radER 3.1 Answer

rader new

Winners

Brian Junnila           Claire Jensen             Krisit Bernath

Shereaf Walid          Rob Klever                  Kyle Perry

Devon Moore          Mike Fernandes        Katie Ohlendorf

Bao Dang               

Case

A 33-year-old man presents to the ED complaining of left thumb pain after he fell from his horse during a polo match.  There is swelling and tenderness at the base of the thumb.  You think the patient may have sustained a fracture of his proximal thumb so you order radiographs.  One of the radiographs is seen below:

thumb1

Questions

1. What is the eponym for this fracture?

2. Which tendon is responsible for displacement of the thumb?

3. What is the ED management for this fracture?

Answer:

1. Bennett Fracture – fracture-dislocation involving the articular surface of the base of the thumb metacarpal.  The metacarpal base is displaced dorsally and radially by the abductor pollicus longus tendon.

thumb1a

2. Abductor pollicus longus tendon

3. ED management includes placing patient in a thumb spica splint

– You should also refer the patient to a Hand Specialist because the fracture usually requires operative fixation

radER is a weekly contest consisting of a radiograph selected from various areas of emergency medicine that are central to the education of medical students and residents in training.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: