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Boccolari P, Pantaleoni F, Donati D, Tedeschi R. Non-surgical treatment of oblique diaphyseal fractures of the fourth and fifth metacarpals in a professional athlete: A case report. Int J Surg Case Rep 2024; 115:109256. [PMID: 38219517 PMCID: PMC10826815 DOI: 10.1016/j.ijscr.2024.109256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 01/16/2024] Open
Abstract
INTRODUCTION Metacarpal fractures are common sports-related injuries, often requiring tailored treatment strategies, especially in athletes. The management of oblique diaphyseal fractures poses unique challenges due to their inherent instability. This case report discusses a non-surgical approach in treating such fractures in a professional athlete. CASE PRESENTATION A 26-year-old professional soccer player sustained oblique diaphyseal fractures of the fourth and fifth metacarpals during training. Given the athlete's professional demands and the fracture's nature, a conservative treatment was implemented. This included the application of a modified ulnar gutter brace, allowing for immobilization of the metacarpophalangeal joints (MP) while permitting active mobilization of the interphalangeal joints(IP). CLINICAL DISCUSSION The non-surgical treatment focused on achieving skeletal stability and maintaining hand function. Despite the complexity of oblique fractures, the conservative approach was successful, enabling the athlete to resume professional activities with minimal risk of fracture displacement. Regular radiographic follow-ups showed no further displacement, highlighting the effective management of such fractures through personalized conservative treatment plans. CONCLUSIONS This case underscores the viability of conservative treatment for specific metacarpal fractures in athletes. Tailoring the treatment to accommodate the athlete's professional needs and understanding the biomechanical characteristics of the fracture are crucial for successful outcomes. The case also suggests that non-surgical management can be a viable option for certain complex metacarpal fractures, especially in high-demand patients.
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Affiliation(s)
- Paolo Boccolari
- Physical Therapy and Rehabilitation Unit, Policlinico di Modena, 41125 Modena
| | - Filippo Pantaleoni
- Physical Therapy and Rehabilitation Unit, Policlinico di Modena, 41125 Modena
| | - Danilo Donati
- Physical Therapy and Rehabilitation Unit, Policlinico di Modena, 41125 Modena; Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Roberto Tedeschi
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
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Christodoulou N, Asimakopoulos D, Kapetanos K, Seah M, Khan W. Principles of management of hand fractures. J Perioper Pract 2023; 33:342-349. [PMID: 36408867 PMCID: PMC10623595 DOI: 10.1177/17504589221119739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The optimal management of hand fractures requires a multidisciplinary approach. Initial assessment should include a thorough medical history and clinical examination, followed by appropriate radiological imaging. These are crucial in determining the appropriate management. Following joint stabilisation to allow fractures to unite, early mobilisation is needed to maximise the functional restoration of the hand. In this review, the principles of operative and non-operative management of these injuries are discussed.
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Affiliation(s)
| | | | | | - Matthew Seah
- Division of Trauma and Orthopaedic Surgery, University of Cambridge, Cambridge, UK
| | - Wasim Khan
- Division of Trauma and Orthopaedic Surgery, University of Cambridge, Cambridge, UK
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Mian SH, Umer U, Moiduddin K, Alkhalefah H. Finite Element Analysis of Upper Limb Splint Designs and Materials for 3D Printing. Polymers (Basel) 2023; 15:2993. [PMID: 37514383 PMCID: PMC10383199 DOI: 10.3390/polym15142993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 06/28/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
Three-dimensional (3D) printed splints must be lightweight and adequately ventilated to maximize the patient's convenience while maintaining requisite strength. The ensuing loss of strength has a substantial impact on the transformation of a solid splint model into a perforated or porous model. Thus, two methods for making perforations-standard approach and topological optimization-are investigated in this study. The objective of this research is to ascertain the impact of different perforation shapes and their distribution as well as topology optimization on the customized splint model. The solid splint models made of various materials have been transformed into porous designs to evaluate their strength by utilizing Finite Element (FE) simulation. This study will have a substantial effect on the designing concept for medical devices as well as other industries such as automobiles and aerospace. The novelty of the research refers to creating the perforations as well as applying topology optimization and 3D printing in practice. According to the comparison of the various materials, PLA had the least amount of deformation and the highest safety factor for all loading directions. Additionally, it was shown that all perforation shapes behave similarly, implying that the perforation shape's effect is not notably pronounced. However, square perforations seemed to perform the best out of all the perforation shape types. It was also obvious that the topology-optimized hand splint outperformed that with square perforations. The topology-optimized hand splint weighs 26% less than the solid splint, whereas the square-perforated hand splint weighs roughly 12% less. Nevertheless, the user must choose which strategy (standard perforations or topology optimization) to employ based on the available tools and prerequisites.
