Radiology Review

Brace for Impact

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A 35-year-old woman arrives at the emergency department following a motor vehicle accident. She was a restrained driver who was crossing an intersection when another vehicle pulled out in front of her. She recalls gripping the steering wheel in anticipation of impact. No air bags deployed. She complains of wrist pain, but denies any other ailment.

Medical history is unremarkable. Vital signs are normal. Physical examination of the patient’s left wrist shows no obvious deformity. There is mild soft-tissue swelling, decreased range of motion, and moderate point tenderness along the radial aspect of the wrist. The nailbeds have good capillary refill. Strong pulses are present, as well.

Triage has already obtained a radiograph of the left wrist (shown). What is your impression?


 

Brace for Impact image

ANSWER

The radiograph shows an oblique fracture through the radial styloid process. The patient was placed in a splint and referred to outpatient orthopedics for follow-up.

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