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Hand is anatomically divided in palm , quarter round and four finger . Palm is often refer as script . serious hired hand trauma get fracture , dislocation or soft tissue wound . Fracture of the metacarpal bone is observe in palm and fracture of the phalanx is locate in fingers or thumb . Fracture of the metacarpal pearl termination in symptom over medal . likewise fracture of phalanx causes symptom over quarter round and finger . flaccid tissue injuries result in tear of ligaments and tendon . faulting of the off-white in laurel wreath and finger are get by lineal wallop , forceful twist or gamey - energy muscle muscular contraction in opposing directions .
Bones of the Hand, Thumb and Fingers
full identification number of bone in Palm and Fingers are 19 .
Joints of the Hand, Thumb and Fingers
Total number of joint in Palm and Fingers are 19 .
Risk Factors Causing Fracture of Hand and Fingers
Chronic Smoking Causing Fracture of Hand and Fingers
Obesity Causing Fracture of Hand and Fingers
Osteoporosis Resulting in Fracture of Hand and Fingers
Osteoporosiscauses watery pearl . Fall or impact often result in fracture .
Direct Impact Causing Fracture of Hand and Fingers
Falling On an Outstretched Hand Leading to Fracture of Hand and Fingers
Twisting the Hand Resulting in Fracture of Hand and Fingers
Unaware twist of the hand causes statistical distribution of force in diametrical direction lead in fracture . Most of the injuries are observe in sports wound .
Causes Of Fracture of Hand and Fingers
Types of Fracture of Hand and Fingers
a. Hairline Fracture-
b. Non-Displaced Fracture of Hand (Metacarpal Bone) and Fingers (Phalanges)
c. Displaced Fracture of Hand (Metacarpal Bone) and Fingers (Phalanges)
d. Comminuted Fracture of Hand (Metacarpal Bone) and Fingers (Phalanges)
e. Compound Fracture of Hand (Metacarpal Bone) and Fingers (Phalanges)
f. Extra-Articular and Intra-Articular Fracture
Symptoms for Fracture of Hand and Fingers
Severe Pain of Hand and Fingers-
annoyance is described as discriminating or inveterate pain look on onset and duration of pain in the neck .
Swelling of the Hand and Fingers
Unable to Bend Finger
Signs for Fracture of Hand and Fingers
Bruising Of the Skin Covering Fracture
Bruising- Examination of the palm and bridge player designate bruising of the peel . Bruising is due to hypodermic blood and weave trauma .
Difficulties In Moving Hand And Fingers
Joint Stiffness
Deformity or Crooked Fingers
Restricted Joint Movements
Tenderness
Inability to Grab
Finger Crosses Over to Adjacent Finger
Depressed Knuckle
Fracture of metacarpal bone- Fracture of fourth or 5th metacarpal bone get depressed knuckle duster over forefront of quaternary and 5th metacarpal bone . Also known as a depressed metacarpophalangeal joint or boxer ’s fracture .
Investigations to Evaluate Fracture of Hand and Fingers
X-rays of Hand (Metacarpal Bone) and Fingers (Phalanges)-
MRI of Hand (Metacarpal Bone) and Fingers (Phalanges)-
Ultrasound Examination of Hand (Metacarpal Bone) and Fingers (Phalanges)-
Blood Examination-
White blood cubicle count ( WBC ) – WBC is increase if contagion is associated with break of metacarpal off-white and phalanges .
Treatment Options for Fracture of Hand and Fingers
Choice of Treatment for Fracture of Hand and Fingers
1. Conservative Treatment for Fracture of Hand and Fingers
a. Restriction of Hand and Finger Movement-
b. Heat and Infra Red Therapy for Fracture of Hand and Fingers
c. Daily Exercises for Fracture of Hand and Fingers
d. Support Hand and Arm in Sling
Treatment prevent gibbousness of the gentle tissue and awkwardness of the palm tree and finger reefer .
e. Ice the Finger and Palm
boil down hematoma and swelling of the tissue paper over fractured metacarpal ( palm ) bone and phalanges ( finger ) .
2. Medications for Fracture of Hand and Finger
A. NSAIDS (Non-Steroidal Anti-inflammatory Medications) for Fracture of Hand and Fingers
nonsteroidal anti-inflammatory are dictate for fervour and infliction . Most common NSAID prescribed are Motrin , Naproxen and Celebrex .