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Affiliation(s)
- Syed Hammad Mian
- Advanced Manufacturing Institute, King Saud University, Riyadh 11421, Saudi Arabia
- King Salman Center for Disability Research, Riyadh 11614, Saudi Arabia
| | - Usama Umer
- Advanced Manufacturing Institute, King Saud University, Riyadh 11421, Saudi Arabia
- King Salman Center for Disability Research, Riyadh 11614, Saudi Arabia
| | - Khaja Moiduddin
- Advanced Manufacturing Institute, King Saud University, Riyadh 11421, Saudi Arabia
- King Salman Center for Disability Research, Riyadh 11614, Saudi Arabia
| | - Hisham Alkhalefah
- Advanced Manufacturing Institute, King Saud University, Riyadh 11421, Saudi Arabia
- King Salman Center for Disability Research, Riyadh 11614, Saudi Arabia
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Henry TW, Tulipan JE, Kwan SA, Beredjiklian PK, Lutsky KF, Matzon JL. Outcomes After Surgically Managed Oblique Extra-Articular Proximal Phalanx Fractures: A Comparison of Closed-Reduction Percutaneous Pinning and Open-Reduction Internal Fixation With Lag Screws. Hand (N Y) 2023; 18:48-54. [PMID: 33834886 PMCID: PMC9806528 DOI: 10.1177/15589447211003185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Long oblique extra-articular proximal phalanx fractures are common orthopedic injuries. When unstable and without substantial comminution, treatment options include closed-reduction percutaneous pinning (CRPP) and open-reduction internal fixation using lag screws (ORIF-screws). The aims of this study are primarily to compare the functional outcomes and complication rates between these techniques and secondarily to assess potential factors affecting outcomes after surgery. METHODS All patients with long oblique extra-articular proximal phalanx fractures treated surgically within a single orthopedic institution from 2010 to 2017 were identified. Outcome measures and complications were assessed at the final follow-up. RESULTS Sixty patients were included in the study with a mean time to the final follow-up of 41 weeks (range: 12-164 weeks). Thirty-four patients (57%) were treated with CRPP and 26 patients (43%) with ORIF-screws. The mean Disabilities of the Arm, Shoulder, and Hand score across both fixation types was 8 (range: 0-43) and did not differ significantly between the 2 groups. Mean proximal interphalangeal extension at the final follow-up was 9° short of full extension after CRPP and 13° short of full extension after ORIF-screws. The rates of flexion contracture and extensor lag were 15% and 41% in the CRPP group compared with 12% and 68% in the ORIF-screws group. Reoperation rates and complication rates did not differ significantly between fixation strategies. CONCLUSIONS Acceptable outcomes can be achieved after surgical fixation of long oblique extra-articular proximal phalanx fractures using both CRPP and ORIF-screws. Extensor lag may be more common after ORIF-screws.
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Faccioli N, Santi E, Foti G, Mansueto G, Corain M. Cost-effectiveness of introducing cone-beam computed tomography (CBCT) in the management of complex phalangeal fractures: economic simulation. Musculoskelet Surg 2020; 106:169-177. [PMID: 33211300 PMCID: PMC9130154 DOI: 10.1007/s12306-020-00687-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 11/02/2020] [Indexed: 11/30/2022]
Abstract
Purpose The purpose of this study was to evaluate the cost-effectiveness of introducing cone-beam computed tomography (CBCT) in the management of the complex finger fractures with articular involvement. Methods We created a decision tree model simulating the diagnostic pathway of complex finger fractures, suggesting the use of CBCT as alternative to multi-slice computed tomography (MSCT), and we compared their clinical outcomes, costs, and cost-effectiveness for a hypothetical cohort of 10,000 patients. Measures of effectiveness are analysed by using quality-adjusted life years, incremental cost-effectiveness ratio, and net monetary benefit. Results Diagnosis of a complex finger fracture performed with CBCT costed 67.33€ per patient, yielded 9.08 quality-adjusted life years, and gained an incremental cost-effectiveness ratio of 29.94€ and a net monetary benefit of 9.07 € at 30,000€ threshold. Using MSCT for diagnosis costed 106.23 €, yielded 8.18 quality-adjusted life years, and gained an incremental cost-effectiveness ratio of 371.15 € and a net monetary benefit of 8.09 €. CBCT strategy dominated the MSCT strategy. The acceptability curve shows that there is 98% probability of CBCT being the optimal strategy at 30,000€ threshold (1 EUR equal to 1.11 USD; updated on 02/02/2020). Conclusion CBCT in complex finger fractures management is cost saving compared with MSCT and may be considered a valuable imaging tool in preoperative assessment, allowing early detection and appropriate treatment. It shortens the time to completion of diagnostic work-up, reduces the number of additional diagnostic procedures, improves quality of life, and may reduce costs in a societal perspective.
