22	zoomWidth: '400px',
23zoomHeight: '400px',
24zoomCaption: 'bottom',
25hint: 'off'
26};
27
28var mzMobileOptionsx = {
29	zoomMode: 'magnifier',
30	zoomWidth: '250px',
31	zoomHeight: '250px',
32	zoomPosition: 'top',
33	zoomCaption: 'bottom'
34}
35</script>
35
36 <link href="https://cdn.jsdelivr.net/npm/[email protected]/dist/css/bootstrap.min.css" rel="stylesheet" integrity="sha384-QWTKZyjpPEjISv5WaRU9OFeRpok6YctnYmDr5pNlyT2bRjXh0JMhjY6hW+ALEwIH" crossorigin="anonymous">
37  </head>
38
39<style>
40html {
41  position: relative;
42  min-height: 100%;
43}
44body {
45  margin-bottom: 60px; /* Margin bottom by footer height */
46}
47.footer {
48  position: absolute;
49  bottom: 0;
50  width: 100%;
51  height: 60px; /* Set the fixed height of the footer here */
52  line-height: 60px; /* Vertically center the text there */
53  background-color: #f5f5f5;
54}
55</style>
56<link type="text/css" rel="stylesheet" href="custom.css">
57<link rel="stylesheet" href="https://use.fontawesome.com/releases/v5.7.2/css/all.css" integrity="sha384-fnmOCqbTlWIlj8LyTjo7mOUStjsKC4pOpQbqyi7RrhN7udi9RwhKkMHpvLbHG9Sr" crossorigin="anonymous">
58
59
60</head>
61<body>
62<div class="container">
63	<div class="row  mt-3">
64		<div class="col-2 my-auto">
65			<div id='logo_img'><img id="logo" class='logo_img' alt="Image Interpretation" src="/images/logo.png"></div>
66		</div>
67		<div class="col-10">
68			<div class='ms-3 mt-1'><h2>Norwich Image Interpretation Course</h2>
69			<h4>Heidi Nunn (Advanced Practice Reporting Radiographer)</h4></div>
70		</div>
71	</div>
72</div>
73
74
75
76<style>
77.logo_img{
78	width:60px;
79}
80h2 {
81    font-size: 1.2rem;
82}
83	h4{
84		font-size: 0.8rem;
85	}
86	
87li { margin-left: -2em }
88
89.navbar-nav li{
90	margin-left: 0em;
91}
92
93
94@media only screen and (min-width: 600px) {
95	/* for tablet */
96   .logo_img{
97		width:95px;
98	}
99	h2 {
100		font-size: 1.4rem;
101	}
102	h4{
103		font-size: 1.1rem;
104	}
105	li { margin-left: -1em }
106}
107@media only screen and (min-width: 768px) {
108    /* For desktop: */
109      .logo_img{
110		width:105px;
111	}
112	h2 {
113		font-size: 2rem;
114	}
115	h4{
116		font-size: 1.5rem;
117	}
118	li { margin-left: 0em }
119}
120
121
122.reset-li {
123	margin-left: 0em;
124}
125
126
127</style>
127<script src="cookietest.js?v=1791161801"></script>
127
128<div class='container mt-3 mb-4'>
129
130<nav class="navbar navbar-expand-lg bg-body-tertiary">
131<button class="navbar-toggler" type="button" data-bs-toggle="collapse" data-bs-target="#navbarSupportedContent" aria-controls="navbarSupportedContent" aria-expanded="false" aria-label="Toggle navigation">
132      <span class="navbar-toggler-icon"></span>
133    </button>
134
135    <div class="collapse navbar-collapse" id="navbarSupportedContent">
136<ul class="navbar-nav nav-fill w-100 me-auto mb-2 mb-lg-0"> 
137
138
139 <li class="nav-item  me-3 text-left" >
140        <a class="nav-link active" href="https://www.imageinterpretation.co.uk/index.php">Home</a>
141      </li>
142
143
144     <li class="nav-item  me-3 dropdown   text-left" >
145        <a class="nav-link dropdown-toggle" href="#" id="navbarDropdown" role="button" data-bs-toggle="dropdown" aria-haspopup="true" aria-expanded="false">
146          Modules
147        </a>
148        <div class="dropdown-menu"  aria-labelledby="navbarDropdown">
149
150			<a class='dropdown-item' href='https://www.imageinterpretation.co.uk/hand.php'>
150Module One - Hand</a>
151<a class='dropdown-item' href='https://www.imageinterpretation.co.uk/wrist.php'>Module Two - Wrist</a>
152<a class='dropdown-item' href='https://www.imageinterpretation.co.uk/elbow.php'>Module Three - Elbow</a>
153<a class='dropdown-item' href='https://www.imageinterpretation.co.uk/shoulder.php'>Module Four - Shoulder</a>
154<a class='dropdown-item' href='https://www.imageinterpretation.co.uk/foot.php'>Module Five - Foot</a>
155<a class='dropdown-item' href='https://www.imageinterpretation.co.uk/ankle.php'>Module Six - Ankle</a>
156<a class='dropdown-item' href='https://www.imageinterpretation.co.uk/knee.php'>Module Seven - Knee</a>
157<a class='dropdown-item' href='https://www.imageinterpretation.co.uk/pelvis.php'>Module Eight - Pelvis and Hip</a>
158<a class='dropdown-item' href='https://www.imageinterpretation.co.uk/thoracolumbar.php'>Module Nine - Thoracolumbar Spine</a>
