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Hand and Finger Fractures

Treatment of the orthopedic trauma injuries is a highly specialized field that deals with a broad set of conditions and symptoms. Using the latest diagnostic and treatment techniques, Dr. Balaguer can successfully treat your upper extremity injury.

Phalanx

Phalanx fractures represent common sports and work-related injuries. They have different prognosis and treatment depending on the location of the fracture:
- Proximal phalanx
 - Middle phalanx
 - Distal phalanx

Treatment

 A phalanx fracture can be addressed using one of several treatments based on clinical and radiographic assessment of the fracture and any associated injury.

Non-operative treatments include the following:

  - Buddy taping (minimally displaced, no rotation)

 - Splinting (minimally displaced, no rotation)


Surgical treatment is necessary if the fracture pattern is unstable. 

Operative techniques for treatment are:

 - Closed vs. open fixation(irreducible or unstable fracture pattern)


Optimal outcome from surgical treatment demands appropriate surgical plan, atraumatic soft tissue handling, and stable fixation to facilitate early motion. 

Metacarpal Fractures

Metacarpal fractures can occur with a variety of injuries, including falls, car accidents, and sports injuries. Typical symptoms of a metacarpal fracture include pain and swelling of the hand. There is usually bruising that develops within a few days of the injury. Patients typically notice stiffness of the fingers and pain when trying to form a fist. 

Treatment

Most metacarpal injuries can be managed nonoperatively with immobilization or controlled mobilization.

Non-operative technique includes:

 - Immobilization

 -- stable fracture

 -- no rotation

 -- acceptable angulation and shortening

Some hand fractures require surgery to realign and stabilize the fracture fragments. Operative treatment is recommended for the following:

 - Intra-articular fractures

 - Rotation of digit

 - Significantly displaced fractures

 - Multiple metacarpal fractures

Most metacarpal fractures heal in about 10 weeks; therefore, it is normal to have stiffness and swelling for that length of time.  

Metacarpal Base Fractures

Bennet's Intra-Articular Fracture
Dislocation of Base of 1st Metacarpal

A Bennett fracture is a fracture of the base of the thumb resulting from a forced abduction of the first metacarpal. This injury is common in athletes participating in boxing, football, rugby, and soccer.

Treatment

Treatment options range from conservative to surgical interventions. Nonoperative treatment for non-displaced fracture includes:

 - Closed reduction immobilization

In most cases, closed reduction and immobilization via a thumb spica orthosis for 4-6 weeks can be effective at managing the fracture.

Operative treatment involves:

 - Closed reduction and percutaneous pinning (majority)

 -- displaced

 -- anatomic reduction unstable

In the long-term outcome after surgical treatment, the overall strength of the affected hand is typically diminished, and post-traumatic osteoarthritis tends to develop in most cases. 

Rolando Fracture

Comminuted Intra-Articular Fracture of Base of 1st Metacarpal

A Rolando fracture will most likely be caused by a sudden impact or trauma, such as punching something hard. The patient will feel immediate severe pain on the thumb side of the wrist. There will be rapid swelling and bruising may appear. The thumb may appear deformed depending on the level of bone displacement. 

Treatment

There are a number of methods to treat this injury.

Nonoperative:

May be indicated in highly comminuted fracture.

 - Immobilization

Surgical treatment is recommended for unstable fractures.

Operative:

 - External fixation

 - Closed vs. open fixation

Following surgery, the wrist may be in plaster for a period of six weeks, possibly using a removable splint rather than a fixed plaster cast. 

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(305) 595-1317

Locations

Main Corporate Office
The Miami Institute for Joint Reconstruction
11801 sw 90th St, Suite 201 Miami, FL 3318
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Cutler Bay Office
9299 SW 152nd St, Suite 103 Miami, FL 33156

Doral Office
3650 NW 82nd Ave #201, Doral, FL 33166

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(305) 595 1317

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