Lesson 1Clinical assessment: inspection, palpation, deformity recognition, neurovascular exam for wrist injuriesThis section details a structured clinical exam for wrist injuries, including inspection, palpation, deformity analysis, and a focused neurovascular assessment to guide imaging, reduction decisions, and immobilization planning.
Inspection for swelling, deformity, and skin breaksPalpation of distal radius, ulna, and carpal bonesAssessing active and passive wrist and finger motionScreening for open fractures and skin compromiseFocused neurovascular exam before immobilizationLesson 2Materials list specific to wrist immobilization: stockinette sizes, padding layers, plaster vs fiberglass rolls, splint boards, casting tape, water temp and mixingThis section lists and explains materials for wrist immobilization, including stockinette sizing, padding layers, plaster and fiberglass options, splint boards, casting tape, and safe water preparation for activation and molding.
Selecting stockinette width and lengthChoosing padding thickness and overlapPlaster versus fiberglass: pros and consUse of splint boards and support surfacesWater temperature, mixing, and setting controlLesson 3Immobilization choices: indications for short arm cast, volar backslab, sugar-tong splint, and thumb spica variantsThis section compares immobilization options for wrist fractures, detailing indications, advantages, and limitations of short arm casts, volar backslabs, sugar-tong splints, and thumb spica variants in different injury patterns.
Indications for short arm circumferential castsWhen to use a volar backslab for wrist injuriesSugar-tong splints for forearm rotation controlThumb spica variants for scaphoid involvementAdjusting choice for swelling and patient factorsLesson 4Imaging basics: indications for X-ray views (PA, lateral, oblique) and recognizing Colles, Smith, intra-articular fracturesThis section introduces essential wrist imaging, covering indications for PA, lateral, and oblique X-ray views, positioning tips, and recognition of Colles, Smith, and intra-articular fracture features that guide management.
Indications for wrist radiographs after traumaPositioning for PA, lateral, and oblique viewsRadiographic signs of Colles fracturesRadiographic signs of Smith fracturesIdentifying intra-articular step-off and gapLesson 5Anatomy of the distal radius, distal ulna, wrist joint, and common fracture patternsThis section reviews distal radius, ulna, and wrist joint anatomy, linking surface landmarks to common fracture patterns, displacement directions, and joint involvement that influence reduction and immobilization strategy.
Bony anatomy of distal radius and distal ulnaRadiocarpal and distal radioulnar joint structuresMuscle and tendon forces affecting displacementExtra-articular versus intra-articular fracturesTypical Colles, Smith, and Barton fracture patternsLesson 6Post-immobilization instructions: elevation, analgesia, signs to return, activity restrictions, cast care and follow-up timingThis section outlines post-immobilization counseling, including elevation, analgesia, cast care, activity limits, red flag symptoms requiring urgent review, and recommended follow-up timing for reassessment and imaging.
Elevation techniques to reduce swellingAnalgesia planning and adjunct measuresCast care, hygiene, and skin protectionActivity restrictions and work or sport adviceWarning signs and follow-up schedulingLesson 7Neurovascular safety checks: baseline and post-application circulation, motor and sensory tests for median, ulnar, radial nerve distributionThis section focuses on neurovascular safety checks before and after immobilization, detailing circulation, motor, and sensory testing for median, ulnar, and radial nerves, and documenting changes that require urgent review.
Baseline capillary refill and pulse assessmentMedian, ulnar, and radial motor testing stepsLight touch and two-point discrimination mappingPost-application neurovascular reassessmentDocumenting findings and escalation triggersLesson 8Compartment syndrome and acute limb ischemia recognition in distal forearm injuriesThis section explains early recognition of compartment syndrome and acute limb ischemia in distal forearm trauma, emphasizing serial exams, key red flags, and urgent actions to prevent irreversible tissue damage.
Pathophysiology in distal forearm traumaPain, paresthesia, pallor, pulselessness, paralysisComparing soft compartments and contralateral limbMonitoring after reduction and immobilizationUrgent escalation and fasciotomy indicationsLesson 9Step-by-step application: positioning, padding technique, slab/cast placement, molding for alignment, creasing for functional positionThis section guides the full sequence of wrist immobilization, from patient positioning and padding to slab or cast placement, molding for alignment, and creasing to maintain a functional, pain-limited position.
Patient and limb positioning for wrist immobilizationPadding techniques for bony prominences and skinSlab versus circumferential cast application stepsThree-point molding for fracture alignment controlCreasing cast for functional wrist and finger position
