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Neurovascular compromise in wrist fracture — DipIMC MCQ

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ModeratePre-Hospital Trauma ManagementNeurovascular compromise in wrist fractureDipIMC

A 63-year-old woman falls on ice and has severe wrist deformity. Fingers are blue and numb, and capillary refill is delayed; analgesia has been given. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Gently realign the wrist and reassess neurovascular status

A distal limb deformity with neurovascular compromise should be realigned by trained clinicians after analgesia, followed by documented reassessment. Waiting for radiographs may prolong ischaemia. A tourniquet is not a treatment for distal vascular compromise without haemorrhage. The pearl is that pre- and post-intervention neurovascular documentation is a key clinical and medicolegal step.

Reference: JRCALC Guidelines 2025; NICE Fractures NG38