Orthopedics


        

Case Discussion

MC 4 and |MC 5 distal transverse fractures   Posted By pranesh    Date : 29-Mar-08   04:05 AM     Reply

31 year old male 77 kgs healthy indian hemaphilliac type A Asthmatic right hand "boxer fracture" of MC 4 and MC 5 distal fractures transverse on both with palmar deviation of the distal fragments px was under GA and fracture reduced and fixated with t-piece plates and scews. large hematoma formed over the op site and was noticed after the traumatic swelling reduced a week later. the hematoma is currently fairly large and considering the history of the px physiotherapy with laser and ultrasound is being employed to reduce the hematoma. the px is a veterinary surgeon and being hemophillic is relectant to undergo surgery to remove the plates as it will incapacitate him for further 8weeks with pain bleeding and physio. the plates are placed dorsally. the px questioned leaving plates inuntil he is ready to remove them later in the year its been 2 weeks since op now.? is removal imperative in this case? px by the way still has severe bruising from the tourniquet placed around elbow...we are concerned that although factor 8 was given pre and post operatively there seems not to have helped? what do we do? is there any chance of op and remove later ? long term affects of implant being left in? please help/ regards pranesh





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