Wrist Dislocation in Emergency Medicine Treatment & Management

Updated: Feb 13, 2015
  • Author: Michael S Beeson, MD, MBA, FACEP; Chief Editor: Trevor John Mills, MD, MPH  more...
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Treatment

Prehospital Care

Prehospital care includes assessment for other injuries that may accompany the wrist injury.

If no other injuries are identified, splint the wrist.

Patients may be transported in their private vehicles, but the prehospital provider must emphasize the potential seriousness of the injury.

Under no circumstances should a prehospital provider attempt a reduction of a suspected wrist dislocation. It may be a distal radius fracture, which requires significant care to reduce.

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Emergency Department Care

Patients with wrist injuries have an entire spectrum of possible injuries that represent potential disability.

Although no specific fracture or dislocation may be seen on x-ray, carpal instability still may be present.

Therefore, splint with plaster even if no injury is found on x-ray.

Carefully splint with AP splints to the fingers until a hand specialist can evaluate the injury.

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Consultations

Patients in whom a wrist dislocation has been identified require referral to a hand specialist who is either an orthopedic or plastic surgeon, depending on local custom.

Wrist dislocations may be reduced by emergency physicians, but only after consulting with the hand specialist.

The patient's own primary care physician may follow up, but it is important to stress to the primary care physician the need for hand specialist referral.

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