General Principles of Hand Fracture Management
1. Avoid over-immobilization
2. Correct angular malalignment and rotation
  1. Splint in position of moderate flexion
  2. Avoid splinting fingers in extension (esp MCP)
  3. Axes of all flexed fingers should point at Scaphoid
3. Evaluate peri-articular Fractures for avulsed tendon
  1. Fragments are often attached to a tendon or ligament
Consider Open Reduction and Internal Fixation (ORIF)
1. Advantages
  1. Avoid excessive manipulation
  2. Avoids prolonged splinting
2. Indications
  1. Unstable displaced intra-articular Fractures
    1. if >25-30% of joint surface involved

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 6/1/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.