F Unglaub1,2, M F Langer3, S Löw4, B Hohendorff5, C K Spies6. 1. Handchirurgie Vulpius Klinik, Vulpiusstraße 29, 74906, Bad Rappenau, Deutschland. unglaub@vulpiusklinik.de. 2. Medizinische Fakultät Mannheim, Universität Heidelberg, Heidelberg, Deutschland. unglaub@vulpiusklinik.de. 3. Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Münster, Deutschland. 4. Praxis für Handchirurgie und Unfallchirurgie, Bad Mergentheim, Deutschland. 5. Abteilung für Hand-, Ästhetische und Plastische Chirurgie, Elbe Klinikum Stade, Stade, Deutschland. 6. Handchirurgie Vulpius Klinik, Vulpiusstraße 29, 74906, Bad Rappenau, Deutschland.
Abstract
OBJECTIVE: Anatomical open reduction and internal fixation using screw/plate osteosynthesis. INDICATIONS: Extra-articular fractures with clinically evident malrotation of the finger, comminution fracture and/or loss of length, which cannot be treated non-operatively; fracture instability; intra-articular fracture with step off greater than 1 mm, which cannot be treated percutaneously but openly using plate/screw osteosythesis; failure of conservative treatment. CONTRAINDICATIONS: General operative limitations. SURGICAL TECHNIQUE: Dorsal, mediolateral, or palmar approach, temporary reduction using pincers or optional Kirschner wires; screw/plate osteosynthesis for internal fixation. POSTOPERATIVE MANAGEMENT: Immediate mobilization facilitated by buddy loops for the first 4-6 weeks, prevention of edema using elastic dressing, physiotherapy. RESULTS: Open reduction and internal fixation using screw/plate osteosynthesis provides good results in combination with immediate mobilization. Nevertheless, adhesion of tendons or capsule tissue with restriction of range of motion is observed.
OBJECTIVE: Anatomical open reduction and internal fixation using screw/plate osteosynthesis. INDICATIONS: Extra-articular fractures with clinically evident malrotation of the finger, comminution fracture and/or loss of length, which cannot be treated non-operatively; fracture instability; intra-articular fracture with step off greater than 1 mm, which cannot be treated percutaneously but openly using plate/screw osteosythesis; failure of conservative treatment. CONTRAINDICATIONS: General operative limitations. SURGICAL TECHNIQUE: Dorsal, mediolateral, or palmar approach, temporary reduction using pincers or optional Kirschner wires; screw/plate osteosynthesis for internal fixation. POSTOPERATIVE MANAGEMENT: Immediate mobilization facilitated by buddy loops for the first 4-6 weeks, prevention of edema using elastic dressing, physiotherapy. RESULTS: Open reduction and internal fixation using screw/plate osteosynthesis provides good results in combination with immediate mobilization. Nevertheless, adhesion of tendons or capsule tissue with restriction of range of motion is observed.
Authors: Christian Karl Spies; Martin Langer; Peter Hahn; Lars Peter Müller; Frank Unglaub Journal: Dtsch Arztebl Int Date: 2018-04-20 Impact factor: 5.594