Journal of the Southern Orthopaedic Association
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A variety of fractures and fracture-dislocations occur about the base of the thumb. With the exception of the extra-articular fracture of the metacarpal base, most of these injuries are best treated surgically. ⋯ The optimal treatment method for Rolando's fracture has not been established, although external fixation with limited internal fixation of the metacarpal base appears promising. Knowledge of the anatomy and deforming forces in these injuries will allow appropriate treatment and restoration of function in the important trapeziometacarpal articulation.
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Fractures of the proximal humerus are common, especially in elderly individuals, and are usually classified according to Neer into fractures having one, two, three, or four parts with or without an associated dislocation or an injury splitting the humeral head. This article is intended to assist the surgeon in selecting and using techniques for internal fixation of these fractures. The use of open reduction and internal fixation using plates and screws has become less popular because of the extensive dissection required and the tendency for the plate to impinge. Use of multiple percutaneous pins to fix the humeral head to the shaft (surgical neck) and heavy sutures or wires to reattach the tuberosities is often preferable.