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Affiliation(s)
- N Faccioli
- Department of Radiology, G.B. Rossi University Hospital, University of Verona, Piazzale L.A.Scuro 10, 37134, Verona, Italy.
| | - E Santi
- Department of Radiology, G.B. Rossi University Hospital, University of Verona, Piazzale L.A.Scuro 10, 37134, Verona, Italy
| | - G Foti
- IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - G Mansueto
- Department of Radiology, G.B. Rossi University Hospital, University of Verona, Piazzale L.A.Scuro 10, 37134, Verona, Italy
| | - M Corain
- Hand Surgery Department, G.B. Rossi University Hospital, Piazzale L.A.Scuro 10, 37134, Verona, Italy
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Lee JK, Hong IT, Cho JW, Ha C, Yu WJ, Han SH. Outcomes Following Open Reduction and Internal Fixation in Proximal Phalangeal Fracture with Rotational Malalignment. J Hand Surg Asian Pac Vol 2020; 25:219-225. [PMID: 32312198 DOI: 10.1142/s2424835520500265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: The rotational malalignment in proximal phalanx fracture is unacceptable. Authors attempted to describe clinical and radiographic outcomes as well as complications after open reduction and internal fixation with screw only or plate for phalangeal fractures accompanied by rotational malalignment. Methods: Authors conducted a retrospective review of 46 patients who had been treated between Jan. 2010 and Dec. 2016. The average follow-up period was 16.7 months. A total active motion (TAM), Disability of Arm, Shoulder and Hand score (DASH), and tip pinch power between thumb and fractured finger were measured at the final follow-up. Complications were investigated during the follow up. We assessed the amount of rotation by measuring angle between 3rd ray and fractured finger. The measurement was divided into two groups depending on rotation direction, divergent and convergent direction group. Results: Twenty-eight cases were fixed with mini LCP plate, 12 cases with lag screws, and rest 6 cases with combined. All patients showed solid bony union on radiographs on average follow-up of 68 days (range, 41-157 days). Average TAM of the injured finger was 244 degrees and average DASH score was 4.9 at the last follow-up. Tip pinch power was 3.2 kg, which was not significantly different from that of the contralateral side at 3.4 kg (p = 0.21). The preexisting rotational angle was significantly adjusted (overall, 11.1°). Depending on rotation direction, preoperative 21.7° to postoperative 12.1° in 27 patients of convergent group and preoperative -5.0° to postoperative 8.3° in 19 patients of divergent group were achieved. Conclusions: The rotation from proximal phalanx fractures could be corrected with anatomic reduction by open reduction. Our results showed that open reduction and rigid internal fixation after physical examination for acute proximal phalanx fractures accompanied by rotational malalignment could achieve good clinical results.
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Affiliation(s)
- Jun-Ku Lee
- Department of Orthopaedic Surgery, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - In-Tae Hong
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Jin Woo Cho
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Cheungsoo Ha
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Woo-Jin Yu
- Department of Orthopaedic Surgery, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Soo-Hong Han
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
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Weber DM, Seiler M, Subotic U, Kalisch M, Weil R. Buddy taping versus splint immobilization for paediatric finger fractures: a randomized controlled trial. J Hand Surg Eur Vol 2019; 44:640-647. [PMID: 30704329 DOI: 10.1177/1753193418822692] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The purpose of this single-centre randomized controlled trial was to assess the non-inferiority of buddy taping versus splint immobilization of extra-articular paediatric finger fractures. Secondary fracture displacement was the primary outcome; patient comfort, cost and range of finger motion were secondary outcomes. Ninety-nine children were randomly assigned to taping or splinting. Sixty-nine fractures were undisplaced; 31 were displaced and required reduction before taping or splinting. Secondary displacement occurred in one patient in the taping and three in the splinting group. The risk difference was below the predefined non-inferiority level of 5%. All secondary displacements occurred in the 31 displaced fractures after reduction and were in little fingers. Patient comfort was significantly higher and cost lower in the taping group. We conclude from this study the non-inferiority of buddy taping versus splint immobilization of extra-articular paediatric finger fractures in general. We advise treatment may need to be individualized for patients with displaced fractures because we cannot make any absolute conclusions for these fractures. Level of evidence: I.