159<a class='dropdown-item' href='https://www.imageinterpretation.co.uk/cervical.php'>Module Ten - Cervical Spine</a>
160<a class='dropdown-item' href='https://www.imageinterpretation.co.uk/face.php'>Module Eleven - Facial Bones</a>
161<a class='dropdown-item' href='https://www.imageinterpretation.co.uk/tumour.php'>Module Twelve - Bone tumours</a>
162
163
164  	 <div class="dropdown-divider"></div>
165     <a class='dropdown-item' href='https://www.imageinterpretation.co.uk/cases_of_the_month.php'>Case of the month</a>
166
167	<div class="dropdown-divider"></div>
168	<a class='dropdown-item' href='https://www.imageinterpretation.co.uk/imagelibrary.php'>Pathology image gallery</a>
169
170
171
172
173    <div class="dropdown-divider"></div>
174
175
176	   <div id='bandwidth_id'>
177		<a class='dropdown-item' href='/wrist.php?bandwidth=lo'>
178		&nbsp;Load images as required</a>
179		<a class='dropdown-item' href='/wrist.php?bandwidth=hi'>
180		<i class="fas fa-check"></i>&nbsp;Load all images at once</a>
181
182	    </div>
183		
183<script>
184		if(!(test_cookie())){
185			document.getElementById('bandwidth_id').style.display='none';
186		}
187		</script>
187
188
189
190
191	   </div>
192
193
194
195      </li>
196	  <li class="nav-item me-3 text-left" >
197        <a class="nav-link" href="self_test.php">Self-tests</a>
198      </li>
199	  	  <li class="nav-item me-3 text-left" >
200	  <a class='nav-link' href='imagelibrary.php'>Pathologies</a>
201	   </li>
202
203	  	  <li class="nav-item me-3 text-left" >
204        <a class="nav-link" href="FAQ.php">Information</a>
205      </li>
206	  <li class="nav-item me-3 text-left" >
207        <a class="nav-link" href="feedback.php">Contact</a>
208      </li>
209
210
211
212
213
214	  
215	  <li class="nav-item me-3 text-left" > <a class="nav-link" href="self_test.php">Login/Register</a></li>
216
217	  
218
219    </ul>
220
221
222	<form class="form-inline my-2 my-lg-0"><input class="form-control me-sm-2"  id="searchBox" type="text" placeholder="search" /></form>
223  </div>
224</nav>
225
226
227
228
229</div>
230
231<div class='container'>
232<div class="alert alert-success alert-dismissible fade show" role="alert" id="bandwidth_alert_id"  ><span  class='fw-bold'><i class='far fa-images'></i> Higher data usage mode:</span> Magnified images are currently set to load all at once - this will give the best viewing experience, but may use more data. You can change this setting in the "Modules" menu, or <a href='/wrist.php?bandwidth=lo'>here</a>.<button type="button" class="btn-close" data-bs-dismiss="alert" aria-label="Close"></button></div><BR>
232<script>
233if(!(test_cookie())){
234	document.getElementById("bandwidth_alert_id").style.display='none';
235}
236</script>
236
237
238<div class='row mb-3'>
239<div class='col-7'>
240<div class="mt-3">
241<h3>The Wrist</h3>
242</div>
243</div>
244<div class='col text-right d-none d-md-block'>
245
246<!-- Sharingbutton Facebook -->
247<a class="resp-sharing-button__link" href="https://facebook.com/sharer/sharer.php?u=https%3A%2F%2Fwww.imageinterpretation.co.uk" target="_blank" aria-label="">
248  <div class="resp-sharing-button resp-sharing-button--facebook resp-sharing-button--small"><div aria-hidden="true" class="resp-sharing-button__icon resp-sharing-button__icon--solid">
249    <svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 24 24"><path d="M18.77 7.46H14.5v-1.9c0-.9.6-1.1 1-1.1h3V.5h-4.33C10.24.5 9.5 3.44 9.5 5.32v2.15h-3v4h3v12h5v-12h3.85l.42-4z"/></svg>
250    </div>
251  </div>
252</a>
253
254
255<!-- Sharingbutton Tumblr -->
256<a class="resp-sharing-button__link" href="https://www.tumblr.com/widgets/share/tool?posttype=link&amp;title=Norwich%20Image%20Interpretation%20Course&amp;caption=Norwich%20Image%20Interpretation%20Course&amp;content=https%3A%2F%2Fwww.imageinterpretation.co.uk&amp;canonicalUrl=https%3A%2F%2Fwww.imageinterpretation.co.uk&amp;shareSource=tumblr_share_button" target="_blank" aria-label="">
257  <div class="resp-sharing-button resp-sharing-button--tumblr resp-sharing-button--small"><div aria-hidden="true" class="resp-sharing-button__icon resp-sharing-button__icon--solid">
258    <svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 24 24"><path d="M13.5.5v5h5v4h-5V15c0 5 3.5 4.4 6 2.8v4.4c-6.7 3.2-12 0-12-4.2V9.5h-3V6.7c1-.3 2.2-.7 3-1.3.5-.5 1-1.2 1.4-2 .3-.7.6-1.7.7-3h3.8z"/></svg>
259    </div>
