Are We Over Treating Hand Fractures? Current Practice of Single Metacarpal Fractures.

Autor:	Retrouvey H; Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.; Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada., Morzycki A; Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada., Wang AMQ; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada., Binhammer P; Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	Plastic surgery (Oakville, Ont.) [Plast Surg (Oakv)] 2018 Aug; Vol. 26 (3), pp. 148-153. Date of Electronic Publication: 2018 Apr 24.
DOI:	10.1177/2292550318767926
Abstrakt:	Purpose: We conducted a national survey of Canadian plastic surgeons to assess if inconsistencies in management strategies exist for single metacarpal fractures. Methods: A cross-sectional study of Canadian plastic surgeons who perform hand surgeries was conducted. A 15-question survey was distributed to all members of the Canadian Society of Plastic Surgeons. Participants' demographics, practice settings, and current treatment strategies for patients presenting with single metacarpal fractures were evaluated. Results: A total of 113 Canadian plastic surgeons met inclusion criteria. The majority of respondents were male (76%), with 50% in practice for more than 15 years. Canadian surgeons used a wide variety of surgical techniques for the management of single metacarpal fractures, with close reduction (94%), Kirshner wires (94%), and splinting and immobilization (89%) being the most common. The majority of plastic surgeons stated that rotational deformity (81%) was the most important indication for surgery. Surgeons demonstrated a trend toward immobilization after splinting (48%), instead of early mobilization after splinting (21%). When results were stratified by years in practice, no differences in surgical and non-surgical management were found, although surgeons in practice for less than 15 years were more likely to suggest hand therapy. Conclusion: These findings demonstrate inconsistencies in management of single metacarpal fractures among Canadian plastic surgeons. Surprisingly, surgeons in the survey tended to favor immobilization, as oppose to the literature that favors mobilization. The study highlights the lack of clear guidelines dictating treatment, possibly leading to these inconsistencies. Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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