Wrist Injuries X-rays and Photographs

Wrist is a very commonly injured organ. In this article wrist injuries x-rays and clinical photographs are being presented.

Image 1 – Xray of Wrist Showing Fracture of Distal Radius [Colles Fracture]

wrist injuries x-rays -Fracture of Distal End Radius

Fracture of Distal End Radius

The xray belongs to 43 years old female who fell from stairs.

Image 2 – Xray of Undisplaced Fracture of Distal Radius

53 years old man, shopkeeper by profession, fell from stool and injured his wrist. The xray of the wrist revealed a fracture of distal radius which was not displaced.

wrist injuries x-rays - Xray of Undisplaced Fracture of Distal End Radius

Xray of Undisplaced Fracture of Distal End Radius

The fracture is marked with an arrow. The fracture was treated by below elbow cast.

Image 3 – Xray Showing Fracture of Radial and Ulnar Styloid

 

Xray of fracture of radial and ulnar styloid process in 43 years old male.

Fracture of Radial and Ulnar Styloid

Fracture of Radial and Ulnar Styloid

The fracture was treated with closed reduction, kwire fixation and ligamentotaxis.

Image 4 – Photograph and Xrays of Volar Distal Radial Plate

Volar distal radial plating is done for fractures of distal radius which require open reduction and internal fixation. The plate is called volar because it is placed on volar aspect or the part of forearm in same side as palm.

First is the clinical photograph of the procedure taken peroperatively

Volar Plating For Distal Radius Fractue - Peroperative Photo

Volar Plating For Distal Radius Fracture – Peroperative Photo

Xray of wrist after two months of surgery.

United fracture in postoperative fim take n after 2 months

United fracture in postoperative fim take n after 2 months

The fracture in the xray is well united.

Image 5 – Volar Barton Fracture of Distal Radius- Lateral Xray

Volar Barton fracture is an intra-articular fracture of distal end of radius bone. The fracture is named after John Rhea Barton, an American surgeon who first described this in 1814.

The fracture is further divided into volar and dorsal type depending upon displacement of the distal fragment which can be either

Volar – Towards the palmar side

Dorsal – To side opposite where palm is.

volar-barton-fracture

The above xray picture is of 20 years old male who fell on outstretched hand and had volar Barton fracture.

The patient was treated with open reduction and internal fixation using volar buttress plate.

Image 6 –  Xray Of Wrist Showing Fracture of Styloid Process Of Radius

Fractures of radial styloid are not less common than fractures of distal metaphyses of radius bone. Here is an xray that I wanted to share with you.

The xray belongs to 39 years old male who had a fall from height.

Fracture of Radial Styloid

Fracture of Styloid Process Of Radius

The fractures treatment can be non operative in form of plaster cast or may involve reduction and fixation by means of Kwires or screw.

The prognosis is usually good.

Image 7 – Xray of Distal End Of Radius And Ulna In 9 Years Old Child

A 9-year-old child fell from height and suffered injury around his wrist. The xray revealed minimally displaced of lower end of radius and ulna.

distal end of radius and ulna in a child

Distal end of radius and ulna in a child

Patient was treated with plaster of Paris cast and is doing quite fine.

Image 8 – Vertical Intra-articular Fracture In Distal End Radius

Following xray belongs to a young man of 31 years old who fell from fence and suffered trauma in right wrist.
The xray revealed an intrarticular fracture of distal end radius in vertical fashion.

Intrarticular Vertical Fracture in Distal End Of Radius

Intrarticular Vertical Fracture in Distal End Of Radius

Interestingly, the patient refused any treatment and wanted to get massaged by an osteopath.

 Image 9 – Distal Radius Type II Epiphyseal Slip Treated By Closed Reduction & Kwire Fixation

This xray belongs to 16 year old boy who had a fall and complained of pain in elbow and wrist following the injury. The xray revealed distal epiphyseal injury and supracondylar fracture in humerus ipsilaterally. Xray of elbow also revealed bent kwires. The child had been operated in childhood for fracture of lateral condyle with Kwire fixation.

Distal radius epiphyseal slip

Distal Radius Type II Epiphyseal Slip Treated By Closed Reduction & Kwire Fixation

The supracondylar fracture was treated by open reduction and internal fixation with reconstruction plates and distal epiphyseal injury to radius was treated with closed reduction and Kwire fixation.

