Differential Diagnosis for FOOSH Injury Wrist
Single Most Likely Diagnosis
- Distal Radius Fracture: This is the most common injury resulting from a FOOSH (Fall On Outstretched Hand) mechanism, accounting for the majority of cases. The fracture typically occurs when the wrist is hyperextended, causing the radius bone to break.
Other Likely Diagnoses
- Scaphoid Fracture: The scaphoid bone is the most commonly fractured carpal bone in the wrist and is often injured in FOOSH incidents. Its unique blood supply makes it prone to complications if not promptly diagnosed and treated.
- Wrist Sprain: A sprain can occur when the ligaments surrounding the wrist joint are stretched or torn during a FOOSH injury. The severity can vary, and while less severe than fractures, sprains can still significantly impact wrist function.
- Colles' Fracture: Essentially a type of distal radius fracture, but it specifically refers to a fracture where the distal fragment is displaced posteriorly. It's a common consequence of osteoporotic falls in the elderly.
Do Not Miss Diagnoses
- Scapholunate Ligament Injury: While not as immediately visible as a fracture, injuries to the scapholunate ligament can lead to significant long-term disability and wrist instability if not identified and treated properly.
- Perilunate Dislocation: A serious injury where the lunate bone is dislocated from the rest of the carpal bones. It can be easily overlooked on initial X-rays but requires prompt reduction to avoid long-term complications.
- Vascular Injury: Although rare, any injury that compromises blood flow to the hand (e.g., damage to the radial or ulnar arteries) is a medical emergency requiring immediate intervention.
Rare Diagnoses
- Barton's Fracture: A type of distal radius fracture that extends into the wrist joint and is associated with a dislocation of the radiocarpal joint. It's less common but can have significant implications for wrist function.
- Galeazzi Fracture: A fracture of the radius with a dislocation of the distal radioulnar joint. It's an uncommon but important diagnosis to consider due to its potential for complications if not properly managed.
- Triquetrum Fracture: While the triquetrum is one of the carpal bones, fractures of this bone are less common compared to the scaphoid or radius. However, they can still occur from a FOOSH injury, especially if there's a direct blow to the bone.