260  </div>
261</a>
262
263<!-- Sharingbutton E-Mail -->
264<a class="resp-sharing-button__link" href="mailto:?subject=Norwich%20Image%20Interpretation%20Course&amp;body=https%3A%2F%2Fwww.imageinterpretation.co.uk" target="_self" aria-label="">
265  <div class="resp-sharing-button resp-sharing-button--email resp-sharing-button--small"><div aria-hidden="true" class="resp-sharing-button__icon resp-sharing-button__icon--solid">
266    <svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 24 24"><path d="M22 4H2C.9 4 0 4.9 0 6v12c0 1.1.9 2 2 2h20c1.1 0 2-.9 2-2V6c0-1.1-.9-2-2-2zM7.25 14.43l-3.5 2c-.08.05-.17.07-.25.07-.17 0-.34-.1-.43-.25-.14-.24-.06-.55.18-.68l3.5-2c.24-.14.55-.06.68.18.14.24.06.55-.18.68zm4.75.07c-.1 0-.2-.03-.27-.08l-8.5-5.5c-.23-.15-.3-.46-.15-.7.15-.22.46-.3.7-.14L12 13.4l8.23-5.32c.23-.15.54-.08.7.15.14.23.07.54-.16.7l-8.5 5.5c-.08.04-.17.07-.27.07zm8.93 1.75c-.1.16-.26.25-.43.25-.08 0-.17-.02-.25-.07l-3.5-2c-.24-.13-.32-.44-.18-.68s.44-.32.68-.18l3.5 2c.24.13.32.44.18.68z"/></svg>
267    </div>
268  </div>
269</a>
270
271<!-- Sharingbutton Pinterest -->
272<a class="resp-sharing-button__link" href="https://pinterest.com/pin/create/button/?url=https%3A%2F%2Fwww.imageinterpretation.co.uk&amp;media=https%3A%2F%2Fwww.imageinterpretation.co.uk&amp;description=Norwich%20Image%20Interpretation%20Course" target="_blank" aria-label="">
273  <div class="resp-sharing-button resp-sharing-button--pinterest resp-sharing-button--small"><div aria-hidden="true" class="resp-sharing-button__icon resp-sharing-button__icon--solid">
274    <svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 24 24"><path d="M12.14.5C5.86.5 2.7 5 2.7 8.75c0 2.27.86 4.3 2.7 5.05.3.12.57 0 .66-.33l.27-1.06c.1-.32.06-.44-.2-.73-.52-.62-.86-1.44-.86-2.6 0-3.33 2.5-6.32 6.5-6.32 3.55 0 5.5 2.17 5.5 5.07 0 3.8-1.7 7.02-4.2 7.02-1.37 0-2.4-1.14-2.07-2.54.4-1.68 1.16-3.48 1.16-4.7 0-1.07-.58-1.98-1.78-1.98-1.4 0-2.55 1.47-2.55 3.42 0 1.25.43 2.1.43 2.1l-1.7 7.2c-.5 2.13-.08 4.75-.04 5 .02.17.22.2.3.1.14-.18 1.82-2.26 2.4-4.33.16-.58.93-3.63.93-3.63.45.88 1.8 1.65 3.22 1.65 4.25 0 7.13-3.87 7.13-9.05C20.5 4.15 17.18.5 12.14.5z"/></svg>
275    </div>
276  </div>
277</a>
278</div>
279</div>
280
281
282<h6 class="text-center mt-4 mb-4">
283<a  class="btn btn-outline-primary btn-sm mb-2"   href="#prevalence">Fracture prevalence</a>
284<a  class="btn btn-outline-primary btn-sm mb-2"   href="#normalPA">Normal anatomy PA</a>
285<a  class="btn btn-outline-primary btn-sm mb-2"   href="#normalLateral">Normal anatomy lateral</a><BR>
286<a  class="btn btn-outline-primary btn-sm mb-2"   href="#Colles">Colles'/Smith's</a>
287<a  class="btn btn-outline-primary btn-sm mb-2"   href="#radial_styloid_fracture">Radial styloid</a>
288<a  class="btn btn-outline-primary btn-sm mb-2"   href="#paediatric">Paediatric</a>
289<a  class="btn btn-outline-primary btn-sm mb-2"   href="#scaphoid">Scaphoid</a>
290<a  class="btn btn-outline-primary btn-sm mb-2"   href="#triquetrum">Triquetrum</a>
291<a  class="btn btn-outline-primary btn-sm mb-2"   href="#hamate">
291Hamate</a>
292<a  class="btn btn-outline-primary btn-sm mb-2"   href="#lunate">Lunate</a>
293<a  class="btn btn-outline-primary btn-sm mb-2"   href="#pisiform">Pisiform</a>
294<a  class="btn btn-outline-primary btn-sm mb-2"   href="#capitate">Capitate</a>
295<a  class="btn btn-outline-primary btn-sm mb-2"   href="#trapezium">Trapezium</a>
296<a  class="btn btn-outline-primary btn-sm mb-2"   href="#trapezoid">Trapezoid</a><BR>
297<a  class="btn btn-outline-primary btn-sm mb-2"   href="#Carpal_dislocations">Carpal dislocations</a>
298<a  class="btn btn-outline-primary btn-sm mb-2"   href="#zov">Zone of Vulnerability</a>
299<a  class="btn btn-outline-primary btn-sm mb-2"   href="#carpalInstability">Carpal Instability</a>
300<a  class="btn btn-outline-primary btn-sm mb-2"   href="#galeazzi">Galeazzi</a>
301<BR><BR>
302(hover over images to zoom, click to enlarge)</h6>
303
304
305<div class="card border-success mb-3" >
306  <div class="card-header">Learning outcomes</div>
307  <div class='card-body  text-success'>
308<ul>
309
310    <li>Assess skeletal radiographs using a systematic  approach on the DP and lateral</li>
311    <li>Describe carpal anatomy</li>
312    <li>Understand mechanisms of injury and the likely  fractures/dislocations which may result </li>
313    <li>Recognise less common fractures to the  individual carpal bones</li>
