Our Summary

This research paper talks about a surgical technique known as dual construct fixation, which is becoming more common for treating complex fractures near joints or prosthetics, particularly in cases where the bone quality is poor or in revision surgeries. The researchers discuss the use of this technique in the case of a specific type of wrist fracture (known as distal pole scaphoid fracture, which is near the joint). They also take a look at what other studies have said about this technique and offer some suggestions on how it could be used in the future. The evidence provided in this paper is at Level V, which means it’s based on expert opinion and case reports.

FAQs

  1. What is dual construct fixation and when is it used?
  2. What is a juxta-articular distal pole scaphoid fracture?
  3. What are some recommendations for the future use of a screw-plate construct in hand surgery?

Doctor’s Tip

A doctor might advise a patient undergoing hand surgery to follow post-operative care instructions carefully, including keeping the hand elevated and immobile as much as possible to promote healing and prevent complications. Additionally, they may recommend physical therapy exercises to help regain strength and mobility in the hand after surgery.

Suitable For

Patients who may be recommended for hand surgery include those with:

  • Fractures of the hand or fingers
  • Carpal tunnel syndrome
  • Arthritis affecting the hand joints
  • Tendon injuries or ruptures
  • Nerve injuries or compression
  • Congenital hand deformities
  • Infections requiring surgical intervention
  • Tumors or cysts in the hand or wrist

It is important for patients to consult with a hand surgeon to determine the most appropriate course of treatment for their specific condition.

Timeline

Before hand surgery:

  • Patient experiences pain, swelling, and limited range of motion in the hand
  • Patient consults with a hand surgeon who performs a physical examination and orders imaging tests to diagnose the issue
  • Treatment options are discussed, including the possibility of surgery
  • Pre-operative preparations are made, including obtaining medical clearance, discussing anesthesia options, and planning for post-operative care

After hand surgery:

  • Patient undergoes the surgical procedure, which in this case involved the use of a screw-plate construct for a juxta-articular distal pole scaphoid fracture
  • Patient is monitored in the recovery room before being discharged home or to a hospital room for further observation
  • Patient follows a rehabilitation plan, which may include physical therapy and hand exercises to improve strength and range of motion
  • Patient attends follow-up appointments with the hand surgeon to monitor healing and make any necessary adjustments to the treatment plan
  • Patient gradually returns to normal activities, with the goal of regaining full function and mobility in the hand.

What to Ask Your Doctor

  1. What is the specific type of hand surgery recommended for my condition?
  2. What are the potential risks and complications associated with the surgery?
  3. How long is the recovery process expected to be and what can I expect in terms of pain and discomfort?
  4. Will physical therapy be necessary after the surgery and if so, for how long?
  5. What are the potential long-term outcomes of the surgery and how likely is it to be successful?
  6. Are there any alternative treatment options available for my condition?
  7. How many times have you performed this type of surgery and what is your success rate?
  8. Will I need to take time off work or make any lifestyle adjustments during the recovery period?
  9. What can I do to help ensure a successful outcome from the surgery?
  10. Are there any specific precautions or restrictions I should be aware of following the surgery?

Reference

Authors: Sivakumar BS, Lawson RD, An VVG, Ledgard JP. Journal: J Hand Surg Asian Pac Vol. 2023 Oct;28(5):587-589. doi: 10.1142/S2424835523710091. Epub 2023 Oct 27. PMID: 37905366