Hand and foot trauma

Navicular bone fracture

It usually occurs in fall on a palm in bearing position or a fist. The pain develops in radiocarpal joint in axial load on 1 – 3 carpal bones and in squeezing of hand into fist. Is immobilized with a circular splint and abducted toe. Knitting lasts 1,5 – 2, sometimes 5 months in average. Long lasting knitting and nonunions are connected with the loss of blood supply by one of fragments due to one-sided blood circulation of navicular bone. In irreparable dislocation and nonunions osteosynthesis with screws is performed.

Metacrpal bones fractures

I metacarpal bone is usually broken at its basis (Bennet’s fracture). The stroke on abducted pollex is a mechanism of traumatizing in this case. In absence of any dislocations circular plaster bandage with abducted pollex is applied. In fractures accompanying with dislocations – closed reposition and fixation with a bandage or pins is carried out. In case if closed reposition is impossible due to different conditions, opened osteosynthesis is performed. Among metacarpal bones fractures the fracture of V metacarpal bone head is the most widespread. It occurs in young individuals mainly in falling on the fist or strokes. Immobilization duration is limited in connection with a threat of metacarpophalangeal articulations contractures formation. Fixation with pins or G-like microplate is performed in secondary dislocation or fragments fixation impossibility.

Damages of tendons

Function of the whole finger is lost in tendon damage. Together with muscles tendons provide fingers’ phalanx motor activity and, therefore, need complete restoration. In case of total damage suture of a tendon with an inner suture with the next immobilization is used; in partial damage the only immobilization is carried out. Plastics may be performed in defects or old damages. Extensor tendons broken on the level of mid or nail palanx don’t have remarkable divergences. These traumas may be treated conservatively under US control of a distance between the edges. In case of damage of a hand combining with tissues defects graded restoration of skin and bones first and tendons after is used.

Heel bone and ankle bone fractures

These two bones are usually broken in falls from the height. This trauma is characterized by marked pain syndrome, especially in case of load. The wholeness of joint’s surface and preservation of foot arch is first-priority in reposition. Immobilization in conservative treatment lasts for 4 – 6 weeks, the loads start 7 – 8 after. Relative to a square of joint surfaces of sole’s bones they have quite a huge load. In fragmental fractures with joint surface dislocation an operative treatment – opened reposition and osteosynthesis with plates and screws is performed.

Metatarsal bones fractures

Mechanism of traumatizing in this kind of damage is a fall of hard objects or a sole running-down with a wheel. Spraining of an ankle causes fracture of V or sometimes IV metatarsal bones. Fracture of V metatarsal bone basis is called Jonson’s fracture. Metatarsal subcapital fractures often lead in violations of load spread in the sole. In axis or metatarsal bones length damage osteosynthesis with either pins, microplates or microscrews is performed.