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Affiliation(s)
- Daniel M Weber
- 1 Division of Hand Surgery, University Children's Hospital, Zurich, Switzerland.,2 Children's Research Center, University Children's Hospital, Zurich, Switzerland
| | - Michelle Seiler
- 2 Children's Research Center, University Children's Hospital, Zurich, Switzerland.,3 Division of Emergency Medicine, University Children's Hospital, Zurich, Switzerland
| | - Ulrike Subotic
- 1 Division of Hand Surgery, University Children's Hospital, Zurich, Switzerland.,2 Children's Research Center, University Children's Hospital, Zurich, Switzerland
| | - Markus Kalisch
- 4 Seminar for Statistics, ETH Zurich, Zurich, Switzerland
| | - Robert Weil
- 1 Division of Hand Surgery, University Children's Hospital, Zurich, Switzerland.,2 Children's Research Center, University Children's Hospital, Zurich, Switzerland
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Torabi M, Lenchik L, Beaman FD, Wessell DE, Bussell JK, Cassidy RC, Czuczman GJ, Demertzis JL, Khurana B, Klitzke A, Motamedi K, Pierce JL, Sharma A, Walker EA, Kransdorf MJ. ACR Appropriateness Criteria® Acute Hand and Wrist Trauma. J Am Coll Radiol 2019; 16:S7-S17. [DOI: 10.1016/j.jacr.2019.02.029] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 02/09/2019] [Indexed: 12/28/2022]
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Rahman AM, Montero-Lopez N, Hinds RM, Gottschalk M, Melamed E, Capo JT. Assessment of Forearm Rotational Control Using 4 Upper Extremity Immobilization Constructs. Hand (N Y) 2018; 13:202-208. [PMID: 28718329 PMCID: PMC5950959 DOI: 10.1177/1558944717691129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Forearm immobilization techniques are commonly used to manage distal radius, scaphoid, and metacarpal fractures. The purpose of our study was to compare the degree of rotational immobilization provided by a sugar-tong splint (STS), short arm cast (SAC), Munster cast (MC), and long arm cast (LAC) at the level of the distal radioulnar joint (DRUJ), carpus, and metacarpals. METHODS Seven cadaveric upper extremity specimens were mounted to a custom jig with the ulnohumeral joint fixated in 90° of flexion. Supination and pronation were unrestricted. K-wires were placed in the distal radius, scaphoid, and metacarpals using fluoroscopic guidance to measure the total arc of rotation referenced to the ulnar ex-fix pin. Baseline measurements followed by sequential immobilization with well-molded STS, SAC, MC, and LAC were obtained with 1.25, 2.5, and 3.75 ft-lb of supination and pronation force directed through the metacarpal K-wire. Each condition was tested 3 times. Digital photographs were taken perpendicular to the ulnar axis to analyze the total arc of motion. RESULTS The most effective constructs from least to greatest allowed rotational arcs were LAC, MC, SAC, and STS. Above-elbow constructs (MC, LAC) demonstrated superior immobilization compared with below-elbow constructs (SAC) ( P < .001). Circumferential constructs (SAC, MC, LAC) were superior to the noncircumferential construct (STS) ( P < .001). There were no significant differences between the MC and LAC in all conditions tested. CONCLUSIONS Both circumferential and proximally extended immobilization independently improved rotational control of the wrist. However, extending immobilization proximal to the epicondyles did not confer additional stability.
