Introduction
While many hand injuries can be treated with splinting and hand therapy, surgical treatment of hand fractures is a large part of the emergency workload of major hospital operating theatres.
Indications
Hand fractures that are unstable, significantly displaced, or where non-surgical treatment would result in a poorer outcome or more lengthy recovery time.
Preoperative Instructions
Depending on the circumstances of your injury, you may be treated straight away via the emergency department. If your surgery is done in a more planned manner, hand fractures are usually treated as day surgery cases. General anaesthetic is the norm, but depending on the specific injury regional or local anaesthetic may be appropriate.
Procedure
The key to fracture management is restoration of the normal anatomy. Once this is achieved by reducing the fracture (lining up the injured bone) the fracture is held in one of several ways. Usually a combination of plates and screws is used to hold the fracture in a stable position.
Postoperative Instructions
The key to a good outcome in most hand fractures is the post-operative hand therapy. After a day or two of immobilization, hand therapy begins with protected range of motion exercises and custom-made splints. You will be advised of the specifics of your rehabilitation before you leave hospital.
Risks
The main long-term complication of hand fracture surgery is stiffness. Even with regular hand therapy sometimes fingers become stiff and require a second surgery to remove the plates and screws and free up scarring.
Treatment Alternatives
Most fractures can be treated non-operatively – even though ideally, they would be fixed surgically. Dr Stewart can discuss the risks and benefits as they apply to your specific injury.