The xray above is 7 days after the surgery.

Image 10 – Xray of Fracture Of Distal Radius

Lateral View of wrist showing distal radius fracture.

Fracture of Distal Radius

Fracture of Distal Radius

It might be difficult to appreciate on this view

but the fracture has intra-articular extension as well.

Image 11 – United Fracture Distal End Radius With Volar Plate In Situ

Following Xrays are of a patient who was operated for fracture of distal end radius using Volar plate. The xray shows volar plate in situ and united fracture of radius.

First the AP view

AP Radiograph Showing United Fracture Radius With Volar Radial Plate In Situ

AP Radiograph Showing United Fracture Radius With Volar Radial Plate In Situ

And now the lateral view

Lateral View of Wrist With Volar Plate In Situ

Lateral View of Wrist With Volar Plate In Situ

The bone profile is better visualized in lateral view.

Image 12 – Minimally Displaced Fracture Distal Radius With Extension To Shaft

Xray of 48 years old male showing minimally displaced fracture of distal radius and multiple fracture lines extending to shaft of the radius.

Fracture of Distal Radius Extending To the Shaft

Minimally Displaced Fracture Distal Radius With Fracture Lines Extending To Shaft

The patient was treated with a plaster cast.

Image 13 – Fracture Distal End Radius With Kwires In Situ and Below Elbow Slab – Xray

Xray of patient operated for distal radius fracture and the radius was fixed with Kwires.

Fracture Distal Radius Reduced And Fxed With Kwires

Fracture Distal Radius Reduced And Fixed With Kwires

Also visible is the shadow of plaster.

Image 14 – Xray of Malpositioned Volar Barton Fracture In Plaster Cast

Xray of volar Barton fracture in malposition in a plaster cast

AP view

Malreduced Volar Barton Fracture In Plaster Cast - AP View

Malreduced Volar Barton Fracture In Plaster Cast – AP View

Lateral View

Volar Barton Fracture Lateral View

Unreduced Volar Barton Fracture In Plaster

The fracture fragment is still displaced volarward.

 Image 15 – Fracture Distal Radius In Child WIth Ulnar Bowing

9 years old child with history of fall and injury to wrist. The xray revealed fracture of distal radius that was slightly displaced and there was slight bowing of ulna as well.

Displaced Fracture of Radius In A Child

Displaced Fracture of Distal Radius With Slight Ulnar Bowing

The patient was treated with closed reduction and above elbow plaster slab followed by plaster cast at a later date.

Image 16 – Xray of Operated Distal Radius and Ulna In Child

Post operative xray of fracture of distal radius and ulna in a child fixed with Kwires.

 

Fracture Dstal Radius Ulna Fixed Wth Kwires

Fracture Dstal Radius Ulna Fixed Wth Kwires

The Kwires were passed under C-arm control after closed reduction of the fracture.

Image 17 – Distal Radial Epihysis Slip In 10 Years Old Child

10 years old child fell from tree and got his wrist injured. His xray showed epiphyseal slip of distal radius.

Distal Radial Epiphyseal Slip

Distal Radial Epiphyseal Slip

He was treated with closed reduction and above elbow cast.

Image 18 – Xray of Fracture Distal Radius With Fracture Ulnar Styloid

Fracture of distal radius with fracture of ulnar styloid in an adult

Fracture Distal Radius WIth Fracture Ulnar Styloid

Fracture Distal Radius With Fracture Ulnar Styloid

The fracture of the distal radius is comminuted but undisplaced whereas fracture of ulnar styloid is displaced .

Image 19 – Xray of Minimally Displaced Fracture of Distal Radius

Xray of wrist showing fracture of distal end of radius

Fracture of Distal Radius

Minimally Displaced Fracture of Distal Radius

Image 20 – Fracture Distal End Radius with Fracture Ulnar Styloid

Xray of wrist of 32 years old male after wrist trauma showing fracture of distal radius and ulnar styloid.

Fracture Distal Radius With Fracture Ulnar Styloid

Fracture Distal Radius With Fracture Ulnar Styloid

The fracture was sustained following a fall from motorbike.

