Hand fractures and joint injuries
Diagnosis of hand fractures and joint injuries requires history, examination, and adequate imaging studies. Treatment decisions are based on fracture geometry, stability, and individual patient needs. Nonoperative principles include reduction, maintenance of reduction through casting or splinting, followed by protected motion. Operative treatment includes closed reduction with or without percutaneous pinning, external fixation, and open reduction and internal fixation. Rehabilitation is an important aspect of caring for patients with hand fractures and joint injuries, and involves splinting and restoring motion. Stiffness and persistent swelling around joints are common following these injuries, and secondary procedures to improve motion or alignment may be considered when the desired outcome is not achieved. These include correction of malunion, tenolysis, and capsulotomy, followed by hand therapy to maximize motion and functional use of the hand.
