Traumatic injuries to the hands are often associated with both soft tissue and bone injuries.
In some cases, fractures can be reduced (reset) under a general anaesthetic using simple manipulation techniques. If the fracture reduces into a good position, and is stable, it may be held with a plaster.
In many cases however the fracture will not be stable and some form of rigid fixation will be required.
In some instances, smooth wires can be passed across the fracture to pin the fracture alignment. These wires usually have to come out again once the fracture has started to unite. In many cases, the patient is unable to start early movement of the affected finger or hand whilst the wires are in place.
When a fracture requires an incision to allow it to be pieced back together, they are usually rigidly fixed with plates and screws. Once fractures have been plated, they are often suitable to start movement early.
Most patients will require some hand therapy to assist with regaining the range of movement of the finger joints. One of the biggest risks with any hand trauma is the development of post injury stiffness.
Patients may experience some ongoing swelling for several months after hand trauma and the range of movement of the affected joints can improve for the first six months at least. Patients are often required to continue with hand exercises for several months after their injury.
Each fracture is unique and the decision with regards to treatment will depend upon the degree of displacement of the fracture fragments and whether or not the affected fingers have any issue with alignment or rotation. Patient will often have injuries to tendons and nerves and vessels in association with bone injuries.