Fractured Hand Surgery

Fractures of the hands (metacarpal) and fingers (phalanges) are the most common fractures of the skeletal system. Most of these fractures are functionally stable before or after surgery and they often do well with splinting. Reynolds Plastic Surgery is very familiar with the intricacies of fractured hand surgery and handles many cases every year for a variety of accidents and injuries.

The determination of when to operate or not depends upon many factors. In injuries where there is an open fracture in which the bone is protruding through the skin, or the fracture involves a joint surface or there is loss of the bone, or the fracture is associated other injuries like tendons, or in nerve and blood vessel injuries an operating room procedure will likely be required. However, a single fracture of a metacarpal or phalangeal bone which is not displaced or rotated and is in good alignment can often be treated with casting or protective splinting.

The History and Physical Examination and x-rays are the physician’s greatest allies in determining what should be done with the goal of full and rapid return of function. Ask anyone who is no longer able to use the hand or fingers how it affected them and the answer is usually, “I never realized how much I do with the hand and fingers”.

When the decision is made to move forward with fractured hand surgery, any number of techniques are available to reduce the bony fractures. The technique is based upon the fracture type and location. The letters “ORIF”, which stand for “Open Reduction and Internal Fixation”, is used and is a general description for reducing and stabilizing the fracture. ORIF procedures may use surgical stainless steel wires (called K-wires) or may use plates and screws or may use screws alone. The improvements in the instrumentation and material over the last century has been a great advancement in the treatment of any fracture.

Physicians who treat fractured hand surgery work closely with Occupational Therapy (OT). [In the general public the words Physical Therapy (PT) are used to include any rehabilitation of the upper and lower extremities. In reality, PT works with the lower extremities and OT works with the upper extremities] The OT will help regain function of the hand after the fractures are repaired. There are any number of ways using any number of techniques employed by OT to help regain the function lost by fractures. After the fracture is repaired, it is a common saying that the patient’s new best friend is OT.