314    <li>Accurately describe carpal dislocations and  associated fractures within the zone of vulnerability</li>
315    <li>Understand common eponyms</li>
316    <li>Recognise potential ligament injuries</li>
317    <li>Understand paediatric fractures –  torus/greenstick terminology</li>
318  </ul>
319</div>
320</div>
321
322<div class="card border-dark mb-3" >
323  <div class="card-header" id="prevalence">Fracture prevalence</div>
324  <div class="card-body text-dark">
325
326<p>A fall on the out-stretched hand (FOOSH) tends to result in specific injuries depending on the general age of the patient:
327</p>
328<ul style="list-style-type:none">
329<li>4-10 years - Torus fracture of the distal radial metaphysis</li>
330<li>11-16 years - Salter-Harris II fracture involving the physeal plate</li>
331<li>17-40 years - Scaphoid fracture</li>
332<li>Over 40 years - Colles'-type fracture</li>
333</ul>
334</div>
335</div>
336
337<div class="card border-dark mb-3" >
338  <div class="card-header" id="normalPA">Normal anatomy - PA radiograph</div>
339  <div class="card-body text-dark">
340
341<ul>
342<li>Distal radial articular surface tilts 17 degrees towards the ulna.</li>
343<li>Medially the radius articulates with the head of the ulna at the ulnar notch. The head of the ulna is normally up to 2mm shorter than the radius, and either touches or slightly overlaps the radius at the distal radioulnar joint.</li>
344<li>The width of the intercarpal joints is uniform, approximately 2mm.</li>
345<li>Three carpal arcs should be traced:
346<ol>
347<li>along the proximal row of carpal bones; proximal aspect.</li>
348<li>along the proximal row of carpal bones; distal aspect.</li>
349<li>along the capitate and hamate proximally.</li>
350</ol>
351</li>
352<li class="no-bullet">
353These three lines should remain unbroken:</li>
354</ul>
355
356<div class="text-center mb-4">
357<a href="images/wrist/normal%20dp.jpg" title="Normal DP wrist"  class="MagicZoom"><img class="tn img-thumbnail" alt="Normal DP wrist" src="images/wrist/normal%20dp-1.jpg"></a>&nbsp;&nbsp;&nbsp;
358
359<a href="images/wrist/normal%20graphic%20dp.jpg" title="Normal DP wrist"   class="MagicZoom"><img src="images/wrist/normal%20graphic%20dp-1.jpg" alt="Normal DP wrist" class="tn img-thumbnail" ></a>
360</div>
361<ul>
362<li>The distal radial epiphyseal line may remain as a linear density, with a spur-like projection laterally, simulating a fracture due to the break in the cortex. However, this is a normal variant.</li>
363</ul>
364<div class="text-center mb-4"><a href="images/wrist/NORMAL%20WRIST%20-%20EPIPHYSEAL%20SPUR.jpg" title="Epiphyseal spur"  class="MagicZoom"><img class="tn img-thumbnail" alt="Epiphyseal spur" src="images/wrist/NORMAL%20WRIST%20-%20EPIPHYSEAL%20SPUR-1.jpg"></a></div>
365</div>
366</div>
367
368<div class="card border-dark mb-3" >
369  <div class="card-header" id="normalLateral">Normal anatomy - Lateral radiograph</div>
370  <div class="card-body text-dark">
371
372<ul>
373<li>The distal articular surface is angled 10-15 degrees anteriorly. This is useful when identifying subtle fractures at the distal radius with flattening of this angle.</li>
374<li>Articular surfaces of radius, lunate and capitate should be in a straight line and be congruent (parallel). The "apple" (capitate) should sit in the "cup" (lunate), which should sit in the "saucer" (radius):</li>
375</ul>
376<div class="text-center mb-4"><a href="images/wrist/normal%20lat.jpg" title="Normal lateral wrist"   class="MagicZoom"><img class="tn img-thumbnail" alt="Normal lateral wrist"  src="images/wrist/normal%20lat-1.jpg"></a>&nbsp;&nbsp;&nbsp;
377<a href="images/wrist/normal%20graphic%20lat.jpg" title="Normal lateral wrist"   class="MagicZoom"><img src="images/wrist/normal%20graphic%20lat-1.jpg" alt="Normal lateral wrist" class="tn img-thumbnail" ></a></div>
378</div>
379</div>
380
381<div class="card border-dark mb-3" >
382  <div class="card-header" id="Colles">Colles' / Smith's fracture</div>
383  <div class="card-body text-dark">
384
385<ul>
386<li>Fractures of the distal radius are classified depending on which direction the distal fragment is displaced. If displaced posteriorly, it is referred to as a Colles' fracture. The term "Colles" was originally used to describe a very specific injury, but the term is now used more generally.
