Injury to the heel of the hand

Der Unfallchirurg
C Voigt

Abstract

A fall onto the hand can be followed by ligament ruptures, bone fractures or dislocated fractures of the carpus. The diagnosis is based on history, clinical evaluation, and X-ray examination in two perpendicular planes, followed if necessary by CT scan or MRI scan. Lesions of the scapholunate ligaments cannot be definitely excluded except by arthroscopy. As well as fractures of the carpometacarpal joints, fractures involving the ring structure of the carpus or ligament ruptures between carpal bones are frequently observed, and these lead to significantly impaired biomechanics. The prognosis is poor. The discontinuity of the ring must be repaired by means of osteosynthesis and/or suturing ligaments, with the carpal bones held in place by temporary arthrodesis using K-wires. Dislocation in this region requires rapid realignment, as untreated perilunate dislocation or dislocation of the lunate bone will lead to serious secondary damage, which can only be treated by salvage operations involving loss of function. Inappropriate treatment of an injury to the heel of the hand can lead to carpal collapse.

References

Sep 1, 1981·The Journal of Hand Surgery·D M LichtmanG R Mack
Apr 16, 1998·Der Orthopäde·S Pechlaner, H Hussl
Jun 20, 2002·Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der Peripheren Nerven und Gefässe : Organ der Vereinigung der Deut·H Piza-KatzerR Margreiter
Aug 7, 2002·The Journal of Hand Surgery : Journal of the British Society for Surgery of the Hand·H Piza-KatzerH Hussl

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Citations

Feb 19, 2011·Der Unfallchirurg·S FreitagC Josten
Jun 19, 2012·Der Unfallchirurg·S Löw, D Herold
Jun 6, 2012·International Journal of Endocrinology·Krystyna Sztefko, Patrycja Szybowska

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