Transcript Distal radius fractures

FINGER FRACTURES
What happened??
 One of the bones in your
finger has been broken, see
the bones of the hand and
fingers to the left.
 Following trauma or
significant force, the bones
may have a nice even break
or may have broken in a
more complicated fashion.
 Source: www.nwoa.com
Different types of finger fractures
 X-ray interpretation
helps guide treatment
 Things to assess:
Location of fracture
Does the break cross into
joint surface
Is the bone still aligned or
not
Picture sourced from:
www.summitmedicalgroup.com
Treatment options
 Regardless of how treated,
most of these fractures
take approximately 6-8
weeks for the bone to heal
 If the bone is still wellaligned and appears
stable, protection and
immobilization in a splint or
a cast is a good option
 At times, the finger is
anesthetized in the office
and the bone is realigned
and casted.
Stax splint 
Hard Cast,
seen below
www.mokast.com
Surgical treatment
 Surgical fixation is necessary
when the bone is significantly
displaced and alignment is off
 Sometimes we can use pins to
keep your fracture in place,
other times, it requires a metal
plate
 Your specific injury will determine
the type of fixation required
 Your surgery can either be done
under local anesthetic or with
your arm made numb with
regional anesthesia
Images from: www.idsportsmed.com
Post-op
 After surgery you will be placed in a soft
dressing that has hard cast material
protecting the finger. Take care to keep this
clean and dry.
 The surgical dressings will be removed at
your post-op visit with Dr. Foad 3-5 days after
surgery. At that time you will use a
removable splint for protection. You may
remove this for bathing and to begin gentle
range of motion.
 Sometimes, we use pins that stay in place for
approximately four weeks and are removed
in the office.
FINGER FRACTURE
POST-SURGICAL FAQ’S
When do I see Dr. Foad after surgery?
You will return to see Dr. Foad for your post-op visit about 3-5
days after surgery.
When can I use my hand?
When you leave the operating room, you will be placed in a
dressing with a splint. You should still be able to move most of
the unaffected fingers, although the broken finger (and maybe
the adjacent fingers) will be immobilized. You should keep
your post-surgical dressing in place until you see Dr. Foad at
your follow up visit. Try not to get your splint wet.
Why is my hand numb?
The anesthetic that is used during the procedure often leaves
some or all of the fingers in your hand numb for many hours.
This may last well into the night of your surgery. The
numbness from the anesthetic usually wears off by the
following morning, but it may last a little longer into the next
day. This varies greatly from patient to patient, and may also
be affected by your age. When you feel the first signs of your
anesthetic wearing off, you may want to start taking your pain
medication to make you feel more comfortable.
How do I care for my dressings?
You will have a soft dressing over your incision and then a
hard splint protecting your finger after surgery. This should
not get wet. This protective splint will be removed at your first
post-operative visit with Dr. Foad.
When may I shower or bathe?
You may begin to shower or bathe as soon as you like,
however, if you are still in your protective splint after surgery,
please do not get this wet. You may place a bag over your
splint or get in the bathtub instead of shower to help prevent
your splint from getting wet. After we have removed your
hard splint and your original dressings over your incision at
your first post-operative visit, you may bathe normally and get
your incision wet in the shower. Do not submerge the incision
underwater for an extended period of time, such as in a pool or
hot-tub. Dry your incision well after it is cleaned.
When do the stitches come out?
We will generally remove stitches approximately 10-14 days
after your surgery, in the office.
What are these pins sticking out of my finger?
Some finger fractures require pinning to keep the bone(s) in
place. If you have pins, they will be covered by your
protective splint after surgery. Once the splint and dressings
are removed at your post-op visit , a cast or custom splint will
be applied and we will teach you how to care for the pin sites.
What if my pain medication causes itching or
nausea?
It is not uncommon for pain medications to cause these two
side effects. If you experience itching you may take Claritin or
Benadryl to help with this. This may add an additional
sedative effect. If you are experiencing nausea, a prescription
for Phenergan (aka promethazine) was prescribed for this
purpose on the day of your procedure. Remember to take your
pain medication with food to diminish the potential for nausea.
Remember, do not drive while taking medications that may
sedate you while driving!
What about swelling?
Swelling is quite common following these procedures. Do
your best to keep the arm elevated above the level of your
heart. Moving the fingers to open and close into a tight fist is
also encouraged. Taking ibuprofen (Advil, Motrin) in addition
to your pain medication will help with swelling (note: do NOT
take more acetaminophen/Tylenol as it is already a component
in the prescriptions you were given).
When may I drive?
You may begin driving again when you feel comfortable
behind the wheel AND you are no longer taking any of the
narcotic pain medications. If you would feel comfortable
driving next to yourself on the road, it is probably safe for you
return to this activity.
When can I go back to work?
It depends on the type of work you do. Those with jobs that
are more sedentary and do not require heavy loads on the
hands are often able to start returning to their duties sooner
rather than later, however fine motor skills such as typing and
writing may be difficult to perform. Jobs that involve
extensive heavy lifting and strain on the hands may take more
time to be able to return to work functions more normally.
This is something quite unique to every patient’s situation and
can be discussed more specifically with Dr. Foad at your office
visit.