title: Skeletal Fixation in a Mutilated Hand.
abstract: Hand fracture fixation in mutilating injuries is characterized by multiple challenges due to possible skeletal disorganization and concomitant severe injury of soft tissue structures. The effects of skeletal disruption are best analyzed as divided into specific locales in the hand: radial, ulnar, proximal, and distal. Functional consequences of injuries in each of these regions are discussed. Although a variety of implants are now in vogue, K-wire fixation has stood the test of time and is especially useful in multiple fracture situations. Segmental bone loss is quite common in such injuries, which can be safely reconstructed in a staged manner.
authors.affiliation: Department of Plastic, Hand & Reconstructive Microsurgery and Burns, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, Tamil Nadu 641 043, India.
authors.forename: Praveen
authors.initials: P
authors.lastname: Bhardwaj
authors.affiliation: Department of Plastic, Hand & Reconstructive Microsurgery and Burns, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, Tamil Nadu 641 043, India.
authors.forename: Ajeesh
authors.initials: A
authors.lastname: Sankaran
authors.affiliation: Department of Plastic, Hand & Reconstructive Microsurgery and Burns, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, Tamil Nadu 641 043, India. Electronic address: rajahand@gmail.com.
authors.forename: S Raja
authors.initials: SR
authors.lastname: Sabapathy
mesh_terms: D000673:Amputation, Traumatic / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D001864:Bone Wires; D005592:Fracture Fixation / Q000379:methods*; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006230:Hand Injuries / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008488:Medical Illustration; D010781:Photography
keywords: Bone loss; Hand fracture; Kirschner wire; Mutilating injury; Wrist arthrodesis