Differential Diagnosis for Fall Outstretched Hand
Single Most Likely Diagnosis
- Wrist Sprain: This is the most common injury from a fall onto an outstretched hand, due to the force transmitted through the wrist, potentially causing ligamentous injury.
Other Likely Diagnoses
- Colles' Fracture: A fracture of the distal radius, common in osteoporotic individuals or from a fall onto an outstretched hand, leading to a characteristic "dinner fork" deformity.
- Scaphoid Fracture: A fracture of one of the carpal bones in the wrist, often occurring from a fall onto an outstretched hand. It's notorious for its difficulty in diagnosis due to subtle symptoms and potential for delayed union or nonunion.
- Wrist Contusion: Direct trauma to the wrist can cause bruising and pain without a significant fracture or sprain.
Do Not Miss Diagnoses
- Radial Head Fracture: Although less common than wrist injuries, a fracture of the radial head can occur from a fall onto an outstretched hand, especially if there's a mechanism involving elbow extension and forearm rotation.
- Monteggia Fracture: A fracture of the ulna with a dislocation of the proximal radioulnar joint. It's a serious injury that requires prompt recognition and treatment to avoid long-term complications.
- Compartment Syndrome: A potentially limb-threatening condition that can arise from increased pressure within the compartments of the forearm or hand, often following a severe injury.
Rare Diagnoses
- Galeazzi Fracture: A fracture of the radius with dislocation of the distal radioulnar joint. It's less common but important to recognize due to its potential for significant morbidity if not properly treated.
- Essex-Lopresti Fracture: A fracture of the radial head with dislocation of the interosseous membrane and the distal radioulnar joint, leading to forearm instability. It's rare but critical to diagnose accurately to ensure appropriate management.