Outpatient treatment of patients with uncomplicated fractures of the hand bones

Purpose. To analyze the efficiency of conservative and surgical methods of treating uncomplicated fractures of the hand tubular bones. Material and Methods. 470 patients with uncomplicated fractures of the hand metacarpals and finger phalanges treated. Among them closed reduction and immobilization with a plaster splint performed in 41 (8.7 %) patients; osteosynthesis with wires - in 71 (15.1 %) ones; extrafocal osteosynthesis - in 19 (4.1 %) cases; external fixation of bone fragments with a plate performed in 2 (0.4%) patients; and osteosynthesis using clamping shape-memory staples including that combined with closed intramedullary and extrafocal osteosynthesis performed in 33 (71.7 %) patients. Results. Osteosynthesis performed after conservative treatment of patients with fractures of the hand middle and proximal phalanges of II-V fingers and those of the hand I-V metacarpals in 31.8 % cases due to the secondary displacement of fragments. Osteosynthesis with external fixators and combined osteosynthesis using clamping shape-memory staples is the most efficient method in patients with uncomplicated fractures of the hand phalanges and metacarpals (92.9 %). Conclusion. The use of extrafocal and combined osteosynthesis with clamping shape-memory staples reduces the probability of fibrosis-inducing processes, secondary displacement of bone fragments, as well as the periods of rehabilitative treatment.