Journal of hand therapy : official journal of the American Society of Hand Therapists
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Review
Fracture healing: bone healing, fracture management, and current concepts related to the hand.
Bones fracture frequently and often result in significant impairments, functional limitations, and disabilities, especially when the hand is involved. When fractures occur, there is a disruption of the skeletal tissue organization and a loss of mechanical integrity. ⋯ This article briefly reviews the history of fracture healing and the advances in mechanics and cellular and molecular biology, which should help the reader better understand the current mechanisms related to bone healing (primarily and secondarily). Fracture fixation modes also are described along with the temporal sequencing as to when to protect or move the fractured region.
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This article addresses current approaches for the rehabilitation of distal phalanx and middle phalanx fractures, excluding proximal interphalangeal joint avulsion fractures. Emphasis is placed on establishing the optimal rehabilitation program based on an understanding of the type and location of the fracture, method of fracture management, fracture stability, fracture healing, complications from soft tissue injuries, and recognizing and preventing common problems associated with fractures. Patient case examples and results reported in the literature are included.
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Proximal interphalangeal joint (PIP) injuries are among the most common in the hand and their severity is often underestimated. These injuries often lead to prolonged disability, pain, and stiffness. ⋯ Such an approach should lead to a rational treatment plan that focuses on the rehabilitation of all damaged components, including osseous, articular, and soft tissue structures. This article reviews all elements in the management of PIP injuries and introduces an assessment method for PIP injuries based on the mechanism of injury rather than primarily on the basis of radiographic findings.