scholarly journals Open reduction and internal fixation of metacarpal fractures using a thermoplastic splint as a surgical instrument

2021 ◽  
Vol 48 (4) ◽  
pp. 384-388
Author(s):  
Theodora Papavasiliou ◽  
Paul Dain Park ◽  
Ricardo Tejero ◽  
Niklaas Allain ◽  
Lauren Uppal
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Care Pathway ◽  
Metacarpal Fracture ◽  
Surgical Instrument ◽  
Operative Repair ◽  
Post Operation ◽  
Hand Fracture ◽  
Minimal Modification ◽  
Metal Work

Adequate positioning of the hand is a critical step in hand fracture operative repair that can impact both the clinical outcome and the efficiency of the operation. In this paper, we introduce the use of a thermoplastic splint with an added thumb stabilizing component as a means to increase the surgeon’s autonomy and to streamline the patient care pathway. The thermoplastic splint is custom fabricated preoperatively by the specialist hand therapist. The splint is used prior, during, and post operation with minimal modification. The thumb component assists maintaining the forearm in a stable pronated position whilst drilling and affixing metal work. This is demonstrated in the video of removal of metal work and open reduction and internal fixation of a metacarpal fracture.

scholarly journals Open Reduction and Internal Fixation with Mini-plate and Screws for Management of Unstable Metacarpal Fracture among Hand Injuries in a Tertiary Care Center: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (239) ◽  
Author(s):  
Sagar Panthi ◽  
Rishiswor Shrestha ◽  
Jigyasu Pradhan ◽  
Bikash Neupane ◽  
Siddhartha Khanal ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Plate Fixation ◽  
Care Center ◽  
Tertiary Care ◽  
Hand Injuries ◽  
Tertiary Care Center ◽  
Metacarpal Fracture ◽  
Metacarpal Fractures ◽  
Mini Plate

Introduction: Hand injuries metacarpal fractures are common and it accounts about 14 to 28%. Mini-plate fixation in unstable metacarpal fractures provides absolute stability and early mobilization of fingers to reduce complications. The purpose of this study is to find out the prevalence of open reduction and internal fixation with mini-plate and screws for management of unstable metacarpal fracture among hand injuries done in a tertiary care center. Methods: This was a descriptive cross-sectional study done from February 2019 and January 2021 in a tertiary care center with unstable isolated metacarpal fracture treated with mini-plate fixation and were followed up for six months duration. Ethical approval and informed written consent were taken from all patients. The outcome was assessed by the American Society for Surgery of the Hand Total Active Flexion Score. Convenient sampling method was used. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Statistical Package for Social Sciences used for analysis. Results: Out of 250 patients who underwent hand surgeries, open reduction and internal fixation with mini-plate and screws for unstable metacarpal fracture were done in 32 (12.8%) (8.66-16.94 at 95% Confidence Interval). The mean time of fracture union was 6.78±1.008 weeks. Functional outcome according to American Society for Surgery of the Hand Total Active Flexion score was excellent in 25 (78.2%), good in 6 (18.8%), and poor in 1 (3%) patient. Conclusions: Fixation of metacarpal fracture by mini-plate and screws was required in fewer patients. Mini-plate fixation provides better stability and early mobilization for unstable metacarpal fractures to achieve a good functional outcome.

scholarly journals Anterior interosseous nerve palsy as a result of prolonged shoulder immobilisation

2019 ◽  
Vol 12 (5) ◽  
pp. e229010
Author(s):  
Evelyn Patricia Murphy ◽  
Christopher Fenelon ◽  
Michael Alexander ◽  
John Quinlan
Keyword(s):  
Internal Fixation ◽  
Conservative Management ◽  
Open Reduction ◽  
Rare Case ◽  
Nerve Palsy ◽  
Clavicle Fracture ◽  
Open Reduction Internal Fixation ◽  
Anterior Interosseous Nerve ◽  
Removal Of Metal ◽  
Metal Work

This is a rare case of an anterior interosseous nerve (AIN) palsy in a patient as a result of a prolonged period of shoulder immobilisation. The patient had an open reduction internal fixation of a midshaft clavicle fracture. They subsequently underwent removal of metal due to symptomatic prominence of the metal work. The patient was in a shoulder immobiliser for a period of 5 months in total. They developed progressive AIN palsy as a result of a positional compression due to prolonged wearing of a shoulder immobiliser. This resolved with conservative management and careful observation.

Combined Fourth and Fifth Metacarpal Fracture and Fifth Carpometacarpal Joint Dislocation

1995 ◽  
Vol 20 (2) ◽  
pp. 249-252 ◽  
Author(s):  
Y. LIAW ◽  
G. KALNINS ◽  
G. KIRSH ◽  
I. MEAKIN
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Clinical Results ◽  
Fracture Dislocation ◽  
Metacarpal Fracture ◽  
Carpometacarpal Joint ◽  
Joint Dislocation ◽  
Good View ◽  
Injury Treatment

Three cases of hamato-metacarpal fracture-dislocation with fracture of the shaft or base of the fourth metacarpal and dorsal dislocation of the fifth metacarpal are described. In one case this was associated with coronal fracture of the hamate. An oblique radiograph of the hand with the forearm pronated 15° and 45° provided a good view of the extent of the fourth and fifth carpometacarpal injury. Treatment with open reduction and internal fixation achieves good clinical results.

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