387</li>
388</ul>
389<div class="text-center mb-4"><a href="images/wrist/COLLES.jpg" title="Colles' fracture"   class="MagicZoom">
389<img src="images/wrist/COLLES-1.jpg" alt="Colles' fracture" class="tn img-thumbnail" ></a>   </div>
390<ul>
391<li>If the distal fragment is displaced anteriorly, the fracture is classified as a &quot;Smith's&quot; fracture:
392</li>
393</ul>
394<div class="text-center mb-4"><a href="images/wrist/smiths.jpg" title="Smith's fracture"   class="MagicZoom"><img src="images/wrist/smiths-1.jpg" alt="Smith's fracture" class="tn img-thumbnail" ></a></div>
395<ul>
396<li>A Barton's fracture refers to an intra-articular shearing fracture with subluxation at the radio-carpal joint. It is described by the direction of displacement. The volar type is most common:
397</li>
398</ul>
399<div class="text-center mb-4"><a href="images/wrist/bartons.jpg" title="Volar type Barton's - fracture volar rim radius (and ulna) with anterior subluxation radiocarpal joint"   class="MagicZoom"><img src="images/wrist/bartons-1.jpg" alt="Volar type Barton's - fracture volar rim radius (and ulna) with anterior subluxation radiocarpal joint" class="tn img-thumbnail" ></a></div>
400<ul>
401<li>If the distal radius fracture is displaced, the attachment of the triangular fibrocartilage tends to result in an avulsion fracture of the ulnar styloid process:
402</li>
403</ul>
404<div class="text-center mb-4"><a href="images/wrist/AVULSION%20ULNAR%20STYLOID.jpg" title="Avulsion fracture of ulnar styloid (and Colles' fracture)"   class="MagicZoom"><img src="images/wrist/AVULSION%20ULNAR%20STYLOID-1.jpg" alt="Avulsion fracture of ulnar styloid (and Colles' fracture)" class="tn img-thumbnail" ></a></div>
405</div>
406</div>
407
408<div class="card border-dark mb-3" >
409  <div class="card-header" id="radial_styloid_fracture">Radial Styloid Fracture</div>
410  <div class="card-body text-dark">
411<ul>
412<li>Fractures are common due to blunt trauma directly to the radial styloid process. Fractures are oblique, intra-articular and are usually minimally displaced:
413</li>
414</ul>
415<div class="text-center mb-4"><a href="images/wrist/RADIAL%20STYLOID.jpg" title="Radial styloid fracture"   class="MagicZoom"><img src="images/wrist/RADIAL%20STYLOID-1.jpg" alt="Radial styloid fracture" class="tn img-thumbnail" ></a></div>
416</div>
417</div>
418
419<div class="card border-dark mb-3" >
420  <div class="card-header" id="paediatric">Paediatric fractures</div>
421  <div class="card-body text-dark">
422
423
424<ul>
425<li>Most common, but often subtle, are torus fractures of the distal radial metaphysis, usually dorsally (due to a FOOSH). The torus fracture will be evident by a buckling of the cortex with little displacement:
426</li>
427</ul>
428<div class="text-center mb-4"><a href="images/wrist/torus.jpg" title="Torus fracture"   class="MagicZoom"><img src="images/wrist/torus-1.jpg" alt="Torus fracture" class="tn img-thumbnail" ></a></div>
429<ul>
430<li>Greenstick fractures of the radial and ulnar shaft are demonstrated by a break in one cortex only (incomplete), with displacement/angulation. An increase in the force will result in a complete fracture.
431</li>
432</ul>
433<div class="text-center mb-4"><a href="images/wrist/greenstick.jpg" title="Greenstick fracture"   class="MagicZoom"><img src="images/wrist/greenstick-1.jpg" alt="Greenstick fracture" class="tn img-thumbnail" ></a></div>
434<ul>
435<li>Salter-Harris fractures involving the physeal growth plate are common, particularly Salter-Harris type II through the dorsal aspect of the distal radial metaphysis (again due to FOOSH):</li>
436</ul>
437
438<div class="text-center mb-4"><a href="images/wrist/SH1,%20ULNA%20STYLOID.jpg" title="Salter-Harris I"   class="MagicZoom"><img class="tn img-thumbnail" alt="Salter-Harris I"  src="images/wrist/SH1,%20ULNA%20STYLOID-1.jpg"></a>&nbsp;&nbsp;&nbsp;
439<a href="images/wrist/SH2,%20ULNA%20STYLOID.jpg"   title="Salter-Harris II"   class="MagicZoom"><img class="tn img-thumbnail" alt="Salter-Harris II" src="images/wrist/SH2,%20ULNA%20STYLOID-1.jpg"></a></div>
440</div>
441</div>
442
443
444
445<div class="card border-dark mb-3" >
446  <div class="card-header" id="scaphoid">Scaphoid</div>
447  <div class="card-body text-dark">
448
449<ul>
450<li>Majority of fractures are at the waist and are non-displaced. Can be difficult to see initially, therefore if clinically suspected repeat radiographs are taken at 10-14 days to demonstrate sclerosis or resorption at the fracture line:</li>
451</ul>
452
453<div class="text-center mb-4"><a href="images/wrist/scaphoid.jpg" title="Scaphoid - fracture demonstrated on follow up images (bottom)"   class="MagicZoom"><img class="tn img-thumbnail" alt="Scaphoid - fracture demonstrated on follow up images (bottom)"  src="images/wrist/scaphoid-1.jpg"></a></div>
454<ul>
455<li>Fractures at the distal pole are usually avulsion injuries caused by the radial collateral ligament. The distal pole has its own blood supply, so healing is quick.</li>
456</ul>
457
458<div class="text-center mb-4"><a href="images/wrist/%23%20DISTAL%20POLE%20SCAPHOID.jpg" title="Fracture distal pole scaphoid"   class="MagicZoom"><img class="tn img-thumbnail" alt="Fracture distal pole scaphoid" src="images/wrist/%23%20DISTAL%20POLE%20SCAPHOID-1.jpg"></a></div>
