Emergency department evaluation and treatment of wrist injuries

This article provides the emergency physician a thorough understanding of the basic and surface anatomy required to accurately diagnose wrist injuries in the emergency department. Functional and neurologic examinations are discussed in detail as they increase precision in diagnosis. Special radiographic studies, guided by exam findings, are often crucial in adequately visualizing an otherwise occult injury. Radiographic evidence of injury is not present at time of initial evaluation in a small but noteworthy percentage of significant injuries. For these reasons, the appropriate use of radiographic studies is included. Finally, a rationale for performing conservative mobilization and promptly referring a suspected occult fracture is provided.