Hand clinics
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Trapeziectomy has been regaining popularity in treatment of thumb carpometacarpal (CMC). Current approaches to trapeziectomy use Kirschner wire fixation to prevent subsidence of the thumb metacarpal into the newly created trapeziectomy space. ⋯ A technique using a suture-button device to suspend the thumb allows for earlier mobilization of the thumb and potentially leads to a faster overall recovery. Preliminary results are promising, but further studies must be conducted to confirm the long-term efficacy of this suture-button suspensionplasty.
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Injuries to a competitive athlete's hand are common occurrences routinely treated by team training staff and physicians. These injuries are particularly prevalent in contact and ball catching sports. ⋯ These injuries are classified according to the pattern of fracture and the resultant stability of the joint. Treating physicians must have an understanding of the biomechanics, injury patterns, assessment, and treatment guidelines in order to identify these injuries and provide for the earliest safe return to play with the best functional outcome for the athletes.
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Most metacarpal fractures are minimally displaced and are treated without surgery. Markedly displaced fractures, fractures causing finger rotation, and displaced intra-articular fractures require surgical intervention. The challenge with the elite athlete is achieving an early return to play without compromising fracture position. Casts, splints, and surgery each have a role in getting the athlete back into action as soon as possible.