[Treatment principles in hand fractures]

The fractures of the hand are frequent and represent a problem of public health. The displacement of the fracture occurs because of post-traumatic musculo-tendinous imbalance. The fractures of the hand are to be treated according to four principles: anatomical reduction, followed, when possible, by immediate mobilization, if necessary, by immobilization of the injured parts in the "protective" position (metacarpophalangeal flexion, interphalangeal extension and with the first web space under stretch), and prevention of post-traumatic edema. When an osteosynthesis is performed, the mounting should be stable enough to allow early mobilization. The most useful techniques include external minifixation, and internal fixation using one or several screws.