Hand trauma
Sebastian Dawson-Bowling, Pramod Achan, Timothy Briggs, Manoj Ramachandran, Stephen Key, Daud Chou in Orthopaedic Trauma, 2014
Proximal metacarpal injuries are often intraarticular fracture-dislocations involving the CMC joints. A true lateral radiograph is essential. Closed reduction and K-wire fixation are advised. Extra-articular injuries to the thumb metacarpal can be reduced closed and managed in a cast.A Bennett fracture (Edward Bennett, 1852) is an intra-articular fracture of the first metacarpal (Fig. 14.4). Displacement is caused by the abductor pollicis longus and adductor pollicis, producing flexion, supination and proximal migration. Treatment involves reduction and immobilization with a K-wire passed from the metacarpal base into the carpus. A reverse Bennett fracture refers to fracture-dislocation of the base of the little finger metacarpal and hamate. The proximal metacarpal fragment is displaced by the extensor carpi ulnaris and may require similar fixation to Bennett’s fracture.The Rolando fracture is a higher-energy injury of the thumb metacarpal base that results in articular comminution in a “Y” or “T” pattern (Fig. 14.5). Often these require open reduction and internal fixation (ORIF). Paradoxically, severely comminuted fractures may well be best treated non-operatively because with fixation it may not be possible to allow early motion.
Hand function 6 weeks following non-surgically treated proximal phalangeal fractures and factors associated to upper extremity disability
Published in European Journal of Physiotherapy, 2023
Katarina Mortazavi, Ingela K. Carlsson, Lars B. Dahlin, Elisabeth Ekstrand
The fractures were initially treated in the emergency room at the hospital and judged as stable, or initially displaced and after reduction judged as stable. No fracture(s) with an articular step at the joints, being open or pathological, or having a rotation that could not be corrected through closed reduction were included. The plain radiographs were later judged and graded by a hand surgeon (LBD) as a non-displaced transverse fracture; non-displaced oblique fracture; non-displaced comminuted fracture; displaced transverse fracture, displaced oblique fracture; displaced comminuted fracture; or an intraarticular fracture without any step(s) at the articular surface.
Complex regional pain syndrome following a centipede bite: a case report
Published in Clinical Toxicology, 2020
Suthimon Thumtecho, Jonathan Schimmel, Satariya Trakulsrichai
The Budapest diagnostic criteria are considered to have excellent sensitivity, and higher specificity compared with previous criteria, but studies are impeded by the lack of a gold standard [14]. CRPS is divided into two types with similar clinical features, except for involvement of nerve injury in CRPS type 2. Potential CRPS risk factors include female sex, especially postmenopausal, ankle dislocation or intraarticular fracture, immobilization, and higher than usual pain levels early in trauma [15].
Related Knowledge Centers
- Cartilage
- Bone Fracture
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