Pearls

Early reduction reduces risk of acute carpal tunnel.

X-ray findings can be subtle and comparison to the uninjured side can be helpful.

Reduction tips:

• Procedural sedation likely needed.
• Place in finger traps with elbow at 90° of flexion.
• Hang 5-10 lbs of traction for 15-20 minutes.
• Reduction maneuver: Start with wrist extension, apply traction and then transition to wrist flexion.