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Affiliation(s)
- Ayesha M. Rahman
- New York University Hospital for Joint Diseases, New York City, USA,Ayesha M. Rahman, NYU Hospital for Joint Diseases, 301 E. 17th Street, 14th Floor, New York, NY 10003, USA.
| | | | - Richard M. Hinds
- New York University Hospital for Joint Diseases, New York City, USA
| | | | - Eitan Melamed
- New York University Hospital for Joint Diseases, New York City, USA
| | - John T. Capo
- New York University Hospital for Joint Diseases, New York City, USA
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Carruthers KH, O'Reilly O, Skie M, Walters J, Siparsky P. Casting and Splinting Management for Hand Injuries in the In-Season Contact Sport Athlete. Sports Health 2017; 9:364-371. [PMID: 28353415 PMCID: PMC5496703 DOI: 10.1177/1941738117700133] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Context: Upper extremity injuries are extremely common in contact sports such as football, soccer, and lacrosse. The culture of competitive athletics provides an environment where hand injuries are frequently downplayed in an effort to prevent loss of game time. However, studies have shown that many sport-induced hand injuries do not actually require immediate surgical attention and can be safely treated through immobilization so that the athlete may complete the athletic season. In these cases, appropriate casting and splinting measures should be taken to ensure protection of the injured player and the other competitors without causing loss of game time. Evidence Acquisition: Articles published between 1976 and 2015 were reviewed to capture historical and current views on the treatment of hand injuries in the in-season athlete. Study Design: Clinical review. Level of Evidence: Level 5. Results: Although traditionally many sports-induced traumatic injuries to the hand held the potential to be season-ending injuries, experience has shown that in-season athletes do not necessarily need to lose game time to receive appropriate treatment. A thorough knowledge of converting everyday splints and casts into game day, sport-approved protective immobilization devices is key to safely allowing athletes with select injuries to play while injured. Conclusion: Protective techniques allow for maximum functionality during gameplay while safely and effectively protecting the injury from further trauma while bony healing takes place.
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Affiliation(s)
| | | | - Martin Skie
- Department of Orthopaedic Surgery, The University of Toledo, Toledo, Ohio
| | - John Walters
- Athletic Department, The University of Toledo, Toledo, Ohio
| | - Patrick Siparsky
- Department of Orthopaedic Surgery, The University of Toledo, Toledo, Ohio
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Abstract
PURPOSE OF REVIEW Phalangeal fractures, dislocations, and fracture-dislocations in the hand are common injuries. We review the current literature on the diagnosis and treatment of these injuries in the athlete. An understanding of the anatomy and its relationship to the mechanism of injury may help to direct appropriate management. Return to play remains an important concern to the patient-athlete. RECENT FINDINGS Findings from recently published articles reinforce previously established treatment methods in the management of finger phalangeal fractures, dislocations, and fracture-dislocations. The majority of these injuries can be treated non-operatively. Technological advances in implant designs may conceivably allow for earlier rehabilitation and, in turn, a more expeditious return to sport. Management of phalangeal injuries in the elite athlete often necessitates special treatment considerations. The majority of phalangeal bone and joint injuries in the athlete can be treated in a comparable manner to the non-athlete. The goals of treatment are restoration of bone and joint alignment and stability in order to hasten a return to competition. Surgery as a means to expedite return to play in the high-level athlete should be determined on a case by case basis. Technological improvements in surgical implants may enable accelerated postoperative recovery. However, to our knowledge, there are no published studies to definitively support this assumption.
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Robertson GAJ, Wood AM. Fractures in sport: Optimising their management and outcome. World J Orthop 2015; 6:850-63. [PMID: 26716081 PMCID: PMC4686432 DOI: 10.5312/wjo.v6.i11.850] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 09/04/2015] [Accepted: 10/01/2015] [Indexed: 02/06/2023] Open
Abstract
Fractures in sport are a specialised cohort of fracture injuries, occurring in a high functioning population, in which the goals are rapid restoration of function and return to play with the minimal symptom profile possible. While the general principles of fracture management, namely accurate fracture reduction, appropriate immobilisation and timely rehabilitation, guide the treatment of these injuries, management of fractures in athletic populations can differ significantly from those in the general population, due to the need to facilitate a rapid return to high demand activities. However, despite fractures comprising up to 10% of all of sporting injuries, dedicated research into the management and outcome of sport-related fractures is limited. In order to assess the optimal methods of treating such injuries, and so allow optimisation of their outcome, the evidence for the management of each specific sport-related fracture type requires assessment and analysis. We present and review the current evidence directing management of fractures in athletes with an aim to promote valid innovative methods and optimise the outcome of such injuries. From this, key recommendations are provided for the management of the common fracture types seen in the athlete. Six case reports are also presented to illustrate the management planning and application of sport-focussed fracture management in the clinical setting.
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