J Korean Fract Soc.  2018 Apr;31(2):61-70. 10.12671/jkfs.2018.31.2.61.

Hand Fractures

• Yang S
• Kim JP

• KMID: 2409762
• DOI: http://doi.org/10.12671/jkfs.2018.31.2.61

Abstract

Hand fractures are the second most common fracture in the upper extremities after the distal radius, and patients with these injuries may be experienced in hand surgery clinics. On the other hand, during the treatment of hand fractures, complications can occur due to complex functions of the hand and small-sized injuries to the bone and soft tissues. This review focused on the principles of management of these fractures, including injury mechanism, evaluations and recent treatment options. Minimally invasive surgery in various types of hand fractures, including the phalanx and metacarpal bone, is preferred because early mobilization after surgery has been emphasized to reduce complications, such as stiffness.

Keyword

Hand fractures; Finger phalanges; Metacarpal bones; Complications

MeSH Terms

Early Ambulation
Finger Phalanges
Hand*
Humans
Metacarpal Bones
Minimally Invasive Surgical Procedures
Radius
Upper Extremity

Figure

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  Fig. 1 Examinations showing rotational deformity of the hand. (A) Examining the digital pulps and the planar alignment of the nails with respect to the adjacent digits. (B) Affected finger deviates from its normal rotational direction to the scaphoid. The arrows indicates the fingers affected by a rotational deformity.

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  Fig. 2 Fan lateral view of the right hand.

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  Fig. 3 Radiographs showing a transverse fracture in the proximal phalanx treated with plate and screw fixation. (A) Posterolateral view. (B) Lateral view.

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  Fig. 4 Radiographs showing multiple fractures in a hand treated with intramedullary pinning of the metacarpal bones and plate and screw fixation of the proximal phalanx. (A) Preoperative radiograph. (B) Postoperative radiograph.

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  Fig. 5 Radiographs showing a ring finger metacarpal spiral fracture treated with a lag screw fixation. (A) Preoperative radiograph. (B) Postoperative radiograph.

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  Fig. 6 (A) Preoperative radiograph showing a bony mallet finger injury. (B) C-arm images performing extension block pinning.

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  Fig. 7 Radiographs and intraoperative photographs after the suture-over-button technique in a Jersey finger injury.

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  Fig. 8 Volar plate reconstruction in proximal interphalangeal joint fracture dislocation. (A) Preoperative radiographs. (B) Illustration showing the surgical procedures of a volar plate reconstruction. (C) Intraoperative radiograph and photograph.

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  Fig. 9 Radiographs showing a proximal phalanx condylar fracture of the little finger treated with headless cannulated screws. (A) Preoperative radiograph. (B) Postoperative radiograph.

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  Fig. 10 Radiographs and arthroscopic images after arthroscopic-assisted reduction and pinning in the thumb proximal phalanx base fracture. (A) Preoperative radiograph. (B) Articular surface reduction with arthroscope. (C) Postoperative radiograph.

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  Fig. 11 Radiographs showing thumb metacarpophalangeal joint arthrodesis due to post-traumatic osteoarthritis. (A) Preoperative radiograph. (B) Postoperative radiograph.

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  Fig. 12 (A) Photographs of a patient who had post-traumatic stiffness in his ring finger after surgery for a proximal phalangeal fracture. (B) Tenolysis of the flexor tendon was performed. (C) Tenotomy of the lumbrical tendon was done to resolve the lumbrical plus finger.

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  Fig. 13 (A) Radiographs and photographs of a 54-year-old male who had malunion of his right little finger. (B) He could make a full fist after a corrective osteotomy had been performed.

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