YEAR 05 • ADVANCED CLINICAL

Orthopaedics & Trauma

20 learning units • 100 chapter sections • 200 explained questions. Assess musculoskeletal disease and injury, recognise limb-threatening emergencies and plan treatment, rehabilitation and prevention.

Original RAHBAR study material for the Year 5 learning pathway. Clinical cases support supervised undergraduate learning. Treatment choices, doses and procedures must follow current local protocols and the responsible clinical team. References & further reading ↓

MODULE 06 / 20

Elbow, Forearm, Wrist & Hand Trauma

Identify associated injuries and protect hand function through careful assessment and follow-up.

Quick revision ↓ Medical Dictionary

01Elbow and forearm

Assess elbow alignment, skin and distal nerve and vascular function. A forearm fracture may coexist with dislocation at the elbow or distal radioulnar joint, so inspect the whole relevant region. Do not focus on the obvious shaft fracture while overlooking a neighbouring joint injury.

02Wrist fractures

Distal radius injuries vary in stability and articular involvement. Record median nerve symptoms and examine the skin before immobilisation. A tight swollen wrist with progressive numbness needs urgent review. Management considers alignment, stability, functional demand and patient factors rather than radiographic appearance alone.

03Occult scaphoid injury

Radial-sided wrist pain and scaphoid tenderness after trauma can represent a fracture despite normal initial radiographs. Follow the suspected-scaphoid pathway, which may include early MRI, protection and review. Missed injury can cause non-union or later degeneration, so provide a definite follow-up plan.

04Hand wounds and tendons

Assess individual tendon movement, sensation and perfusion before local anaesthesia when feasible. Small wounds can conceal tendon, nerve or joint penetration. Bite wounds over a knuckle need particular care because joint or tendon infection can follow; avoid assuming a superficial appearance means low risk.

05Function and review

Finger rotation may be most apparent during gentle flexion and can substantially impair function. Splinting, operative decisions and hand therapy should match the injury. Give warning signs for infection, pressure and worsening nerve symptoms, and arrange review for persistent pain or functional loss.

High-Yield Revision

Check joints associated with a forearm fracture.
Normal initial films do not exclude scaphoid injury.
Small hand wounds can hide important structural damage.

Common Pitfalls

Missing rotational deformity in a finger fracture.
Dismissing a knuckle bite as a harmless cut.

References & Further Reading

Read the relevant guideline sections alongside these original clinical teaching cases. Local pathways, available services and individual patient factors determine care.

Reference review: 28 September 2026. Consult current local protocols for prescribing, procedures and escalation.