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Emergency Orthopedics, 6e
| Part III. Upper Extremities > |
Hand Fractures
Sections: Treatment, Distal Phalanx Fractures, Distal Phalanx Fractures: Extra-Articular, Treatment, Distal Phalanx Fractures: Intra-Articular, Dorsal Surface (Mallet Finger), Treatment, Nondisplaced, Displaced and >25% of Articular Surface, Distal Phalanx Fractures: Intra-Articular, Volar Surface, Treatment, Middle Phalanx Fractures, Middle Phalanx Fractures: Extra-Articular, Treatment, Nondisplaced Transverse, Displaced or Angulated Transverse, Spiral or Oblique, Middle Phalanx Fractures: Intra-Articular, Treatment, Nondisplaced Condylar, Displaced Condylar, Comminuted Basilar, Middle Phalanx Fractures: Avulsion, Treatment, Extensor Tendon Avulsion Fracture, Volar Plate Avulsion Fracture (Wilson's Fracture), Collateral Ligament Avulsion Fracture, Proximal Phalanx Fractures, Proximal Phalanx Fractures: Extra-Articular, Treatment, Nondisplaced Transverse, Displaced or Angulated Transverse, Spiral or Oblique, Proximal Phalanx Fractures: Intra-Articular, Treatment, Small (<20% Articular Surface) and Nondisplaced, Large (>20% Articular Surface), Displaced, or Comminuted, Metacarpal Fractures (2 through 5), Metacarpal Head Fractures, Treatment, Metacarpal Neck Fractures, Treatment, Metacarpal Neck Fractures: Digits 4 or 5, Nondisplaced, Nonangulated, Angulated, Metacarpal Neck Fractures: Digits 2 or 3, Nondisplaced, Nonangulated, Displaced or Angulated >10 Degrees, Metacarpal Shaft Fractures, Treatment, Nondisplaced Transverse Fractures, Displaced Transverse Fractures, Oblique or Spiral, Comminuted, Metacarpal Base Fractures, Treatment, First Metacarpal Fractures, First Metacarpal Fractures: Extra-Articular, Treatment, First Metacarpal Fractures: Intra-Articular Base, Treatment, Bennett's Fracture—Dislocation, Rolando's Fracture, First Metacarpal Sesamoid Fracture, Treatment.
Excerpt:
"The ED management of hand fractures is not complex, but requires an understanding of both bony and soft-tissue anatomy to implement a therapy based on sound medical judgment. Frequently, these fractures are improperly treated as minor injuries without realizing that lifelong crippling disabilities can result. For example, a small degree of rotational malalignment with a metacarpal or proximal phalanx fracture will result, if uncorrected, in a partially disabled hand. Only with a thorough understanding of essential hand anatomy can one correctly diagnose hand injuries and initiate appropriate therapy.Mobility is a critical consideration in the management of fractures. Those bones with a high degree of mobility can withstand a greater degree of angulation with the retention of normal function. Those bones with less mobility (second and third metacarpals) require a much more precise reduction to ensure a return to full function.Extra-articular fractures of the distal phalanx may be longitudinal, transverse, comminuted, or transverse with displacement (Fig. 11–18). The most common fracture is a comminuted fracture. When..."
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