Complications of Hand Fractures and Their Prevention

Markiewitz, Andrew D.

doi:10.1016/j.hcl.2013.08.012

Cited by 17 publications

(12 citation statements)

References 40 publications

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“…Decreased length of the phalangeal bone may contribute to relative extensor tendon elongation. A previous cadaveric study has suggested that a decrease of 1 mm could lead to a 12° extension lag [29], that could cause functional limitation of the hand. In this study, equal weightings were given to the cost function components of the extensor tendon and the center of rotation to reduce the potential for bone–tendon length discrepancy following PIPJ implant insertion; thus, optimization was performed to maintain the long–axis phalangeal bone length.…”

Section: Discussionmentioning

confidence: 99%

Novel implant design of the proximal interphalangeal joint using an optimized rolling contact joint mechanism

et al. 2019

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Background The aims of this study were to propose a novel implant design for the proximal interphalangeal joint (PIPJ) of the hand using a rolling contact joint (RCJ) mechanism and to derive an optimal implant design based on human PIPJ kinematics. Methods In total, 10 participants with normal PIPJs were enrolled in this study. True lateral finger radiographs were obtained in 10° increments from 0º (full extension) to 120° flexion of PIPJ. Radiographs were used to determine the average center of rotation, which formed the basis of a mathematical expression of the PIPJ kinematics. The variations in extensor tendon excursions in relation to the range of motion of PIPJ were determined using results from previous cadaveric studies. As the next step, a PIPJ implant design using an RCJ mechanism that was most consistent with the mathematically expressed PIPJ kinematics and tendon excursions was determined using a constrained optimization algorithm. Results The final proposed PIPJ implant had a relatively constant center of rotation over the entire PIPJ range of motion among the participants. In addition, the extensor tendon excursions of the proposed implant as applied to the phalangeal bones were similar to those of the human tendon. The proposed PIPJ implant achieved an acceptable position of the RCJ surface on the proximal and middle phalanges, which was derived from the constrained optimization algorithm. Conclusions A novel PIPJ implant design using an RCJ mechanism demonstrated acceptable outcomes in terms of PIPJ human kinematics and tendon excursions.

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Section: Discussionmentioning

confidence: 99%

Novel implant design of the proximal interphalangeal joint using an optimized rolling contact joint mechanism

et al. 2019

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“…Many patients required nail bed repair especially those having underlain distal phalangeal fracture. Conservative management comprised close reduction and splint in intrinsic plus position of James (70-degree flexion at metacarpo-phalangeal joint and 90-degree exten-sion at distal and proximal inter-phalangeal joints) for at least 4 weeks [7,22]. Early mobilization is needed for good functional outcome of hand, irrespective of conservative or surgical manage-ment.…”

Section: Discussionmentioning

confidence: 99%

Managing Hand Fractures: 15 Years’ Experience-from-a Tertiary Care Hospital from Pakistan

Khan¹,

Beg²

2017

J Surg

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Background: Fractures of hand bones predisposes a man to great disability by restricting daily working ability. We want to share our experience of dealing with hand fractures and its outcome in hand injuries. Methods: 15 years of data was retrieved from a tertiary care hospital and analyzed for age, gender, comorbidities, etiology, fractures involved, management and outcome in terms of days to return to daily activities. Results: We managed 969 patients with hand bones fractures, which had total of 1764 bones involved. Median age of presentation was 41 years. Carpal bones accounted for 187 (10.6%), metacarpals 627 (35.5%) and phalanges 950 (53.8%). Most were managed with K-wires (63.2%) and screws (3.9%) with return of daily activity was within 45 ± 10 days. Most common complication was soft tissue infections followed by osteomyelitis due to nature of injuries. Conclusion: Early surgical management and mobilization of hand after fractures fixation remains vital for good functional outcome of hand. Close follow up is required for timely intervention of associated complications.

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“…Em crianças de baixa idade, de 0 a 6 anos, é o local de maior trauma na mão. 18,19 Avulsões da unha devem ser reinseridas, com utilização de ponto em "U" orientando a extremidade do dedo. 20 Recomenda-se a drenagem asséptica de hematomas subungueais que ocupem mais de 25% do leito, embora alguns autores citem 50%.…”

Section: Unhaunclassified