Fractures of the Hand and Carpus

Description:

Hand fractures account for millions of emergency room visits annually. The extraordinary importance of the hand in so many activities of daily living necessitates inordinate surgical competence in repairing fractures, in order to preserve the vast range of motion and functionality of this highly complex structure.

Key Features:

General overview chapters covering anatomy, epidemiology, fixation types, role of arthroscopy, and strategies for compound hand injuries (soft tissue, flaps, etc.)

Contributions from a large number of renowned subspecialists

Hand fractures in special patient groups: athletes, musicians, patients with a paralytic extremity

Specific chapters covering the full range of fracture types and locations, including diaphyseal and intra-articular fractures of the phalanges and metacarpals, bony avulsions, fracture dislocations, and carpal bone fractures

Complications and their treatment: infection, malunion, hardware failures, and more

Evidence-based treatment suggestions, with the goal of restoring anatomic alignment and functional range of motion

Hundreds of high-quality radiographs and color photographs

Ideal for all orthopaedic and plastic surgeons in training, and of benefit to experienced surgeons as well, Fractures of the Hand and Carpus is a complete introduction to evidence-based techniques in hand surgery.

1 Epidemiology and Specific Challenges

1.1 Incidence of Hand and Carpal Fractures

2 Evidence in the Treatment of Hand Fractures

2.1 Introduction

2.2 Quality and Distribution of the Studies

2.3 Results

2.4 Discussion

3 Nonoperative Management of Hand Fractures

3.1 Introduction

3.2 Methods and Materials

3.3 Results

3.4 Discussion

4 K-wire Fixation, Intraosseous Wiring, Tension Band Wiring

4.1 Intraosseous and Cerclage Wiring

4.2 K-wire Fixation

5 Intramedullary Screw Fixation of the Metacarpals and Phalanges of the Hand

5.1 Introduction

5.2 Indications

5.3 Surgical Technique

5.4 Results

5.5 Complications

5.6 Conclusions

6 Plate and Screw Fixation of Hand and Carpal Fractures

6.1 Introduction and Historical Perspective

6.2 Implants and Technical Principles

6.3 General Considerations and Indications

6.4 Specific Indications and Procedures

6.5 Complications

7 External Minifixation

7.1 Introduction

7.2 Surgical Technique

7.3 Indications

7.4 Results

7.5 Discussion

8 Role of Arthroscopy in the Treatment of Carpal Fractures and Nonunion

8.1 Introduction

8.2 Indications

8.3 Method

8.4 Conclusion

9 Strategies in Compound Hand Injuries

9.1 Introduction

9.2 Patient Expectation

9.3 Clinical Examination

9.4 Imaging

9.5 Classification

9.6 Timing

9.7 Surgery

9.8 Surgical Steps

10 Pediatric Hand Fractures

10.1 Introduction

10.2 Special Children Fractures

11 Fractures in the Paralytic Extremity

11.1 Introduction

11.2 Basic Science

11.3 Epidemiology

11.4 Prevention

11.5 Diagnosis

11.6 Management of Fractures

11.7 Evidence

11.8 Future

12 Hand Injuries in the Athlete

12.1 Metacarpal and Phalangeal Fractures

12.2 Carpal Fractures

12.3 Scapholunate Injuries

13 Special Aspects in Musicians

13.1 Introduction and Historical Perspective

13.2 Instruments and Movements Required to Play Them

13.3 General Principles and Clinical Examples

13.4 Conclusions

14 Fractures of the Hand and Carpus: Complications and Their Treatment

14.1 Infection/Osteomyelitis

14.2 Malunion

14.3 Nonunion

14.4 Bone Necrosis

14.5 Complications of Intra-articular Fracture: Osteoarthritis and Stiffness of Ligaments

14.6 Summary of Clinical Points to Aid in Prevention of Complications

14.7 Special Clinical Points in Judgment and Surgical Treatment

