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Hand and Upper Extremities

  • David T. Netscher
  • Idris Gharbaoui

Abstract

A motorcyclist is brought to the trauma bay after crashing into a parked pick-up truck. He is alert, oriented, and hemodynamically stable. The patient has no intrathoracic or abdominal injuries. He does have extensive abrasions and bruises of his upper extremities, although radiologic evaluation demonstrates no skeletal fractures or dislocation. However, over of the course of 3 hours, the patient complains of increasing numbness and paresthesia of the left forearm. On physical examination, the involved extremity is swollen and very tense, with tenderness over the forearm musculature and paresthesia confirmed over the distribution of the median and ulnar nerves. The patient has a very strongly palpable radial pulse. Which of the following should be the management at this time?
  1. (A)

    Application of a sequential compression garment

     
  2. (B)

    Elevation of the involved extremity and artenography

     
  3. (C)

    Three-compartment fasciotomy

     
  4. (D)

    Venous Doppler studies

     
  5. (E)

    Repeated extremity x-rays

     

Keywords

Median Nerve Carpal Tunnel Ulnar Nerve Compartment Syndrome Radial Head 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • David T. Netscher
    • 1
  • Idris Gharbaoui
    • 2
  1. 1.Department of Surgery, Division of Plastic Surgery, Baylor College of MedicineVeterans Affairs Medical CenterHoustonUSA
  2. 2.Department of OrthopaedicsUniversity of Texas Health Science Center at HoustonHoustonUSA

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