Fracture

Types of Fractures

Fracture distal radius

earlier known as Colles fracture is a fracture of the distal inch of the radius bone. It is one of the commonest injuries. It may follow a trivial fall or on other occasions, it may be after a high-velocity injury.

symptom

Symptoms

There will be deformity of the wrist, pain, swelling, and movement of the wrist are painful.

loupe 1

Investigation

X-Rays of the wrist and the forearm are obtained. After assessing the X-Rays, the extent of the deformity is assessed. At times, CT Scan or MRI Scan are required.

Fracture-Distal-radius
Based on the extent of the deformity, the age of the patient and other associated injuries or diseases, the treatment options can be
Plaster cast as a modality of treatment

Plaster cast as a modality of treatment

Plating as a modality of treatment

Plating as a modality of treatment

Kirschner wire as a modality of treatment

Kirschner wire as a modality of treatment

Fracture dislocation of proximal interphalangeal joint

In a cricket-playing country like India, fracture-dislocation is a common injury.

symptom

Diagnosis

An x-ray reveals a loss of alignment of the bones. Interpreting the x-ray properly helps to avoid missing the diagnosis. At times, the report accompanying the x-ray film may be erroneous and delays establishing the correct diagnosis. A good quality x-ray image with the appropriate position of the finger and magnification will show loss of concentric bones.Once the loss of alignment is established, the next step, is to assess the extent of joint affection and whether the fracture has resulted in gross multiple pieces (comminution).

Treatment

Several methods of treatment are available The common methods of treatment include

Close reduction

Close reduction and internal fixation with one or more wires

External fixation in the form of Suzuki frame or its variants

Hemi hamate interposition arthroplasty

Volar plate interposition

Scaphoid fracture

In a cricket-playing country like India, fracture-dislocation is a common injury.

symptom

Symptoms

Following a fall on the outstretched hand, the person will develop a swelling, though insignificant, at the base of the thumb over the wrist. Pain may often not be much. The insignificant swelling and pain may be presumed to be a sprain and but is not so and should not be neglected.

symptom

Signs

There will be tenderness in the snuff box. There may be tenderness over the front of the wrist, what is called a scaphoid tubercle.

symptom

Investigation

X-rays with special views are needed to confirm the diagnosis.At times CT scan and MRI are needed

Fracture-Scaphoid

Treatment

The fracture which are undisplaced can be treated with a plaster cast.
At times one may need open surgery and fixation with screws or wires. If the fracture is displaced, shattered, delayed diagnosis, or involves other joints, it requires surgical intervention. Proximal pole fracture is an entity which requires early intervention and surgery

Fracture img7
*Figure…Kirschner wire holding a very tiny proximal pole.
Fracture img8
*Figure… Screw fixation of fracture scaphoid.
Non union The bone is notorious for not uniting. This requires bone grafting and fixation with screw or wires.

Fracture Hamate

not a very common fracture. The bone has rotated by 180 degrees. By open reduction, the fractures were brought back into alignment and fixed with wires. The wires were removed after a few weeks.

After Surgery
Before Surgery

Fracture Hook of Hamate

is not a very common condition. The patient presents with pain in a small focal area on the palmar aspect of the hand, just distal to the wrist crease but in line with the ring finger. X-ray called carpal tunnel view may at times pick up the fracture. If this does not help, one may require a CT scan to diagnose the fracture. The fracture may irritate the ulnar nerve(Ulnar nerve neuropathy) and cause tingling in the small finger. The fracture may require surgery.

Either fixation or excision of part of the bone (HAMATE) alleviates the symptoms. When the skin is lost due to trauma or any other reason and the bone or tendon are exposed or the wound is deep with require a skin cover which has a blood supply. An island of skin which has its own blood supply is called a flap

There is pain in the center of the wrist at the level of wrist joint. In this picture, the broken piece of bone called the Hook of the Hamate is dissected out.
hookHamateFracture1
hookHamateFracture2
Bennett-Fracture

Bennett Fracture

A fracture of the first meta carpal resulting in a single piece of bone extending into the joint is called Bennett’s fracture. They usually require a surgery to restore the alignment.

Case Study

Before & After Surgery,
the kirschner wires are holding the fracture in good alignment.

After Surgery
Before Surgery

Finger Fracture

The child sustained fracture to his fingers. The fractures were brought back to their alignment.

Case Study

After Surgery
Before Surgery

A fracture of the fifth metacarpal as depicted here is called a Boxer’s fracture. It occurs following hitting a hard object. The treatment varies from a plaster support to surgical restoration depending on the extent of the deformity.

Perilunate-Dislocation

Trans Scaphoid Perilunate Dislocation

This patient had a massive fall leading to a terrible wrist injury. X-rays showed a trans scaphoid perilunate injury.

This consisted of a fracture of the scaphoid bone and tear of multiple ligaments.
He visited several hospitals and ended up loosing some precious months! We opted to create a new joint by a salvage procedure called proximal row carpectomy, this gave him a painless mobile wrist.

Case Study

After Surgery
Before Surgery

Open Finger Fracture

This young man sustained a open fracture of the finger. There was a large wound in the front of the finger.

We converted contaminated wound into a clean wound. Primary fixation of the fracture was done with fixation device. Our fixation method allows early finger movements with immediate wound closure, the gentleman made a full recovery.

fingerfracturefixation_1280

Case Study

After Surgery
Before Surgery
Scroll to Top