Addressing Multiple Hand Fractures - 01/10/26

Doi : 10.1016/j.hcl.2026.06.002

Jin Xi Lim, MBBS, MRCS (Edin) ^a,^b,^⁎ , Alphonsus Khin Sze Chong, MBBS ^b,^c

^a Division of Hand and Reconstructive Microsurgery, Ng Teng Fong General Hospital, 1 Jurong East Street 21, 609606, Singapore

^b Department of Hand and Reconstructive Microsurgery, National University Hospital, National University Health System, 1E Kent Ridge Road Level 11, Singapore 119228

^c Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore

^∗ Corresponding author. Ng Teng Fong General Hospital, 1 Jurong East Street 21, Singapore 609606. Ng Teng Fong General Hospital 1 Jurong East Street 21 609606 Singapore

Resumen

Management of multiple hand fractures in a mangling injury requires an individualized approach that balances biomechanical stability with soft tissue preservation and surgical efficiency. While plate-and-screw constructs offer strength, less rigid methods like Kirschner wires may achieve comparable outcomes, particularly when soft tissues are intact. Evidence showed that rigid fixation does not consistently give better outcomes, and early mobilization remains key to preventing stiffness. A tailored strategy using both absolute and relative stability principles can optimize function while minimizing complications and improve surgical efficiency.

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Keywords : Multiple hand fractures, Crushing injury, Replantation, Fracture fixation, Rigid fixation