The Wrist

Fracture prevalence | Normal anatomy PA| Normal anatomy lateral
Colles'/Smith's | Radial styloid | Paediatric   
| Triquetrum | Hamate | Lunate | Pisiform | Capitate| Trapezium| Trapezoid
Carpal dislocations | Zone of Vulnerability | Carpal Instability | Galeazzi

(hover over images to zoom, click to enlarge)
Learning outcomes
  • Assess skeletal radiographs using a systematic approach on the DP and lateral
  • Describe carpal anatomy
  • Understand mechanisms of injury and the likely fractures/dislocations which may result
  • Recognise less common fractures to the individual carpal bones
  • Accurately describe carpal dislocations and associated fractures within the zone of vulnerability
  • Understand common eponyms
  • Recognise potential ligament injuries
  • Understand paediatric fractures – torus/greenstick terminology
Fracture prevalence
Normal anatomy - PA radiograph

These three lines should remain unbroken:

Normal DP wrist   Normal DP wrist
Epiphyseal spur
Normal anatomy - Lateral radiograph
Normal lateral wrist   Normal lateral wrist
Colles' / Smith's fracture
Colles' fracture
Smith's fracture
Volar type Barton's - fracture volar rim radius (and ulna) with anterior subluxation radiocarpal joint
Avulsion fracture of ulnar styloid (and Colles' fracture)
Radial Styloid Fracture
Radial styloid fracture
Paediatric fractures
Torus fracture
Greenstick fracture

Salter-Harris I   Salter-Harris II

Scaphoid - fracture demonstrated on follow up images (bottom)

Fracture distal pole scaphoid
AVN proximal pole of scaphoid
Bennett's fracture-dislocation

Triquetral fracture

Fracture hamate

AVN lunate
Fracture pisiform
Comminuted fractures proximal capitate and lunate, with impaction and rotation   Comminuted fractures proximal capitate and lunate, with impaction and rotation
Fracture trapezium, fracture triquetral

Carpal Dislocations
Lunate dislocation    Lunate dislocation    Lunate dislocation
Perilunate dislocation, fracture scaphoid    Perilunate dislocation    Perilunate dislocation
Midcarpal dislocation, fracture radial styloid    Midcarpal dislocation    Midcarpal dislocation
Zone of vulnerability

Zone of vulnerability
Carpal instability

Carpal instability
Clenched fist view
Galeazzi fracture-dislocation
Galeazzi fracture-dislocation

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