Manual of Fracture Management - Hand by Jesse B Jupiter Fiesky Nuñez Renato Fricker

Author:Jesse B Jupiter, Fiesky Nuñez, Renato Fricker
Language: eng
Format: azw3
Publisher: Thieme
Published: 2015-12-16T05:00:00+00:00

5 Reduction

Inspect the joint

Fig 3.2-17 Hyperextend the middle phalanx to gain maximal vision of the joint. Use a syringe to clean out blood clots with a jet of Ringer lactate. Assess fracture geometry, look for multifragmentation or impaction, which would contraindicate the use of a lag screw, and determine the ideal position for the gliding hole (perpendicular to the fracture plane and in the center of the fragment). Often, multifragmentation is not apparent from the x-rays, and can only be detected under direct vision. Also check for additional cartilage damage at the head of the proximal phalanx.

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