Intra-Articular Fractures of the Hand

Oak, Nikhil R.; Lawton, Jeffrey N.

doi:10.1016/j.hcl.2013.08.007

Cited by 20 publications

(10 citation statements)

References 73 publications

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“…These fractures are commonly associated with dislocations caused by the high-energy mechanism (Fig 18). Although the fractures are well depicted on posteroanterior radiographs, associated dislocations are best evaluated with true lateral or oblique radiographs and with CT, if needed (47). Extra-articular metacarpal base fractures are managed similarly to shaft fractures.…”

Section: Metacarpal Fracturesmentioning

confidence: 99%

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Traumatic Finger Injuries: What the Orthopedic Surgeon Wants to Know

Wieschhoff¹,

Sheehan²,

Wortman³

et al. 2016

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Traumatic finger injuries account for a substantial number of emergency visits every year. Imaging plays an important role in diagnosis and in directing management of these injuries. Although many injuries can be managed conservatively, some require more invasive interventions to prevent complications and loss of function. Accurate diagnosis of finger injuries can often be difficult, given the complicated soft-tissue anatomy of the hand and the diverse spectrum of injuries that can occur. To best serve the patient and the treating physician, radiologists must have a working knowledge of finger anatomy, the wide array of injury patterns that can occur, the characteristic imaging findings of different finger injuries, and the most appropriate treatment options for each type of injury. This article details the intricate anatomy of the hand as it relates to common finger injuries, illustrates the imaging findings of a range of injuries, presents optimal imaging modalities and imaging parameters for the diagnosis of different injury types, and addresses which findings have important management implications for the patient and the orthopedic surgeon. With this fund of knowledge, radiologists will be able to recommend the most appropriate imaging studies, make accurate diagnoses, convey clinically relevant imaging findings to the referring physician, and suggest appropriate follow-up examinations. In this way, the radiologist will help improve patient care and outcomes. Online supplemental material is available for this article. (©)RSNA, 2016.

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Section: Metacarpal Fracturesmentioning

confidence: 99%

“…Percutaneous pinning can be considered for patients with Bennett fractures in whom anatomic reduction is achieved; otherwise, ORIF is required. ORIF is necessary for treatment of all Rolando fractures (47).…”

Section: Thumb Metacarpal Injuriesmentioning

confidence: 99%

Traumatic Finger Injuries: What the Orthopedic Surgeon Wants to Know

Wieschhoff¹,

Sheehan²,

Wortman³

et al. 2016

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“…The presence of displaced articular fragments, rotational misalignment, abnormal angulation and/or shortening, and soft tissue injury indeed may require a surgical approach [6][7][8][9]. Furthermore, an involvement of more than 25% of the articular surface represents an indication for surgery, in order to align the joint and minimize all that complications negatively influencing patients' quality of life [7][8][9][10][11][12][13]. However, the final decision on the fracture's management is based largely on clinical impairment of hand function, considering comorbidities, compliance, and the need to return to activities or work [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of introducing cone-beam computed tomography (CBCT) in the management of complex phalangeal fractures: economic simulation

et al. 2020

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Purpose The purpose of this study was to evaluate the cost-effectiveness of introducing cone-beam computed tomography (CBCT) in the management of the complex finger fractures with articular involvement. Methods We created a decision tree model simulating the diagnostic pathway of complex finger fractures, suggesting the use of CBCT as alternative to multi-slice computed tomography (MSCT), and we compared their clinical outcomes, costs, and cost-effectiveness for a hypothetical cohort of 10,000 patients. Measures of effectiveness are analysed by using quality-adjusted life years, incremental cost-effectiveness ratio, and net monetary benefit. Results Diagnosis of a complex finger fracture performed with CBCT costed 67.33€ per patient, yielded 9.08 quality-adjusted life years, and gained an incremental cost-effectiveness ratio of 29.94€ and a net monetary benefit of 9.07 € at 30,000€ threshold. Using MSCT for diagnosis costed 106.23 €, yielded 8.18 quality-adjusted life years, and gained an incremental cost-effectiveness ratio of 371.15 € and a net monetary benefit of 8.09 €. CBCT strategy dominated the MSCT strategy. The acceptability curve shows that there is 98% probability of CBCT being the optimal strategy at 30,000€ threshold (1 EUR equal to 1.11 USD; updated on 02/02/2020). Conclusion CBCT in complex finger fractures management is cost saving compared with MSCT and may be considered a valuable imaging tool in preoperative assessment, allowing early detection and appropriate treatment. It shortens the time to completion of diagnostic work-up, reduces the number of additional diagnostic procedures, improves quality of life, and may reduce costs in a societal perspective.

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“…The treatment often implies immobilization with consequences like scarring, adhesion, and stiffness with poor outcome and compromised global hand function. 3 , 6 , 7…”

Section: Introductionmentioning

confidence: 99%