- Training
- 12/05/2020
- USA
Metacarpal Fracture: Fellowship Virtual Debate Series
Description
This presentation begins with Dr. Jeff Greenberg introducing the topic of metacarpal fractures through the examination of two patient cases. The first case involves a 17-year-old male who suffered a closed small finger metacarpal fracture while playing hockey, demonstrating typical symptoms such as tenderness, deformity, and loss of extension. The second case discusses a 50-year-old female who was admitted after a high-speed motor vehicle accident, showcasing multiple metacarpal fractures and requiring urgent surgical intervention.
Dr. Daniel Hess follows, discussing metacarpal plating, addressing the complexity and common occurrence of these fractures, especially among the ulnar digits, and emphasizing the importance of proper fixation to avoid complications such as loss of motion due to shortening or malrotation. He advocates for the stable fixation provided by plating as critical for patients aiming to return quickly to work or sports. He also highlights advancements in plating techniques that reduce complication rates, particularly concerning extensor tendon irritation.
In contrast, Dr. Peter Wilton argues for the use of intramedullary (IM) k-wires, positing them as a cost-effective and less complex alternative to plating. He emphasizes the ease of k-wire placement, minimal soft tissue disruption, and ability to achieve good outcomes with lower complication rates. He references a specific case of a young motocross rider who benefitted from k-wire fixation after failed previous surgeries.
Dr. Jed Maslow rounds out the discussion, asserting the various options available for treating metacarpal fractures. Each presenter highlights their surgical techniques and rationale, contributing to a comprehensive overview of current best practices in managing metacarpal fractures. The session closes with personal opinions from the presenters, supporting the need for a nuanced approach based on fracture type and patient circumstances.
Part of: Surgical Techniques and Training Collection
"Metacarpal Fracture: Fellowship Virtual Debate Series" is included in the following Surgical Techniques and Training playlist: