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Hand Fractures and Dislocations
This document outlines principles and considerations for the diagnosis and management of hand fractures and dislocations. It discusses specific injuries including fractures of the distal phalanx, mallet finger, phalanges, PIP joint, metacarpals, and thumb. Treatment approaches include splinting, closed and open reduction, and fixation methods depending on the injury type, location, stability, and degree of displacement. The importance of early mobilization is emphasized while minimizing soft tissue disruption.
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Hand Fractures and Dislocations
- 1. Adam C Watts ConsultantHand and Upper Limb Surgeon, Wrightington Hospital Visiting Professor, Manchester University Hand Fractures and Dislocations Edinburgh Hand Course
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- 5. www.wrightington.com History Age Sex Hand Dominance Occupation Mechanism ofinjury Low energy / high energy Crush Penetrating
- 6. www.wrightington.com Hand Fractures Diagnosis Neurovascular Softtissue envelope X-rays CT (rarely)
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- 10. www.wrightington.com General Principles 10 Early mobilisation Minimumsoft tissue disruption if stable = mobilise if unstable = splint / fixation
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- 25. www.wrightington.com Paediatric Distal Phalanxfracture - Seymour Lesion Beware Subluxation Epiphyseal injury Nail bed injury
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- 27. www.wrightington.com Phalangeal Shaft Fractures Transversefractures usually stable and are immobilized for 3 weeks Spiral fractures unstable and should be stabilized.
- 28. www.wrightington.com Normal alignment androtational deformity Beware Malrotation
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- 35. www.wrightington.com 35 Basal phalangealfractures – intra-articular
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- 44. www.wrightington.com ORIF Basal Phalangealfractures – Pilon Fractures
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- 59. www.wrightington.com ORIF Basal Phalangealfractures – intra-articular Screws and wires
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- 64. www.wrightington.com Metacarpal Fractures Minimally displacedor angulated fractures can be treated nonoperatively Displacement of more than 5 mm, unacceptable angulation, or clinical malrotation are indications for intervention.
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- 66. www.wrightington.com Fixation of TransverseMetacarpal Fractures
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- 72. www.wrightington.com Dislocation of Metacarpalbases Get true laterals Reduce K wire
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- 82. www.wrightington.com Take Home 82 Early Mobilisation Leastinvasive intervention that will achieve aims Anticipate compliance and complications
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