title: Skin necrosis complicating functional bracing.
abstract: We report a complication associated with functional bracing of a metacarpal shaft fracture that required operative intervention. A 30-year-old man with a closed, dorsally angulated, metacarpal shaft fracture of the right ring finger was treated with a functional brace. During brace immobilization, the patient developed full-thickness skin necrosis on the dorsum of the right hand. The patient underwent surgical debridement of the ulcerated area and fracture stabilization with an intramedullary Kirschner wire. Patients treated with a metacarpal brace should be instructed to release the strap every 5 to 6 hours for a short period to allow restoration of blood flow to the potentially ischemic skin.
authors.affiliation: Department of Orthopaedic Surgery, University of Oklahoma Health Sciences Center Oklahoma City, USA.
authors.forename: B C
authors.initials: BC
authors.lastname: Nossaman
authors.forename: G M
authors.initials: GM
authors.lastname: Rayan
mesh_terms: D000328:Adult; D001915:Braces / Q000009:adverse effects; D050723:Fractures, Bone / Q000628:therapy*; D006801:Humans; D008297:Male; D008663:Metacarpus / Q000293:injuries*; D009336:Necrosis; D012867:Skin / Q000098:blood supply*