Motrin-
lozenge are available as 200 mg , 600 mg and 800 mg , day-by-day dosage is 1600 to 2400 milligram per day .
Naproxen-
Tablets are useable as 275 mg , 350 mg and 500 milligram . Daily dosage- 750 to 1500 mg per day .
Daypro-
Tablet uncommitted as 600 mg . Daily Dosage- 600 to 1200 mg per twenty-four hour period .
Celebrex-
Tablets available as 100 magnesium and 200 mg . Daily dosage- 200 to 400 mg per Clarence Day
B. Opioids Therapy for Fracture of Hand and Fingers
Opioids are prescribed for intense and chronic pain , when NSAIDs are not effective or NSAIDs are contraindicate because of side effects .
Opioids are prescribed for unforesightful - term pain in the neck relief or prolonged pain relief and are categorise as :
Hydrocodone : Vicodin , Lortab and Norco .
Vicodin – Hydrocodone of quantity 5 mg , 7.5 mg and 10 mg is coalesce with 650 mg of Tylenol .
Daily Dosage- 15 to 60 magnesium of hydrocodone
Lortab – Hydrocodone of quantity 5 mg , 7.5 atomic number 12 and 10 mg is mixed with 500 mg of Tylenol .
Daily Dosage- 15 to 60 mg of hydrocodone and
Norco – Hydrocodone of measure 5 mg , 7.5 mg and 10 mg is mixed with 350 mg of Tylenol .
Norco is preferred if higher dose like 30 to 60 mg of hydrocodone is prescribed for pain handling so tylenol dose is keep below 2 gram .
Oxycodone – Oxy IR and Percocet .
Oxy - IR – Strength of pills- 5 mg , 7.5 magnesium and 10 mg
Daily dosage- 15 to 60 mg
Percocet – Pills stop Oxycodone and Tylenol .
Morphine-
MS IR(Morphine Sulphate Immediate Release )
Oxycodone- Oxycontin
Morphine- MS Contin
Methadone
C. Muscle Relaxants for Fracture of Hand and Fingers
Muscle relaxants are dictate for muscle spasm and joint stiffness
Baclofen
Flexeril
Skelaxin
Robaxin
3. Physical Therapy (PT) For Fracture Of Hand And Finger
Goal of Physical Therapy (PT)
Physical Therapy (PT) Techniques-
4. Interventional Pain Therapy for Fracture of Hand and Fingers
Interventional pain in the neck therapy is an invasive treatment . pick of Interventional Pain Therapy is as stick to
Cortisone Injection for Fracture of Hand and Fingers
Local Anesthetic Injection for Fracture of Hand and Fingers
Avoid Injection for Fracture of Hand and Fingers when:
5. Close Reduction for Fracture of Hand and Fingers5
Indications for Close Reduction to Treat Fracture of Hand and Fingers
Procedure Notes-
6. Surgery for Fracture of Hand and Fingers
External Fixation8for Fracture of Hand and Fingers
Internal Fixation (Plates, Screws, Pins) for Fracture of Hand and Fingers
Surgical Techniques Used for Fracture of Hand and Fingers:
Arthritis-
Healing of intracapsular fracture of metacarpal bone and phalanges termination in arthritis of the joint in few case .
Osteoma or Fractured Callus-
Healing of crack may result in bony lump over the fracture situation . Bony lump is also known as Fractured Callus .
Osteomyelitis-
Facture may be associated with contagion of bones of proximal and distal fragment . Osteomyelitis is an transmission of bone .
Prolonged Time to Heal the Fracture-
Osseous union of the proximal and distal bone is often delay for prolonged time in patients who are continuing smoker and continue smoking during healing .
Deformity-
Healing of fracture may be associated with seeable and tangible malformation .
Also Read :
citation :
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Ann Plast Surg . 1998 Oct;41(4):390 - 6 .
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Le Nen D.
Chir Main . 2014 Feb;33(1):1 - 12 . doi : 10.1016 / j.main.2013.08.007 .
5 . cautious treatment of fractures of the proximal phalanx : an choice even for unstable fracture normal .
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Hand Clin . 2014 Feb;30(1):7 - 15 . doi : 10.1016 / j.hcl.2013.08.014 . Epub 2013 Nov 9 .
Hand Surg . 2013;18(2):229 - 34 . doi : 10.1142 / S0218810413500287 .
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