A 21year old male presents to the emergency room having sust

A 21year old male presents to the emergency room having sustained injuries after falling off his skateboard. Upon visual examination you note abrasions to the right thenar eminence (palmar thumb pad area). There is substantial edema (swelling) and associated pain. Upon palpation the patient reports pain as 9 on a scale from 1-10 at the anatomical snuff box (lateral and somewhat dorsal surface proximal to the thumb and between two tendons when thumb is abducted). 1. What bone/s of the carpus are likely to have been injured? 2. What bone/s of the forearm could have been damaged? 3. What statement/s within this intake (verbage above) allows you to discriminate between injury of a carpal/s and injury of bone/s? 4. What test/s would you order to attain a final diagnosis? 5. What concerns might you have about the healing process given the area of injury?

Solution

is1) As we know , carpus is made up of 8 distinguishable bones that connect the hand to the forearm. Since the patient reports pain lateral and somewhat dorsal surface proximal to the thumb and between two tendons when thumb is abducted, there is a high chance that the two bones of the carpus which might have been injured are Trapezium and Scaphoid bones.

2) -

3) The patient indicating that he fell from his skateboard, which could be considered as a high speed contact sport, falling at a queer position on his hand suggests that his carpal might have been affected.

4) To attain a final diagnosis an x ray of the right hand or a CT scan. In the Xray, anterioposterior, lateral and oblique views are required.

5) The only concern about the patient that i might be having is, if the injury is not treated properlt, it made lead to permanent disabilities.