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performing this technique, the surgeon should be careful not to laterally translate the metacarpal head. Numerous other techniques for pinning have been advocated (Table 41-1).

Rarely, open reduction through a dorsal extensor splitting approach is necessary. Although pin fixation as described previously can be employed for fixation, a dorsal tension band wire loop also works well and avoids the potential problems associated with exposed pins. Alternatively, some authors advocate the use of a laterally placed minicondylar plate.

After any surgical stabilization, a Pl-blocking plaster or Orthoplast splint is employed to protect the fixation. Active PIP and distal interphalangeal (DIP) range-of-motion exercises of the injured finger to full composite flexion of adjacent digits are begun immediately postoperatively. Residual MP stiffness is treated with active, passive, and dynamic modalities 6 weeks after surgery.

Delayed presentation of an open boxer's fracture is a contraindication to internal fixation. All wounds over a metacarpal neck fracture should be considered a human bite until proven otherwise. If the status of the wound is questionable, delay fixation until the soft tissue envelope has healed.

Essentials of Human Physiology

Essentials of Human Physiology

This ebook provides an introductory explanation of the workings of the human body, with an effort to draw connections between the body systems and explain their interdependencies. A framework for the book is homeostasis and how the body maintains balance within each system. This is intended as a first introduction to physiology for a college-level course.

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