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Skin necrosis complicating functional bracing

B C Nossaman1, G M Rayan

  • 1Department of Orthopaedic Surgery, University of Oklahoma Health Sciences Center Oklahoma City, USA.

American Journal of Orthopedics (Belle Mead, N.J.)
|May 30, 1998
PubMed
Summary
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Functional bracing for metacarpal fractures can cause skin necrosis. Patients should release brace straps periodically to ensure adequate blood flow and prevent complications like skin breakdown.

Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Trauma Care

Background:

  • Metacarpal shaft fractures are common hand injuries.
  • Functional bracing is a standard non-operative treatment for certain metacarpal fractures.
  • Maintaining fracture stability while allowing functional use is key in treatment.

Observation:

  • A case report details a complication in a 30-year-old male with a right ring finger metacarpal shaft fracture.
  • The patient was treated with a functional brace for a closed, dorsally angulated fracture.
  • During immobilization, full-thickness skin necrosis developed on the dorsum of the hand.

Findings:

  • The skin necrosis necessitated surgical intervention, including debridement and intramedullary Kirschner wire fixation.

Related Experiment Videos

  • This complication highlights a potential risk associated with functional metacarpal bracing.
  • Improper brace application or prolonged immobilization can compromise skin viability.

    • Implications:

    • Patients undergoing functional bracing for metacarpal fractures require careful monitoring for skin integrity.
    • Clear patient instructions are crucial: periodically releasing brace straps (every 5-6 hours) is recommended.
    • This preventative measure aims to restore blood flow and mitigate the risk of ischemic skin complications.