Hand fractures refer to fractures of bones of the fingers, palm, wrists. These bones may be fractured during road traffic accidents or while working on heavy machines. Hand bones may also be fractured during sports activities like wrestling and boxing. Boxers fracture refers to Metacarpal head fracture only.
Bones form the structural framework of the hand. If bones are damaged rest of the soft tissues like tendons and joints are not able to work. Hand fractures are one the most diverse fractures with numerous variations. Because of so many small bones and joints involved hand fractures can be quite tricky to correct.
Fractures might be simple like single fractures involving shaft either horizontal or oblique. Or they may be complex with multiple fragments involving the joints where joints are partially or fully destroyed.
Clinical examination and X-rays form the basis of diagnosing hand fractures. Some complex fractures may need a CT-scan and 3d Reconstruction of the injury for better assessment. Treatment depends on the area injured, the number of fractures, and the type of fracture involved.
Either way, any fracture leads to a non-functional hand till the injury is repaired. Bones take weeks to heal, during this period bones need to be immobilized for healing. This presents a unique challenge, especially in adults. Prolonged immobilization leads to stiff joints and a less functional hand. This prompted the use of implant-based fixation for the early mobilization of hand fractures.
I prefer to use implants so that early mobilization of joints can be done. I use splints and casts for minimally displaced simple fractures where the hand is immobilized within 4 weeks. Complex or multiple fractures need some form of internal fixation either K-wires or mini plates and screws.
Bone fixation is followed by aggressive mobilization and physiotherapy for the coming weeks. Rehabilitation is a very important part of such treatments. My patients undergo a supervised physiotherapy and rehabilitation regimen for maximum possible recovery.
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