15 Rehabilitation of Hand and Finger Fractures

15.1 Challenges in Rehabilitation of Hand and Wrist Fractures

15.2 Patient Evaluation before Therapy

15.3 Techniques Used in Rehabilitation

15.4 Extension and Traction

15.5 Summary

Section II Phalangeal Fractures

16 Fractures at the Base of the Proximal Phalanx

16.1 Trauma Mechanism

16.2 Classification

16.3 Clinical Signs and Tests

16.4 Investigatory Examinations

16.5 Possible Concurrent Lesions of Bone and Soft Tissue

16.6 Evidence

16.7 Author's Favored Treatment Option

16.8 Alternative Treatment Options

16.9 Prognosis

17 Extra-articular Fractures of the Phalanges

17.1 Trauma Mechanism

17.2 Classification

17.3 Clinical Signs and Tests

17.4 Investigatory Examinations

17.5 Concurrent Soft Tissue Lesions

17.6 Evidence

17.7 Author's Favored Treatment Options

17.8 Alternative Treatment Options

17.9 Treatment of Specific Fracture Configurations

17.10 Prognosis

17.11 Tips and Tricks

18 Intra-articular Fractures of the Proximal Interphalangeal Joint

18.1 Trauma Mechanism

18.2 Classification

18.3 Clinical Signs and Tests

18.4 Investigatory Examinations

18.5 Evidence

18.6 Author's Favored Treatment Options

18.7 Alternative Treatment Options

18.8 Prognosis

19 Avulsion Fractures of the Flexor and Extensor Tendons

19.1 Extensor Avulsion Fractures

19.2 Flexor Avulsion Fractures

Section III Metacarpal Fractures

20 Intra-articular Fractures and Dislocations at the Base of Metacarpals 2 to 5

20.1 Introduction

20.2 Trauma Mechanism and Anatomy

20.3 Classification

20.4 Clinical Signs and Tests

20.5 Investigatory Examinations

20.6 Treatment

20.7 Evidence

20.8 Author's Favored Treatment Option

20.9 Tips and Tricks

20.10 Prognosis

21 Intra-articular Fractures at the Base of the First Metacarpal

21.1 Trauma Mechanism

21.2 Classification

21.3 Clinical Signs and Tests

21.4 Investigatory Examinations

21.5 Possible Concurrent Lesions of Bone and Soft Tissue

21.6 Evidence

21.7 Authors’ Favored Treatment Option

21.8 Alternative Treatment Options

21.9 Prognosis

21.10 Tips and Tricks

22 Diaphyseal Fractures of the Metacarpals

22.1 Trauma Mechanism

22.2 Classification

22.3 Clinical Signs

22.4 Investigatory Examination

22.5 Possible Concurrent Lesions of Bone and Soft Tissue

22.6 Evidence and Anatomical Considerations

22.7 Indications for Surgery

22.8 Authors’ Favored Treatment Option

22.9 Alternative Treatment Options

22.10 Prognosis

22.11 Tips and Tricks

23 Metacarpal Neck Fractures

23.1 Trauma Mechanism

23.2 Classification

23.3 Clinical Signs and Tests

23.4 Radiographs

23.5 Possible Concurrent Lesions of Bone and Soft Tissue

23.6 Evidence

23.7 Author's Favored Treatment Option

23.8 Alternative Treatment Options

23.9 Prognosis

23.10 Tips and Tricks

24 Correction of Malunion in Metacarpal and Phalangeal Fractures

24.1 Trauma Mechanism

24.2 Classification

24.3 Clinical Signs and Tests

24.4 Evidence

24.5 Author's Favored Treatment Options

24.6 Clinical Results

24.7 Tips and Tricks

Section IV Carpal Fractures

25 Acute Scaphoid Fractures

25.1 Introduction

25.2 Trauma Mechanism

25.3 Clinical Signs and Tests

25.4 Investigatory Examinations

25.5 Alternative Treatment Options

25.6 Prognosis

25.7 Conclusion

26 Nonunion of the Scaphoid

26.1 Trauma Mechanism

26.2 Diagnostic Techniques and Criteria

26.3 Treatment Options

26.4 Evidence and Prognosis

26.5 Salvage Procedures

27 Other Carpal Fractures

27.1 General Considerations

27.2 Fracture of Triquetrum

27.3 Fracture of the Pisiform

27.4 Fracture of the Lunate

27.5 Fracture of the Trapezium

27.6 Fracture of Capitate

27.7 Fracture of Hamate