{"id":12161,"date":"2022-10-20T09:23:08","date_gmt":"2022-10-20T07:23:08","guid":{"rendered":"https:\/\/www.physiotutors.com\/?post_type=wiki&p=12161"},"modified":"2022-10-20T09:23:08","modified_gmt":"2022-10-20T07:23:08","slug":"caradeniz-wrist-rule","status":"publish","type":"wiki","link":"https:\/\/www.physiotutors.com\/wiki\/caradeniz-wrist-rule\/","title":{"rendered":"Caradeniz Wrist Rules"},"featured_media":12162,"template":"","class_list":["post-12161","wiki","type-wiki","status-publish","has-post-thumbnail","hentry"],"acf":{"sections":[{"acf_fc_layout":"page-header-detail-page","background":{"background_image":12162,"background_image_alt_text":"Caradeniz Wrist Rules"},"heading":"Caradeniz Wrist Rules | Wrist Fracture Screening","subheading":"Screening","content_editor":"","button_type":"internal_link","button_label":"Check our shop","button_style":"button-five","button_internal_link":"","button_anchor":"","button_url":"","button_file":"","label":""},{"acf_fc_layout":"submenu","links":[{"button_type":"anchor","button_label":"Learn","button_internal_link":null,"button_anchor":"section-number-3","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Assessment E-Book","button_internal_link":null,"button_anchor":"section-number-4","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Reviews","button_internal_link":null,"button_anchor":"section-number-5","button_url":"","button_file":null}],"dropdown_label":"Go to","button_right":{"button_type":"internal_link","button_label":"Become a member","button_style":"button-three","button_internal_link":16662,"button_anchor":"","button_url":"","button_file":""},"button_description":"Find this wiki on the Physiotutors platform"},{"acf_fc_layout":"content-content","section_options":{"vertical_alignment":"top","column_right_box":false,"column_left_width":"col-12 col-lg-4 offset"},"column_left":{"content_editor":"

Learn<\/h4>"},"column_right":{"content_editor":"

Caradeniz Wrist Rules | Wrist Fracture Screening<\/h2>\nAlthough only 39% of patients presenting to the emergency department with wrist trauma have sustained a fracture, the majority of patients are routinely referred back for radiography. <\/span>For this reason, the Caradeniz wrist rules were developed in order to decrease the number of x-rays in suspected distal radius, distal ulna and carpal bone fractures within 24 hours after acute wrist traumas.<\/span>\n\nAccording to Karaca et al. (2016)<\/a>, the Caradeniz wrist rules have a sensitivity of 100% and a low specificity of 6.6 % in the detection of wrist fractures. T<\/span>hese results have not been externally validated yet, which is why we give the rule a moderate clinical value to rule out wrist fractures.<\/span>\n
\n\n[embed]https:\/\/www.youtube.com\/watch?v=S3fDxUWoeus[\/embed]\n\n<\/div>\nThe Decision Rule contains the following items. Due to their provocative nature, we propose the following order:<\/span>\n
    \n \t
  1. Ask your patient to perform active dorsiflexion of the wrist<\/span><\/li>\n \t
  2. Ask your patient to perform active radial deviation<\/span><\/li>\n \t
  3. Palpate the distal ulna for sensitivity<\/span><\/li>\n \t
  4. The radioulnar drawer test: Stabilize your patient's distal radius with the dorsum of his hand facing upwards. Then apply alternating dorsal-volar stress to the distal ulna. This test is positive if you patient reports pain or if there is increased movement compared with the other side.<\/span><\/li>\n \t
  5. Axial compression tests: <\/span>Hold on to the metacarpal bone and give axial pressure on the rapezium and scaphoid. Perform the same axial pressure with the metacarpal bones 2 \u2013 5.<\/span><\/li>\n<\/ol>\nAll of the 5 items are considered positive if pain is provoked. In the radioulnar drawer test, an increased amplitude of movement compared to the other side is considered as a positive test as well.<\/span>\n\nIn case all 5 items are negative, a fracture of the radius, ulna, and carpal bones could be ruled out with 100% confidence in the study of Karaca et al. (2016)<\/a>.<\/span>\n\n \n\n[cta]\n\n \n\nIf you want to screen for fractures in other body parts, check out the list below:\n