Welcome to the Emergency Medicine Cases podcast. I'm your host, Dr. Anton Hellman, bringing you Canada's brightest minds in emergency medicine from EMC studios in Toronto.

EM cases is part of SREMI, Schwartz-Risman Emergency Medicine Institute, the nonprofit organization dedicated to improving EM care through research and education.

The opinions expressed on this podcast are intended for information and education purposes only

and should not be used to diagnose treat or prevent any medical condition, nor should they be used as a

substitute for medical advice and qualified practice and physician.

In part one of our two-part podcasts on wrists and carpal bone injuries, we covered constructing

an initial differential diagnosis from the history, physical exam tips and

tricks, mastering the wrist and hand x-ray, and the dreaded drudge injury. We also talked a little

bit about Barton fractures and Smith fractures. Now, especially important in part one is that we

reviewed the surface anatomy of the hand and wrist with the memory aid

so long to pinky, here comes the thumb for the carpal bones, which I highly recommend that you

listen to again and review in the show notes if you haven't already. Because in this part

two, we'll dive into the most commonly missed and mismanaged carpal bone

injuries, what I like to call the big four, triquetrial fractures, lunate fractures, hemate fractures,

hemate fractures, and scaphoid fractures. So if you imagine the surface anatomy of the hand and the

wrist that Dr. C.L reviewed in part one while I'm discussing these injuries,

then you'll be golden. And after we discuss the big four, we'll drive it all home with a summary

and some more master tips. But before we get into these injuries, I first want to kind of step

back a little bit and take a more bird's eye view of this topic of carpal bone injuries and ask Dr. Stefano, how should we sort of understand carpal bone injuries from an anatomical perspective, from a mechanistic perspective? How should we think about carpal bone injuries from a philosophical point of view, shall we say?

Good question, Anton, because we should approach the wrist with as eyes wide open as possible

and thinking, as always like we do in medicine for anything, age-related prevalence of disease.

That is the lens through which you see these MSK injuries and risks in particular.

...