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5 Cards in this Set
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What are 10 general indications for fixation of metacarpal or phalangeal fractures?
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1. Irreducible fracture
2. Malrotation 3. Intra-articular 4. Subcapital (phalangeal) 5. Open 6. Segmental bone loss 7. Polytrauma with hand fractures 8. Multiple fractures 9. Fractures with soft tissue injury 10. Reconstruction (osteotomy etc) |
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What two mechanisms cause the apex dorsal angulation of a boxer's fracture?
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1. Impact on dorsum of metacarpal head, causing volar comminution of neck
2. Intrinsics lie volar to axis of rotation |
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What three factors determine the treatment of a MC neck fracture?
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1. Which neck is fractured
2. Degree of angulation 3. Presence of rotation |
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What are indications for open reduction of metacarpal shaft fractures?
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1. Open fracture: boen loss, contamination, soft tissue injury
2. Multiple fractures: loss of stabilizing force from adjacent metacarpals 3. Unstable fractures: border 4. Malalignment: rotation, or dorsal angulation > 10-30 degrees, shortening >2-5mm |
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In what planes should interfragmentary screws be placed in MC shaft fractures? What size of fracture is required? What size of screws?
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Fracture length must be a minimum of 2x bone diameter
Axial forces counteracted by placing screw at 90deg to long axis, torsional forces resisted by placing screw 90deg to plane of fracture Three 2.4 or 2mm screws, or two 2.7mm screws |
