Wide-Awake Surgical Management of Hand Fractures: Technical Pearls and Advanced Rehabilitation
| Autor: | Peter Charles Rhee, Brad T. Hyatt |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Percutaneous Time Factors Epinephrine medicine.drug_class medicine.medical_treatment 030230 surgery Anesthesia General 03 medical and health sciences Fixation (surgical) Finger Phalanges Fracture Fixation Internal Fractures Bone Necrosis 0302 clinical medicine Fracture fixation medicine Humans Vasoconstrictor Agents Local anesthesia Anesthetics Local Range of Motion Articular Fracture Healing Tourniquet Rehabilitation Local anesthetic business.industry Hand Injuries Metacarpal Bones Surgery Treatment Outcome 030220 oncology & carcinogenesis Postoperative Nausea and Vomiting Analgesia Patient Participation Range of motion business Anesthesia Local Bone Wires |
| Zdroj: | Plastic and reconstructive surgery. 143(3) |
| ISSN: | 1529-4242 |
| Popis: | Most unstable metacarpal and phalangeal fractures for which operative treatment is indicated can be reduced and stabilized with either open or closed techniques using local anesthetic with epinephrine instead of intravenous sedation or general anesthesia. With the patient wide-awake during surgery, the hand can be taken through active range of motion to assess fracture stability. In this article, the authors review the rationale and technique for wide-awake, local anesthesia, no tourniquet surgery in the treatment of phalangeal and metacarpal fractures and impart pearls to optimize the patient experience and illustrate common fixation techniques using percutaneous Kirschner wires. The intraoperative assessment of fracture stability permits an accelerated, protected-range-of-motion protocol that minimizes postoperative stiffness and facilitates expedient recovery. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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