Good Enough: When to Avoid Perfection and Accept Adequate Surgery Results in Pediatric Hand Surgery

Pediatric hand surgery frequently requires precise surgical reconstruction of the upper limb to prevent worsening deformity. However, there is a balance of achieving a perfect radiologic film of the planned surgery and causing inadvertent harm from performing overly aggressive surgery. Precise K-wire placement and immobilization are important for optimal results; however, surgery that is too invasive results in several downsides, including loss of reduction, poor bony healing, loss of blood supply, growth plate failure, and scar contractures from poor wound healing. Here, we review this important concept of "Good Enough" to accept completely adequate results over unattainable perfection in pediatric hand surgery.