Fall on Outstretched Hand

Aka: Fall on Outstretched Hand, FOOSH

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II. Imaging

  1. Wrist XRay (or ulna-radius xray)
    1. Consider Scaphoid XRay views
  2. Hand XRay with Carpal Tunnel view (if thenar or hypothenar eminence pain)
    1. Hypothenar eminence region (Fracture associated with Ulnar Nerve injury in Guyon's canal)
      1. Hook of hamate Fracture
      2. Pisiform Fracture
    2. Thenar eminence region
      1. Scaphoid tubercle Fracture
    3. References
      1. Swadron and Mallon in Herbert (2018) EM:Rap 18(12): 3-4

III. Associated Conditions: Fractures

  1. Distal Radius Fracture (Colles' Fracture)
    1. Seen in older adults (esp. Osteoporosis)
  2. Scaphoid Fracture
    1. Seen in young adults
    2. Snuff-box tenderness
  3. Distal Radius Greenstick Fracture
    1. Seen in toddlers
  4. Epiphyseal Fracture of distal radius
    1. Seen in teens
  5. Carpal Bone Fracture at ulnar aspect wrist
    1. Hook of hamate Fracture
    2. Pisiform Fracture

IV. Associated Conditions: Ligamentous Injury

  1. Thumb Ulnar Collateral Ligament Rupture (Game Keeper's Thumb)
  2. Scapholunate Dislocation

V. Associated Conditions: Infection Risks

  1. Dorsal Laceration over joint of hand
    1. Risk for intra-articular infection
  2. Nail bed bleeding suggests Tuft Fracture
    1. Consider Osteomyelitis

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