ABSTRACT
Fractures of the metacarpal and phalanges constitute 10% of all fractures. No where
in the body, the form and function are so closely related to each other than in hand.
Too often these fractures are treated as minor injuries resulting in major disabilities.
Diagnosis of skeletal injuries of the hand usually does not pose major problems if
proper clinical examination is supplemented with appropriate radiological investigations.
Proper preoperative planning, surgical intervention wherever needed at a centre with
backing of equipment and implants, selection of appropriate anaesthesia and application
of the principle of biological fixation, rigid enough to allow early mobilisation
are all very important for a good functional outcome. This article reviews the current
concepts in management of metacarpal and phalangeal fractures incorporating tips and
indications for fixation of these fractures. The advantages and disadvantages of various
approaches, anaesthesia, technique and mode of fixation have been discussed. The take-home
message is that hand fractures are equally or more worthy of expertise as major extremity
trauma are, and the final outcome depends upon the fracture personality, appropriate
and timely intervention followed by proper rehabilitation. Hand being the third eye
of the body, when injured it needs a multidisciplinary approach from the beginning.
Though the surgeon's work appears to be of paramount importance in the early phase,
the contribution from anaesthetist, physiotherapist, occupational therapist, orthotist
and above all a highly motivated patient cannot be overemphasised.
KEY WORDS
Skeletal hand trauma - metacarpal fractures - phalangeal fractures
