Name of the Procedure:

Open Treatment of Metacarpal Fracture, Single, Including Internal Fixation

Summary

An open treatment of a metacarpal fracture involves surgically exposing the fractured bone of the hand and stabilizing it with internal fixation (e.g., plates, screws). This procedure is employed to ensure proper alignment and healing when the bone is broken.

Purpose

The procedure addresses fractures of the metacarpal bones in the hand. The goal is to realign and stabilize the bone to promote proper healing, restore functionality, and prevent future complications.

Indications

• Visible deformity of the hand due to a fracture.
• Severe pain or inability to move the affected finger.
• Fractures that are displaced or cannot be aligned with closed treatment methods.
• Multiple fractures in the same hand.
• Non-healing fractures.

Preparation

• Fasting for a certain period before surgery, typically 6-8 hours.
• Adjustments or temporary discontinuation of certain medications, such as blood thinners.
• Preoperative imaging studies like X-rays for surgical planning.
• Blood tests and a general physical examination to ensure fitness for surgery.

Procedure Description

1. The patient is administered anesthesia (general or regional).
2. An incision is made over the fractured metacarpal bone.
3. The bone fragments are realigned properly.
4. Internal fixation devices (like screws or plates) are used to hold the bone in place.
5. The incision is closed with sutures, and a sterile dressing is applied.
6. The hand is often immobilized with a splint or cast postoperatively.

Duration

The procedure typically takes about 1 to 2 hours, depending on the complexity of the fracture.

Setting

Performed in a hospital operating room or a specialized surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist or nurse anesthetist
• Operating room nurses and surgical technicians

Risks and Complications

• Infection at the incision site
• Bleeding or hematoma formation
• Nerve or blood vessel damage
• Non-union or delayed union of the fracture
• Allergic reactions to anesthesia
• Hardware-related complications, such as loosening or irritation

Benefits

• Proper alignment and stabilization of the bone for optimal healing
• Restoration of hand function and strength
• Prevention of long-term complications like malunion or chronic pain
• Generally, benefits are realized within a few weeks, with pain relief and improved function becoming noticeable.

Recovery

• Keep the hand elevated to reduce swelling.
• Follow the specific instructions regarding wound care and activity restrictions.
• Attend follow-up appointments for monitoring and removal of sutures or cast.
• Physical therapy may be recommended to restore hand strength and flexibility.
• Full recovery usually takes several weeks to a few months.

Alternatives

• Non-surgical treatments like closed reduction and casting, which may be less effective for severe or displaced fractures.
• External fixation, which is less invasive but may not provide as stable a result.
• Each alternative has its own risks and benefits that should be discussed with a healthcare provider.

Patient Experience

• During the procedure, the patient will be under anesthesia and should not feel pain.
• Postoperatively, there can be pain and swelling managed by prescribed medications.
• Some discomfort and limited hand function initially, progressing to improved comfort and mobility as healing occurs.