Hand Fracture Follow-up
- Author: Erik D Schraga, MD; Chief Editor: Trevor John Mills, MD, MPH more...
Further Outpatient Care
Because most patients have splints applied in the ED, discharge instructions should include signs and symptoms of constrictive splints or casts. Instruct patients of date and time of their follow-up appointment with an orthopedic surgeon or the phone number to call for an appointment.
Instruct patients to rest and elevate the injured hand to reduce swelling and pain. Cold packs may also be recommended to minimize swelling.
Further Inpatient Care
Care for the vast majority of patients with hand fractures is completed on an outpatient basis.
Reserve inpatient care for those who must go directly to the operating room for open reduction and internal fixation (ORIF). This is not a common occurrence.
Transfer of the patient with a hand fracture seldom is required.
An exception is the patient with an amputated digit or hand requiring transfer to a hospital capable of emergent reimplantation.
Complications include the following:
- Degenerative arthritis
- Adhesion of tendon to bone (more likely in open or widely angulated fractures)
- Joint stiffness from immobilization
- Boutonniere deformity (may result from improperly treated middle phalanx fracture)
- Nonunion of fractures resulting in prolonged disability
Both operative and nonoperative treatment of hand fractures can result in numerous complications, including stiffness, malunion, nonunion, arthritis, infection, and complex regional pain syndrome.
The prognosis is excellent with good ED management and appropriate, timely referral.
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