Our Summary

This research paper looks at how the COVID-19 pandemic affected the treatment of hand fractures. The researchers examined the cases of 82 patients who had hand fractures during the lockdown period from March to May 2020. Two experienced hand surgeons, who didn’t know how the cases were actually managed, independently looked at the X-rays and other relevant medical history to give their opinion on the best treatment.

Most of these fractures happened at home, either due to accidents or falls. The fractures were either in the metacarpals (the long bones in the hand) or the distal phalanx (the bone at the tip of the finger). Some patients had surgery, while others were treated non-surgically.

The study found a moderate agreement between what the surgeons thought was the best treatment and what was actually done. However, when it came to metacarpal fractures, there was less agreement. The two surgeons mostly agreed on the best treatment for metacarpal fractures, but not as much for distal phalanx fractures.

In simple terms, this study is saying that, overall, hand fractures were treated appropriately during the pandemic. However, there was some disagreement about how to best treat fractures in the long bones of the hand.

FAQs

  1. How has the COVID-19 pandemic affected the treatment of hand fractures?
  2. Were there any disagreements between the surgeons’ opinions and the actual treatment given to patients with metacarpal fractures?
  3. Were hand fractures treated appropriately during the COVID-19 pandemic according to the study?

Doctor’s Tip

One helpful tip a doctor might tell a patient about hand surgery is to follow post-operative instructions carefully, including keeping the hand elevated, wearing a splint or cast as directed, and doing any prescribed exercises to aid in recovery and prevent stiffness. It is important to attend follow-up appointments and communicate any concerns or changes in symptoms to your healthcare provider. By following these instructions, you can help ensure a successful outcome from hand surgery.

Suitable For

Patients who are typically recommended for hand surgery include those with:

  1. Fractures that are displaced or unstable, meaning the bones are not aligned properly or are at risk of shifting further.

  2. Open fractures, where the bone has broken through the skin, increasing the risk of infection.

  3. Intra-articular fractures, where the fracture extends into a joint, affecting movement and function.

  4. Non-union fractures, where a fracture has not healed properly on its own.

  5. Malunited fractures, where a fracture has healed in an incorrect position, leading to deformity or functional impairment.

  6. Soft tissue injuries, such as tendon or ligament damage, that may require surgical repair.

  7. Chronic conditions, such as arthritis or carpal tunnel syndrome, that may benefit from surgical intervention to improve symptoms and function.

Overall, hand surgery may be recommended for patients who have injuries or conditions that are impacting their hand function, causing pain, or affecting their quality of life. It is important for patients to discuss their treatment options with a hand surgeon to determine the best course of action for their individual case.

Timeline

Here is a brief timeline of what a patient may experience before and after hand surgery for a fracture:

Before hand surgery:

  1. Patient experiences a hand injury, such as a fracture, due to an accident or fall.
  2. Patient seeks medical attention and undergoes imaging tests, such as X-rays, to diagnose the extent of the injury.
  3. Orthopedic surgeon assesses the injury and recommends the best course of treatment, which may include surgery or non-surgical methods.
  4. Patient undergoes pre-operative evaluations and tests to ensure they are fit for surgery.
  5. Surgical date is scheduled and patient receives pre-operative instructions.

After hand surgery:

  1. Patient undergoes hand surgery to repair the fracture, which may involve the use of screws, plates, or other fixation devices.
  2. Patient is monitored in the recovery room before being discharged home or to a hospital room.
  3. Patient follows post-operative instructions, which may include wearing a splint or cast, taking pain medication, and attending physical therapy.
  4. Patient attends follow-up appointments with the surgeon to monitor healing and progress.
  5. Patient gradually resumes normal activities and may undergo additional therapy to regain strength and function in the hand.

Overall, the timeline for a patient before and after hand surgery for a fracture involves initial injury, diagnosis, treatment decision, surgery, recovery, and rehabilitation to regain hand function.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hand surgery include:

  1. What type of hand fracture do I have and what are my treatment options?
  2. How soon do I need to have surgery and what are the potential risks and benefits?
  3. What is the expected recovery time and rehabilitation process after hand surgery?
  4. Will I need physical therapy or occupational therapy after surgery?
  5. How will hand surgery affect my daily activities and ability to use my hand?
  6. What are the potential complications or long-term effects of hand surgery?
  7. Are there any alternative treatments or non-surgical options for my hand fracture?
  8. How experienced are you in performing hand surgery and what is your success rate?
  9. Can you provide me with information on post-operative care and what to expect during the healing process?
  10. Are there any specific precautions or restrictions I should follow after hand surgery to prevent further injury?

Reference

Authors: Rojoa DM, Raheman FJ, Irvine E, Sharma V, Macdonald CR, Cutler L. Journal: J Hand Surg Asian Pac Vol. 2022 Apr;27(2):261-266. doi: 10.1142/S2424835522500394. Epub 2022 Mar 31. PMID: 35404204