Specific management Complicated Hand and Finger Fractures A hand X-ray should have PA, oblique, and fan lateral views and will include all bones of the hand, carpus, and distal radio-ulnar joint.įor general assessment and management, see Fractures - Overview.This should have PA, oblique, and lateral views and include the metacarpal and carpometacarpal joint. Request a finger X-ray if the injury is localised to one digit.Test sensation and motor function of the median, radial, and ulnar nerves.Assess for ulnar collateral ligament injury (Gamekeeper’s Thumb) by palpating for tenderness on the ulnar side at the base of the proximal phalanx and looking for pain / laxity on abduction of the thumb.Look for “scissoring” or crossing over of the fingers. Assess for rotational deformity by asking the patient to make a first.Testing against resistance may identify ligamentous injury. Passive and active range of movement of all joints in hand and wrist should be examined.Palpate for obvious areas of tenderness.Compare both hands and look for bruising, erythema, swelling and deformity.Thumb ulnar collateral ligament injury (Gamekeeper’s thumb) is caused by hyper-abduction of the thumb. ![]()
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