459<ul>
460<li>Blood supply to the proximal pole enters at the waist. This supply may be cut off by a fracture through the waist. The proximal pole is consequently at risk from delayed union or avascular  necrosis, where the proximal fragment collapses and becomes radiographically denser:</li>
461</ul>
462<div class="text-center mb-4"><a href="images/wrist/AVN%20SCAPHOID.jpg" title="AVN proximal pole of scaphoid"   class="MagicZoom"><img class="tn img-thumbnail" alt="AVN proximal pole of scaphoid"  src="images/wrist/AVN%20SCAPHOID-1.jpg"></a></div>
463<ul>
464<li>Clinical assessment of the injured scaphoid includes compression by axial loading which causes pain to the anatomical snuff-box. However, fractures to both the base of the 1st metacarpal and to the radial styloid will also produce pain to the anatomical snuff-box with this clinical assessment. It is therefore important to assess these areas carefully on the scaphoid views:
465</li>
466</ul>
467<div class="text-center mb-4"><a href="images/wrist/bennetts%20on%20scap.jpg" title="Bennett's fracture-dislocation"   class="MagicZoom"><img src="images/wrist/bennetts%20on%20scap-1.jpg" alt="Bennett's fracture-dislocation" class="tn img-thumbnail" ></a></div>
468</div>
469</div>
470
471
472<div class="card border-dark mb-3" >
473  <div class="card-header" id="triquetrum">Triquetrum</div>
474  <div class="card-body text-dark">
475
476<ul>
477<li>This is the second most common carpal bone to be fractured.</li>
478<li>An avulsed bony fragment will be demonstrated on the lateral radiograph, dorsal to the proximal row of carpal bones:</li>
479</ul>
480
481<div class="text-center mb-4"><a href="images/wrist/%23%20TRIQUETRUM.jpg" title="Triquetral fracture"   class="MagicZoom"><img class="tn img-thumbnail" alt="Triquetral fracture"  src="images/wrist/%23%20TRIQUETRUM-1.jpg"></a></div>
482</div>
483</div>
484
485<div class="card border-dark mb-3" >
486  <div class="card-header" id="hamate">
486Hamate</div>
487  <div class="card-body text-dark">
488
489<ul>
490<li>Associated with fracture-dislocations at the base of the 4th and 5th metacarpals. Important to spot but often subtle.</li>
491<li>Ensure there is a 2mm joint space with the adjacent metacarpals on the DP view.</li>
492<li>Scrutinise the cortex of the hamate, particularly on an oblique view:</li>
493</ul>
494
495
496<div class="text-center mb-4">
497<p><a href="images/wrist/Hamate.jpg" title="Fracture hamate"   class="MagicZoom"><img class="tn img-thumbnail" alt="Fracture hamate"  src="images/wrist/Hamate-1.jpg"></a></p>
498</div>
499</div>
500</div>
501
502
503<div class="card border-dark mb-3" >
504  <div class="card-header" id="lunate">Lunate</div>
505  <div class="card-body text-dark">
506
507<h5><a id="lunate"></a></h5>
508<ul>
509<li>Fractures are rare. Lunate dislocations may occur following high impact trauma. A sclerotic lunate is sometimes seen, which is due to avascular necrosis (decreased blood supply), known as Keinbock's disease. The lunate becomes denser radiographically, fragments and collapses:
510</li>
511</ul>
512<div class="text-center mb-4"><a href="images/wrist/AVN%20LUNATE.jpg"  title="AVN lunate"   class="MagicZoom"><img src="images/wrist/AVN%20LUNATE-1.jpg" alt="AVN lunate" class="tn img-thumbnail"></a></div>
513</div>
514</div>
515
516
517
518<div class="card border-dark mb-3" >
519  <div class="card-header" id="pisiform">Pisiform</div>
520  <div class="card-body text-dark">
521<ul>
522<li>Fractures very occasionally seen due to direct trauma to the antero-medial aspect of the carpus:
523</li>
524</ul>
525<div class="text-center mb-4"><a href="images/wrist/PISIFORM.jpg" title="Fracture pisiform"   class="MagicZoom"><img src="images/wrist/PISIFORM-1.jpg" alt="Fracture pisiform" class="tn img-thumbnail" ></a></div>
526</div>
527</div>
528
529<div class="card border-dark mb-3" >
530  <div class="card-header" id="capitate">Capitate</div>
531  <div class="card-body text-dark">
532
533<ul>
534<li>Isolated fractures are rare, but as part of complex carpal fractures and lunate/perilunate fracture-dislocations, a fracture of the capitate may be seen.</li>
535</ul>
536<div class="text-center mb-4"><a href="images/wrist/capitate%20and%20lunate.jpg" title="Comminuted fractures proximal capitate and lunate, with impaction and rotation"   class="MagicZoom"><img src="images/wrist/capitate%20and%20lunate-1.jpg" alt="Comminuted fractures proximal capitate and lunate, with impaction and rotation" class="tn img-thumbnail" ></a>&nbsp;&nbsp;&nbsp;
537<a href="images/wrist/capitate%20graphic.jpg"  title="Comminuted fractures proximal capitate and lunate, with impaction and rotation"  class="MagicZoom"><img src="images/wrist/capitate%20graphic-1.jpg" alt="Comminuted fractures proximal capitate and lunate, with impaction and rotation" class="tn img-thumbnail"></a></div>
538</div>
539</div>
540
541<div class="card border-dark mb-3" >
542  <div class="card-header" id="trapezium">Trapezium</div>
543  <div class="card-body text-dark">
544
545<ul>
546<li>Fractures are rare. The 1st carpo-metacarpal joint is a very common site for arthritic changes.
547</li>
548</ul>
549<div class="text-center mb-4"><a href="images/wrist/TRAPEZIUM,%20TRIQUETRAL.jpg" title="Fracture trapezium, fracture triquetral"   class="MagicZoom"><img src="images/wrist/TRAPEZIUM,%20TRIQUETRAL-1.jpg" alt="Fracture trapezium, fracture triquetral" class="tn img-thumbnail" ></a></div>
550</div>
551</div>
552
553<div class="card border-dark mb-3" >
554  <div class="card-header" id="trapezoid">Trapezoid</div>
555  <div class="card-body text-dark">
556
557<ul>
558<li>Fractures are rare.</li>
559</ul>
560</div>
561</div>
562
563
564<div class="card border-dark mb-3" >
565  <div class="card-header" id="Carpal_dislocations">Carpal Dislocations</div>
566  <div class="card-body text-dark">
567
568
569<ul>
570<li>Lunate dislocation - Lunate loses its articulation with both the capitate and the radius and is displaced anteriorly with up to 90 degrees rotation. The capitate remains aligned with the radius but sinks proximally:</li>
571</ul>
572<div class="text-center mb-4"><a href="images/wrist/lunate%20dis%20dp.jpg" title="Lunate dislocation"   class="MagicZoom"><img src="images/wrist/lunate%20dis%20dp-1.jpg" alt="Lunate dislocation" class="tn img-thumbnail" ></a>&nbsp;&nbsp;&nbsp;
573<a href="images/wrist/lunate%20dis.jpg"  title="Lunate dislocation"class="MagicZoom"><img src="images/wrist/lunate%20dis-1.jpg" alt="Lunate dislocation" class="tn img-thumbnail"></a>&nbsp;&nbsp;&nbsp;
574<a href="images/wrist/lunate%20dis%20graphic.jpg" title="Lunate dislocation"   class="MagicZoom"><img src="images/wrist/lunate%20dis%20graphic-1.jpg" alt="Lunate dislocation" class="tn img-thumbnail" ></a></div>
575<ul>
576<li>Perilunate dislocation - The lunate maintains its normal articulation with the radius, but the capitate articular surface is dislocated from the lunate, normally dorsally:</li>
577</ul>
578<div class="text-center mb-4"><a href="images/wrist/perilunate%20dis%20dp.jpg" title="Perilunate dislocation, fracture scaphoid"   class="MagicZoom"><img src="images/wrist/perilunate%20dis%20dp-1.jpg" alt="Perilunate dislocation, fracture scaphoid" class="tn img-thumbnail" ></a>&nbsp;&nbsp;&nbsp;
579<a href="images/wrist/perilunate%20dis.jpg"  title="Perilunate dislocation"   class="MagicZoom"><img src="images/wrist/perilunate%20dis-1.jpg" alt="Perilunate dislocation" class="tn img-thumbnail"></a>&nbsp;&nbsp;&nbsp;
580<a href="images/wrist/perilunate%20dis%20graphic.jpg" title="Perilunate dislocation"   class="MagicZoom"><img src="images/wrist/perilunate%20dis%20graphic-1.jpg" alt="Perilunate dislocation" class="tn img-thumbnail" ></a></div>
581<ul>
582<li>Midcarpal dislocation - The lunate tilts volarly but is not dislocated from the radius. The capitate is dislocated from the lunate but not as dorsally as seen in a perilunate dislocation:</li>
583</ul>
584<div class="text-center mb-4"><a href="images/wrist/midcarpal_dp.jpg"  title="Midcarpal dislocation, fracture radial styloid"   class="MagicZoom"><img class="tn img-thumbnail" alt="Midcarpal dislocation, fracture radial styloid" src="images/wrist/midcarpal_dp-1.jpg"></a>&nbsp;&nbsp;&nbsp;
585<a href="images/wrist/midcarpal_lat.jpg"  title="Midcarpal dislocation"   class="MagicZoom"><img src="images/wrist/midcarpal_lat-1.jpg" alt="Midcarpal dislocation" class="tn img-thumbnail"></a>&nbsp;&nbsp;&nbsp;
586<a href="images/wrist/midcarpal_graphic.jpg"  title="Midcarpal dislocation"   class="MagicZoom"><img src="images/wrist/midcarpal_graphic-1.jpg" alt="Midcarpal dislocation" class="tn img-thumbnail"></a></div>
587</div>
588</div>
589
590
591<div class="card border-dark mb-3" >
592  <div class="card-header" id="zov">Zone of vulnerability</div>
593  <div class="card-body text-dark">
594
595<ul>
596<li>Most fracture-dislocations fall within the "zone of vulnerability".</li>
597<li>When identifying a fracture or dislocation, it is helpful to understand that likely associated fractures will be within this zone, i.e., radial styloid, waist of the scaphoid or capitate, proximal pole of the hamate, triquetrum or ulnar styloid.</li>
598<li>With progression from the radial to the ulnar side of the arch, the severity of the injury increases and the frequency of the injury decreases:</li>
