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the stability of the fragments after surgery. Custom-fabricated traction splint for traumatic PIP intra-articular fractures of the middle and ring fingers. In summary, a large, well-done, retrospective cohort study (Level III evidence) supports closed reduction and percutaneous pinning of all displaced supracondylar fractures over closed reduction and plaster immobilization. This add-on is available with, iCD-10 code S72.463 for Displaced supracondylar fracture with intracondylar extension of lower end of unspecified femur is a medical classification as listed by WHO under the range - Injury, poisoning and certain other consequences of external causes. The fingers are attached to a custom-made outrigger by means of springs, which are hooked to surgically placed K-wires that exit through the skin from the middle phalanx, providing consistent traction through the available range of motion. Chung, in Operative Techniques: Hand and Wrist Surgery (Third Edition), 2018 Step 3: Alignment and Joint Fixation Small plates, interfragmentary screws, or percutaneous pinning can be used for fixation; we prefer using Kirschner wires (K-wires) for the ease of fusion and no retained hardware. The latter is presented here. The optimal traction and motion parameters vary, depending on the fracture. CPT Code: 26608Percutaneous skeletal fixation of metacarpal fracture, each bone. In particular, external fixation can be useful as an adjunct to pin fixation in fractures with significant comminution in which direct fixation or buttressing of the fracture fragments cannot be obtained, or as temporary or definitive fixation in fractures associated with severe soft tissue contamination.
The traction reduces the fracture fragments through ligamentotaxis and restores optimal joint space for tissue healing and gliding (Figure 10-20). Tension can be adjusted relatively easily by the physician. Avoid multiple drillings that will create holes in the bones to cause premature wire loosening.
This has led to the development of lower profile designs. Types of Fixation Following Distal Radius Fracture and Associated Rehabilitation Guidelines Type of Fixation or Immobilization General Rehabilitation Guidelines Cast Early pain and edema control using positioning (elevation of extremity retrograde massage, and arom of uninvolved joints Cast on for 4 to 6 weeks; then. Once the position is confirmed in the distal phalanx, the wire is driven through until level with the joint plane. Thus, it is difficult to establish a safe zone for pin placement, especially laterally (Kamineni., 2004). The orthosis supports the transverse arch of the hand and allows full motion of the thumb and fingers but limits forearm rotation. S72.46, excludes1: supracondylar fracture without intracondylar extension of lower end of femur (. Step 3 Pearls K-wires can be driven retrograde from the DIP joint through the distal phalanx to confirm the vector of the pin. Reduction by means of an external fixator allows the therapist access to the hand and wrist for hygiene and edema control.