Patient presented with fall on outstretched hand. X-ray taken is shown below. Which of the following vessel is most likely involved:-
**Core Concept:** The question pertains to vascular injuries following a fall on an outstretched hand. The collateral ligaments, specifically the ulnar collateral ligament, are responsible for maintaining the stability of the wrist joint. When these ligaments are injured, it results in a Colles fracture, which is a type of distal radius fracture.
**Why the Correct Answer is Right:** In this scenario, the patient has fallen on an outstretched hand, putting pressure on the ulnar side of the wrist. This forces the distal radius to be forced into flexion and ulnar deviation, causing damage to the collateral ligaments. The ulnar collateral ligament, specifically, is most likely to be injured due to its location and function in maintaining wrist stability.
**Why Each Wrong Option is Incorrect:**
A. Radial collateral ligament: This ligament is located on the radial side of the wrist and is less likely to be affected due to its location and function.
B. Ulnar collateral ligament (correct answer): This ligament is discussed above in the explanation of why the correct answer is right.
C. Radius: The radius is a bone and does not directly contribute to the vascular supply of the wrist.
D. Collateral ligaments: Both radial and ulnar collateral ligaments are part of collateral ligaments; however, only the ulnar collateral ligament is the correct answer as explained above.
**Clinical Pearl:** A patient presenting with a fall on an outstretched hand should be evaluated for potential collateral ligament injuries. Collateral ligament injuries are often missed initially due to the patient's denial of ligamentous injury or the examiner's focus on the fracture. A thorough clinical examination, including range of motion and joint line tenderness, is essential in detecting collateral ligament injuries.
**Correct Answer:** D. Collateral ligaments (with a focus on ulnar collateral ligament)
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