eMedicine Specialties > Emergency Medicine > Trauma & Orthopedics
Fracture, Hand: Differential Diagnoses & Workup
Updated: Dec 10, 2009
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
- Multimedia
Differential Diagnoses
Dislocations, Hand
Dislocations, Wrist
Hand Infections
Hand Injury, Soft Tissue
Workup
Laboratory Studies
- Lab studies are not indicated in the workup of acute fractures.
Imaging Studies
- In ED, plain radiography is diagnostic test of choice to evaluate potential hand fractures.1
- Standard radiographs include AP, lateral, and oblique views. Example radiographs are shown below.
- Special imaging studies, such as MRI, CT, and bone scans, seldom are needed in ED to evaluate hand injuries.
Procedures
- Patients in severe pain or those who require reduction may be anesthetized by metacarpal or wrist nerve blocks.
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Differential Diagnoses & Workup: Fracture, Hand |
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References
[Guideline] Rubin DA, Daffner RH, Weissman BN, Bennett DL, Blebea JS, Jacobson JA, et al. ACR Appropriateness Criteria acute hand and wrist trauma. [online publication]. Reston (VA): American College of Radiology (ACR). 2008;[Full Text].
Oetgen ME, Dodds SD. Non-operative treatment of common finger injuries. Curr Rev Musculoskelet Med. Jun 2008;1(2):97-102. [Medline].
Henry MH. Fractures of the proximal phalanx and metacarpals in the hand: preferred methods of stabilization. J Am Acad Orthop Surg. Oct 2008;16(10):586-95. [Medline].
American Society for Surgery of the Hand, Idler RS, Mantktelow RT. The Hand Examination and Diagnosis. New York: Churchill Livingstone; 1990:13-73.
Emergency Medicine: Concepts and Clinical Practice [book on CD-ROM]. Mosby-Year Book; 1998. Antosia R, Lyn E.
Harwood-Nuss A, Wolfson A. Hand injuries. In: Clinical Practice of Emergency Medicine. 4th ed. 2005:1062-1065.
Rosen P, Doris P. Musculoskeletal trauma. In: Diagnostic Radiology in Emergency Medicine. 1992:178-182.
Ruiz E, Cicero JJ. Hand injuries and infections. In: Emergency Management of Skeletal Injuries. St. Louis, MO: Mosby-Year Book; 1990:339-59.
Simon RR, Koenigsknecht SJ. Fractures of the hand. In: Emergency Orthopedics. 4th ed. New York: McGraw-Hill; 2001:97-133.
Stewart C, Winograd S. Hand injuries: a step by step approach for clinical evaluation and definitive management. Emerg Med Rep. 1997;18:223-234.
Tintinalli JE, Ruiz E, Krome RL. Injuries to the hand and digits. In: Emergency Medicine: A Comprehensive Study Guide. 2004. 6th ed. New York: McGraw Hill; 2004:1665-1674.
Further Reading
Keywords
hand fracture, broken hand, hand injury, fractures of the phalanges, volar fracture dislocation, middle phalanx fractures, transverse fracture of distal phalanx, middle phalangeal fractures, proximal phalangeal fractures, transverse fracture of the proximal phalanx, oblique fractures, spiral fractures, condylar fractures, metacarpal fractures, metacarpal head fractures, metacarpal neck fractures, metacarpal shaft fractures, metacarpal base fractures, Bennett fractures, Rolando fractures






Differential Diagnoses & Workup: Fracture, Hand