A 15-year-old male presented with multiple right-hand fractures, including a severely angulated small finger metacarpal neck fracture. Multiple closed attempts failed, and open reduction was performed. At surgery, the extensor tendon was found to be interposed within the fracture, thereby preventing closed reduction. The tendon was extricated from the fracture site, adequate reduction was obtained, and the fracture was stabilized using K-wires. The fracture united well, with good return of motion and strength. Extensor tendon interposition is a rare scenario associated with metacarpal neck fractures and should be suspected when there is complete loss of contact between the fracture ends and multiple attempts at closed reduction have failed.
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http://dx.doi.org/10.1055/s-0041-1731656 | DOI Listing |
Hand Surg Rehabil
January 2025
Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York City, NY, United States.
Background: Patients are increasingly turning to the internet, and recently artificial intelligence engines (e.g., ChatGPT), for answers to common medical questions.
View Article and Find Full Text PDFMalays Orthop J
November 2024
Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Raipur, India.
Free fibula flap has been a workhorse for head, neck, and extremity long bone defects. We discuss the reconstruction challenge in an unusual hand injury case involving the loss of multiple metacarpals and soft tissue with surprising preservation of finger vascularity. The reconstructive goals were addressed with a microvascular osteocutaneous fibula flap transfer with multiple osteotomies to create spitting images of metacarpals and soft tissue defects restored with the skin paddle.
View Article and Find Full Text PDFCureus
November 2024
Orthopaedics and Traumatology, São João University Hospital Center, Porto, PRT.
Introduction The fifth metacarpal neck fracture is a common injury, and the treatment of such injuries is still a matter of debate. It typically presents in young adults of working age, and it represents a significant burden for both the health services and the patient. The purpose of this study was to compare the results of operative and conservative treatment of this fracture.
View Article and Find Full Text PDFCurr Biol
December 2024
Lauer Foundation for Paleontology, Science and Education, Wheaton, IL 60189, USA.
Plast Surg (Oakv)
April 2024
Division of Plastic Surgery, University of Ottawa, Ottawa, Ontario, Canada.
Hand injuries are common in children. Most simple pediatric hand fractures do not require surgery and can be treated with protective immobilization, yielding good outcomes. A recent institutional audit revealed significant practice variation in managing these children with many being overtreated with unnecessary follow-up visits.
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