- See:
Over Distraction of Wrist
- Discussion:
- patient is instructed to move all unaffected joints throughout the joint;
- avoid pronation and supination of forearm since this applies skin tension over most proximal screw; (infection is most common here);
- when limited finger or thumb motion is present, a mechanical reason such as transfixation of tendons and muscles must be ruled out;
- Duration of Treatment:
- depending on the type of frx and its fixation, the period of immobilization in the fixator is about 4-6 weeks;
- it is noteworthy that prolonged immobilization in the fixator will not prevent late frx collapse;
- the bottom line is that unstable fractures, that are properly reduced, immobilized (pins and ex-fix), and bone grafted will not collapse, where as, unstable
fractures that are not properly managed (not bone grafted) may go on to collapse (whether they are immobilized for 3 weeks or for 8 weeks);
- w/ in 4 to 5 wks after fixator removal most patients regain a normal range of finger motion;
- Painful Wrist:
- ischemia (tight dresings, compartment syndrome of the hand or forearm)
- transfixation of tendons or muscles
- overdistraction
- over flexion of the wrist causing carpal tunnel syndrome;
Treatment of External Fixation Pins About the Wrist: A Prospective, Randomized Trial.
