Die-punch fracture - Revision history

Danbot: Re-added X-ray and CT links now that those pages exist

2026-03-19T19:01:56Z

Re-added X-ray and CT links now that those pages exist

← Older revision		Revision as of 19:01, 19 March 2026
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	==Evaluation==		==Evaluation==
	===Workup===		===Workup===
	*Wrist X-ray: PA, lateral, and oblique views		*Wrist [[X-ray]]: PA, lateral, and oblique views
	**Look for a depressed articular fragment on the lateral view		**Look for a depressed articular fragment on the lateral view
	**Subtle step-off on PA view		**Subtle step-off on PA view
	*CT scan recommended to fully characterize fracture pattern and articular depression		*[[CT\|CT scan]] recommended to fully characterize fracture pattern and articular depression

	===Diagnosis===		===Diagnosis===
	*CT scan is the gold standard for identifying and classifying the fracture		*[[CT\|CT scan]] is the gold standard for identifying and classifying the fracture
	*Fracture involves depression of the lunate facet of the distal radius articular surface		*Fracture involves depression of the lunate facet of the distal radius articular surface

Danbot: Removed broken links to non-existent X-ray and CT pages

2026-03-19T18:47:36Z

Removed broken links to non-existent X-ray and CT pages

← Older revision		Revision as of 18:47, 19 March 2026
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	==Evaluation==		==Evaluation==
	===Workup===		===Workup===
	*Wrist [[X-ray]]: PA, lateral, and oblique views		*Wrist X-ray: PA, lateral, and oblique views
	**Look for a depressed articular fragment on the lateral view		**Look for a depressed articular fragment on the lateral view
	**Subtle step-off on PA view		**Subtle step-off on PA view
	*[[CT]] scan recommended to fully characterize fracture pattern and articular depression		*CT scan recommended to fully characterize fracture pattern and articular depression

	===Diagnosis===		===Diagnosis===

Danbot: Added Category:Orthopedics

2026-03-19T18:36:52Z

Added Category:Orthopedics

← Older revision		Revision as of 18:36, 19 March 2026
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	==References==		==References==
	<references/>		<references/>

			[[Category:Orthopedics]]

Danbot: Created new page with standard template

2026-03-19T18:33:49Z

Created new page with standard template

New page

==Background==
*Die-punch fracture is a depressed fracture of the lunate fossa of the [[distal radius fractures|distal radius]]
*Caused by axial load transmitted through the lunate onto the lunate facet
*Often occurs with fall on outstretched hand (FOOSH)
*May be associated with other [[distal radius fractures]] patterns
*Can be easily missed on plain radiography

==Clinical Features==
*Wrist pain and swelling after axial loading injury
*Tenderness over the distal radius, particularly the ulnar aspect
*Decreased grip strength
*Limited wrist range of motion (especially extension)

==Differential Diagnosis==
{{Forarm fracture DDX}}

==Evaluation==
===Workup===
*Wrist [[X-ray]]: PA, lateral, and oblique views
**Look for a depressed articular fragment on the lateral view
**Subtle step-off on PA view
*[[CT]] scan recommended to fully characterize fracture pattern and articular depression

===Diagnosis===
*CT scan is the gold standard for identifying and classifying the fracture
*Fracture involves depression of the lunate facet of the distal radius articular surface

==Management==
*Non-displaced (<2mm step-off): [[Sugar tong splint]] with orthopedic follow-up
*Displaced (≥2mm articular step-off): operative fixation (ORIF) to restore articular congruity
*Early orthopedic consultation for most cases given intra-articular involvement

==Disposition==
*Discharge with orthopedic follow-up if non-displaced and splinted
*Orthopedic consultation in ED if displaced or significant comminution

==See Also==
*[[Distal radius fractures]]
*[[Colles' fracture]]
*[[Barton fracture]]
*[[Forearm fracture]]

==External Links==

==References==
<references/>