Principles of Surgical Management of Hand Fractures
An accurate history of the patient’s injury is essential. This should include the mechanism of the accident, functional clinical examination, and precise diagnostic imaging (conventional X-ray plus CT—using high-field scanning with thin slices, if necessary and possible, and MRI). The results determine management and may decide whether or not surgery is necessary.
Note
The patient must always be informed of potential complications of surgical management and this information must be documented.
Hand and wrist fractures are stabilized surgically according to the following basic plan.
Preoperative measures:
Inform the patient about the extent of the injury.
Present the treatment options: conservative or surgical; explain the advantages and disadvantages of the treatments.
Address potential complications: impaired motion, infections, sympathetic reflex dystrophy.
Point out the need for intensive postoperative treatment.
Record the information provided:
General anesthesia / plexus anesthesia, complications
Screw/plate loosening
Wound infection
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