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Complex wrist fractures 

Complex wrist fractures
Complex wrist fractures

Evan Coughlan

, and Sam Thenabadu

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date: 19 January 2022

This chapter provides a discussion of the challenges facing the emergency physician dealing with the complex and unstable wrist fracture in the emergency department. It describes an overview of the range of potential fracture presentations and the radiographical signs that will be seen. It describes the options of anaesthesia and manipulation and the potential for nerve injuries.

It examines the evidence base for three key clinical questions: the use of early manipulation to minimize nerve damage even in the cohort that will require definitive fixation; a comparison with the different anaesthietic techniques (haematoma block versus Bier’s block); and an examination of the potential use of ultrasound to assess fractures and their position post reduction.

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