Upper Extremity Fractures in Adults with Dr. Daniel Marek

Ridgeview Podcast: CME Series

In this podcast, Dr. Daniel Marek - an orthopedic hand surgeon with Twin Cities Orthopedics, brings pearls and wisdom of how to better manage various injuries of upper extremity fractures in adults.

Enjoy the podcast.

Objectives:Upon completion of this podcast, participants should be able to:

• Summarize various types of upper extremity injuries that can occur in adults.
• Describe how to diagnose and treat common hand injuries that present to an urgent or emergency healthcare setting.
• Evaluate when a referral is needed to an orthopedist and/or orthopedic surgeon.

This activity has been planned and implemented in accordance with the accreditation criteria, standards and policies of the Minnesota Medical Association (MMA). Ridgeview is accredited by the Minnesota Medical Association (MMA) to provide continuing medical education for physicians.

CME credit is only offered to Ridgeview Providers & Allied Health staff for this podcast activity. After listening to the podcast, complete and submit the online evaluation form. Upon successful completion of the evaluation, you will be e-mailed a certificate of completion within approximately 2 weeks. You may contact the accredited provider with questions regarding this program at [e-mail].

Click the link below, to complete the activity's evaluation.

CME Evaluation

(**If you are listening to the podcasts through iTunes on your laptop or desktop, it is not possible to link directly with the CME Evaluation for unclear reasons. We are trying to remedy this. You can, however, link to the survey through the Podcasts app on your Apple and other smart devices, as well as through Spotify, Stitcher and other podcast directory apps and on your computer browser at these websites. We apologize for the inconvenience.) DISCLOSURE ANNOUNCEMENT

The information provided through this and all Ridgeview podcasts as well as any and all accompanying files, images, videos and documents is/are for CME/CE and other institutional learning and communication purposes only and is/are not meant to substitute for the independent medical judgment of a physician, healthcare provider or other healthcare personnel relative to diagnostic and treatment options of a specific patient's medical condition; and are property/rights of Ridgeview Medical Center & Clinics. Any re-reproduction of any of the materials presented would be infringement of copyright laws.

It is Ridgeview's intent that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts. It is not assumed any potential conflicts will have an adverse impact on these presentations. It remains for the audience to determine whether the speaker’s outside interest may reflect a possible bias, either the exposition or the conclusions presented.

Ridgeview's CME planning committee members and presenter(s) have disclosed they have no significant financial relationship with a pharmaceutical company and have disclosed that no conflict of interest exists with the presentation/educational event.

Thank-you for listening to the podcast.

SHOW NOTES: *See the attachment for additional information.

The Hand- Alignment - Fractures - Splinting

The WristScaphoid - The most commonly missed fracture - How to diagnose injury - Treatment = 6 to 10 weeks of treatment

Lunate - Rare fracture - Slow healing injury (6 to 10 weeks) - Requires splint and cast - Scapholunate ligament ter - 10 weeks of cast and surgery bookended - Lunate/Perilunate dislocation - needs immediate reduction and surgery - Triquetral Fracture - treatment with removable splint

Distal Radius and Ulna- Fall onto outstretched hand - most common - Colles' Fracture - ncbi.nlm.nih.gov/books/NBK553071/ - Smith's Fracture - ncbi.nlm.nih.gov/books/NBK547714/ - Barton's Fracture - ncbi.nlm.nih.gov/books/NBK499906/ - Ulnar styloid fracture - Median nerve symptoms - Volar displaced fractures very hard to maintain reduction - will likely need surgery. - What needs to be reduced? 3 radiographic angles (length, radial inclination, tilt) - Closed fracture complications - Splinting issues

The Forearm- Monteggia - Galeazzi - Radial head fracture (very common) - Radial neck fracture - Proximal ulna (olecranon)

The Humerus- Mid humerus - Proximal humerus - Distal humerus

Describing Fracture to Orthopedist- Looking at correct film/correct patient - Open or closed fracture - Location of fracture - Involvment of articular surface? - Simple or comminuted fracture and what direction? (transverse, oblique, spiral, avulsed) - Displaced? if so which direction - Angulation - Rotation - Impaction

Future horizon for Upper Extremity and Hand Surgery - Awake surgery - Hand transplant

Thanks to Dr. Daniel Marek for his knowledge and contribution to this podcast.

Please check out the additional show notes for more information/resources.