599</ul>
600
601<div class="text-center mb-4"><a href="images/wrist/NORMAL%20WRIST%20ZONE%20graphic.jpg" title="Zone of vulnerability"   class="MagicZoom"><img src="images/wrist/NORMAL%20WRIST%20ZONE%20graphic-1.jpg" alt="Zone of vulnerability" class="tn img-thumbnail" ></a></div>
602</div></div>
603
604<div class="card border-dark mb-3" >
605  <div class="card-header" id="carpalInstability">Carpal instability</div>
606  <div class="card-body text-dark">
607
608<ul>
609<li>Refers to ligament rupture within the carpal bones, most commonly at the scapho-lunate joint.</li>
610<li>Scapholunate dissociation is demonstrated by the gap between the scaphoid and lunate increasing in size more than 2mm. It may al
610so become triangular in appearance on the PA radiograph.</li>
611<li>There is foreshortening of the scaphoid and a cortical "ring sign" is seen at the distal pole:</li>
612</ul>
613
614<div class="text-center mb-4"><a href="images/wrist/CARPAL%20INSTABILITY.jpg" title="Carpal instability"  class="MagicZoom"><img class="tn img-thumbnail" alt="Carpal instability" src="images/wrist/CARPAL%20INSTABILITY-1.jpg"></a>
615</div>
616<ul>
617<li>A 'clenched fist' view is sometimes helpful to demonstrate the widening at the joint:</li>
618</ul>
619<div class="text-center mb-4"><a href="images/wrist/CARPAL%20INSTABILITY%20CLENCHED%20%20FIST.jpg" title="Clenched fist view"   class="MagicZoom"><img class="tn img-thumbnail" alt="Clenched fist view" src="images/wrist/CARPAL%20INSTABILITY%20CLENCHED%20%20FIST-1.jpg"></a></div>
620</div>
621</div>
622
623<div class="card border-dark mb-3" >
624  <div class="card-header" id="galeazzi">Galeazzi fracture-dislocation</div>
625  <div class="card-body text-dark">
626
627<ul>
628<li>Refers to a displaced fracture of the radial shaft accompanied by a dislocation to the distal radioulnar joint:</li>
629</ul>
630<div class="text-center mb-4"><a href="images/wrist/GALLEAZZI.jpg" title="Galeazzi fracture-dislocation"   class="MagicZoom"><img class="tn img-thumbnail" alt="Galeazzi fracture-dislocation" src="images/wrist/GALLEAZZI-1.jpg"></a></div>
631<ul>
632<li>Similar pattern seen at the elbow where a displaced fracture to the proximal ulna is accompanied by a dislocation of the radial head. This is termed a <a href="elbow.php#Monteggia">"Monteggia" fracture-dislocation</a>.</li>
633</ul>
634</div>
635</div>
636
637<div class="text-center mb-4">
638<p><a href="self_test.php?new=1"><i class="fas fa-university fa-5x"></i>
639TAKE THE WRIST SELF-TEST</a></p>
640<p> </p>
641</div>
642<p class="text-center mb-4"><a href="#top">- return to top -</a></p>
643</div>
644
645
646 
647
648
649
650
651
652
653<div class="footer">
654<div class="container text-center">
655  <small>&copy; 2008-2026 Heidi &amp; <a href='https://www.medicalwebsystems.co.uk' target='_blank'>David Nunn</a>. All rights reserved. </small>
656</div>
657
658</div>
659
660</div>
661<div class="end"> </div>
662
663
664<script src="https://cdn.jsdelivr.net/npm/[email protected]/dist/js/bootstrap.bundle.min.js" integrity="sha384-YvpcrYf0tY3lHB60NNkmXc5s9fDVZLESaAA55NDzOxhy9GkcIdslK1eN7N6jIeHz" crossorigin="anonymous"></script>
664
665
666<script>
667const tooltipTriggerList = document.querySelectorAll('[data-bs-toggle="tooltip"]')
668const tooltipList = [...tooltipTriggerList].map(tooltipTriggerEl => new bootstrap.Tooltip(tooltipTriggerEl))
669</script>
669
670
671<script type="text/javascript">
672   /* Create a configuration object */
673   var ss360Config = {
674      /* Your site id */
675      siteId: 'imageinterpretation',
676      /* A CSS selector that points to your search  box */
677      searchBoxSelector: '#searchBox',
678   };
679</script>
vendor: 2 bytes, line 679
679
680<script src="https://sitesearch360.com/cdn/sitesearch360-v10.min.js"></script>
680
681</body>
682</html>

Line numbers count LF bytes from the start of the resource, as the search results do. Vendor segments are library code the classifier recognised; they are stored but not indexed. Bytes are shown as Latin1 characters, one per byte.