Introduction

• Cause: usually vehicular trauma if limb abrasion against road surface by braking vehicle's tyre.
• Signs: loss of variable amounts of soft tissue and bone usually affecting medial aspect of joint, ie may be large open wound, joint instability due to loss or rupture of supporting ligaments, and loss of bone stock (radial styloid process and medial aspect carpal bones).
• Hyperextension often occurs.
• Treatment: complicated by open nature of injury: careful open wound management, surgical repair of torn ligaments where possible, external fixation.
• Prognosis: chronic local osteomyelitis or septic arthritis may result, necessitating arthrodesis to salvage limb function, or amputation.

Pathogenesis

Etiology

• Trauma, especially vehicular trauma.

Pathophysiology

• Variable amounts of soft tissue/bone damage caused by shearing force of, eg vehicular trauma.

Diagnosis

Treatment

Outcomes