Name of the Procedure:

Percutaneous Skeletal Fixation of Metacarpal Fracture, Each Bone (PSFMF)

Summary

The procedure involves fixing broken bones in the hand (metacarpals) using minimally invasive techniques. Thin metal wires or pins are inserted through the skin to stabilize the bones, which helps them heal properly.

Purpose

The procedure is used to treat broken bones in the hand (metacarpal fractures). The goal is to stabilize the bones, allowing them to heal in the correct position and restoring function to the hand.

Indications

• Severe metacarpal fractures that cannot be treated with a cast alone.
• Misaligned fractures or fractures with bone fragments.
• Patients with poor healing ability who need surgical intervention for proper bone healing.

Preparation

• The patient may be asked to fast for several hours before the procedure.
• Blood tests and imaging studies (e.g., X-rays, CT scans) are often required to assess the extent of the fracture.
• Medications may need to be adjusted as per the medical team's recommendations.

Procedure Description

1. The patient is given either local or general anesthesia to ensure comfort.
2. The surgeon cleans the hand and inserts thin metal wires or pins through the skin and into the broken bones.
3. The wires/pins are precisely positioned to hold the bone fragments in place.
4. An X-ray may be taken during the procedure to confirm proper placement.
5. Once the bones are stabilized, the wires/pins are left in place until the bones heal.

Duration

The procedure typically takes about 30-60 minutes, depending on the complexity of the fracture.

Setting

The procedure is performed in a hospital operating room or outpatient surgical center.

Personnel

• Orthopedic surgeon
• Surgical nurse
• Anesthesiologist

Risks and Complications

• Infection at the site of insertion
• Damage to surrounding nerves or blood vessels
• Pins/wires may migrate or become loose
• Potential for allergic reaction to anesthesia

Benefits

• Proper alignment and stabilization of metacarpal fractures.
• Faster and more complete healing compared to non-surgical methods.
• Restoration of hand function and strength.

Recovery

• Patients may need to keep the hand elevated and clean to prevent infection.
• Initial pain may be managed with prescribed pain medications.
• Follow-up appointments are necessary to monitor healing and pin/wire positions.
• Typically, the wires/pins are removed after 4-6 weeks once the bone has healed.

Alternatives

• Non-surgical treatment with a cast or splint.
• Open reduction and internal fixation with plates and screws.
• Pros of non-surgical methods include avoiding surgical risks, but may not adequately stabilize the fracture.
• Cons of alternative surgical methods include longer recovery times.

Patient Experience

• Mild to moderate discomfort during recovery, manageable with pain medication.
• Some patients may feel the wires/pins under the skin, but this is generally not painful.
• Practical measures like hand elevation and limited movement help manage swelling and facilitate healing.