J Korean Fract Soc.
1988 Nov;1(1):24-35. 10.12671/jksf.1988.1.1.24.
A Clinical Study of complicated Fractures in the Hand
- Affiliations
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- 1Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Korea.
- KMID: 2311798
- DOI: http://doi.org/10.12671/jksf.1988.1.1.24
Abstract
- Fractures of the metacarpals and phalanges are the most common fractures in the skeletal system. Because these fractures are so common, they are considered as minor injuries frequently and treated in improper methods in many cases. As a result, complications such as malunion, stiffness, nonunion, traumatic arthritis, and infection may develop and cause severe functional disability and economic loss. The authers reviewed 138 cases of fractures of the hand and 20 complicated cases which were admitted and treated in the department of orthopedic surgery, Severance hospital from 1983 to 1987. 1. Fractures occured more commonly in man(81.9%) than woman, and more commonly in the second decade(32.6%). 2. The most common cause was the machinary injury(42.8%), the traffic accident was the second(34.8%). 3. Open fractures occured in 57 cases(41.3%), and the cases with multiple fractures were 54(39.1%). 4. The most frequently fractured bone was the metacarpal(44.6%), especially metcarpal neck, then the proximal phalanx(33.0%), middle phalanx(12.7%), distal phalanx(9.7%) in decreasing frequency. 5. The most frequent associated injuries were dislocation and subluxation(45.8%), tendon injury was the second(28.8%). 6. Complications were found in 20 cases(14.5%), and malunion and stiffness occured most frequently. 7. The incidence of malunion was 7.5% of all fractures. Malunion occured most frequently in metacarpal fractures(10.9%) and angulatory deformity was most common(55.0%). 8. Stiffness occured in 12 cases(8.7%). The most common sites were distal and proximal interphalangeal joints(33.3%, respectively). 9. Traumatic arthritis occured in 8 cases, which were all intraarticular fractures. The metacarpophallangeal joint was the most common site(50.0%). 10. Nonunion occured in 3.0% of the all fractures and was most common in proxiaml phalangeal fractures(4.5%). The bone graft and internal fixation were carried out in 2 cases, and the results were good. 11. Infection occured in 6 cases(4.3%) and confined to pin tract and soft tissue. They were treated well with conservative treatment.