Image 21 – Xay of Fracture Distal Radius Treated By Closed Reduction and K-wires

Xray of 37 years old lady with radius distal end fracture treated by closed reduction and Kwire insertion under guidance of C-arm image intensifier.

Fracture Distal Radius Treated By Closed Reduction and Kwire Insertion

Fracture Distal Radius Treated By Closed Reduction and Kwire Insertion

The xray was taken after about a week of surgery.

 Image 22 – Xray of Undisplaced Fracture of Ulna In Distal Region

Xray of undisplaced fracture of ulna in distal fourth region of ulna.

Xray of Undisplaced Fracture of Ulna In Distal Region

Xray of Undisplaced Fracture of Ulna In Distal Region

The patient was treated with above elbow plaster cast.

Image 23 – AP and Lateral Xray of Forearm Showing Fracture of Distal Radius and Ulna In A Child

Six years old child with a history of fall from height and injury to forearm near the wrist.

Xray revealed fracture of both radius and ulna with mild displacement.

Xray of fractrue of distal radius and ulna in 6 years old child

Xray of fracture of distal radius and ulna in child

The fracture was reduced under C-arm image intensifier control and above elbow cast was applied.

Image 24 – Undisplaced Fracture of Distal Fourth of Radius In 14 Years Old

Fourteen old years boy fell from height and injured his right arm. He presented to us after 12 days of injury and xray at that time revealed following fracture in distal fourth region.

Fracture Radius Distal Fourth

Fracture Radius Distal Fourth

The patient was treated with a below elbow plaster cast.

Image 25 – Xray of Fracture of Radius In Distal Fourth of Bone In 14 Years Old Child

Xray of fracture of radius in 14 years old male. Patient fell while playing Kabaddi in the school.

Fracture of Radius Bone In 14 Years Old Child

Fracture of Radius Bone In 14 Years Old Child

Closed reduction and internal fixation was done using kwires and an above elbow plaster splint was applied.

Image 26 – Xray of Volar Barton Fracture of Distal Radius

Volar Barton fracture is intra-articular fracture of distal radius and this xray show a volar Barton fracture in a 31 years old male.

Volar Barton Fracture

Volar Barton Fracture

The patient was advised open reduction and internal fixation using a volar plate for radius but the patient refused for any surgery.

Option of ligamentotaxis was also discussed using external fixation device but refused.

The limb was splinted with plaster slab. The patient never followed up.

Image 27 – Xray of Fracture Distal Radius Ulna in 5 Years Old Child

Xray of child of five years of age who fell from roof and fracture both bones of forearm radius and ulna in distal region

Distal Radius Ulna Fracture In Child

Distal Radius Ulna Fracture In Child

Closed reduction and above elbow slab was given to the child.

Image 28 – Xray of Fracture Distal Radius Ulna in 5 Years Old Child

Xray of child of five years of age who fell from roof and fracture both bones of forearm radius and ulna in distal region

Distal Radius Ulna Fracture In Child

Distal Radius Ulna Fracture In Child

Closed reduction and above elbow slab was given to the child.

Image 29 – Xrays of Comminuted Fracture Distal End Radius

Xray of comminuted fracture of distal radius.

AP view

Comminuted Fracture Distal End of Radius - AP view

Comminuted Fracture Distal End of Radius – AP view

Lateral View

distal-radius-fracture-lateral

Fracture was treated with closed reduction and below elbow cast.

Image 30 – Vertical Undisplaced Fracture Distal End Radius

Following xray shows an undisplaced vertical fracture of distal radius in 34 years old male who struck his forearm in a moving object.

Vertical Fracture Distal Radius

Vertical Fracture Distal Radius

The fracture was treated by below elbow cast.

Image 31 – Xray of Fracture Shaft of Radius with Fracture of Ulnar Styloid with Distal Radio-Ulnar Joint Disruption

Xray of -Fracture Shaft of Radius with Fracture of Ulnar styloid with Distal Radio-Ulnar Joint Disruption. The image belong to 34 old year worker who fell from height.

Xray of -Fracture Shaft of Radius with Fracture of Ulnar styloid with Distal Radio-Ulnar Joint Disruption

Xray of -Fracture Shaft of Radius with Fracture of Ulnar styloid with Distal Radio-Ulnar Joint Disruption

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