Fixation of Phalangeal Fractures

Baratz, Mark E.; Divelbiss, Brian J.

doi:10.1016/s0749-0712(21)00116-5

Cited by 11 publications

(8 citation statements)

References 16 publications

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“…Conservative measures, including buddy taping, orthosis, and early range of motion, are employed in these circumstances. [3][4][5][6][7][8] The term "early range of motion" is one that most hand surgeons embrace to prevent stiffness. The definition of early range of motion varies, however.…”

Section: Disclosurementioning

confidence: 99%

“…Almost every article that is written about the management of metacarpal fractures or phalangeal fractures mentions early motion. [1][2][3][4][5][6][7][8][9][10][11][12][13]42 For most, the strength and rigidity of the fixation defines how aggressive one is with motion and defines the timing of the early motion. The early motion protocols often allow for some swelling to decrease and pain to subside before embarking upon therapy.…”

Section: Disclosurementioning

confidence: 99%

“…68 Stiffness is the most commonly reported complication. [1][2][3][4][5][6][7]17,33,45,68,70 Residual extensor lag has been reported as high as 14% with open reduction internal fixation techniques. 68 Page and Stern reported a 92% total complication rate of phalangeal fractures treated operatively, with stiffness being the most frequent at 67%.…”

Section: Disclosurementioning

confidence: 99%

“…The first is that most nonarticular hand fractures do not require surgery. [1][2][3][4][5][6][7][8][9][10][11][12][13] This is a finding that has transcended generations of hand surgeons believing that stable isolated fractures can be treated with conservative measures, such as splinting, followed by therapy. The second truism is that there is no consensus on the optimal way to treat most fractures of the hand.…”

mentioning

confidence: 99%

“…[5][6][7][8][9][10][11][12][13][14][15] But stiffness is undoubtedly the most common untoward sequelae of fracture management, and this outcome is true for both conservative and operative treatment regimens. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Perhaps, therefore, labeling fractures as "stable" or "unstable" should not define our management but rather the function of the hand. The management of metacarpal and phalangeal fractures in the hand is intended to culminate in the restoration of normal function.…”

mentioning

confidence: 99%

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Phalangeal and Metacarpal Fractures of the Hand: Preventing Stiffness

Neumeister

Winters

Maduakolum

2021

Plastic and Reconstructive Surgery - Global Open

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Fractures of the phalangeal or metacarpal bones of the hand are common. Many of these fractures are treated without surgery. However, both conservative and operative management of fractures of the hand can result in stiffness. Stiffness is the most common complication in the management of hand fractures.The key to preventing stiffness is early range of motion exercises. This article challenges many of the current treatment regimens offered to patients with the so-called unstable fractures. The evaluation of the patients' function is the primary factor that should determine the course of conservation versus operative management. X-rays do not demonstrate function and therefore act as an adjunct only to the care of the patient. The goal of treating hand fractures is to restore function. Early motion may not only improve healing but may also hasten the return to normal hand function. The tenets of how to prevent stiffness are described in this review.

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