Houston Methodist. Leading Medicine

Wrist FAQ

Question:

I'm doing a school project on my uncle's wrist fracture. I hope to be a surgeon myself someday. He gave me all the pictures the surgeon took during the operation. One thing I don't understand is a photo with his fingers in what looks like a Chinese finger trap. What does that do?

Answer:

Wrist fractures (or any fracture for that matter) can be comminuted and/or impacted requiring traction to pull the pieces apart. Comminuted means the bone has broken into several fragments (often there are many tiny pieces). Impacted tells us the bones have been jammed together. Traction gives a distractive force needed to pull the impacted bones apart. This is a necessary step before the pieces can be lined back up and wired together. What you see in the photos that looks like a Chinese finger trap is used to suspend the hand allowing the weight of the arm to give the distractive force needed. It's a very handy technique called vertical distraction. It may sound simple to say the surgeon suspends the patient's forearm in a vertical traction unit and in reality, it only takes about five minutes. But the process is a bit more complicated than that. And just try operating on a hand suspended in mid-air. The position is awkward for the surgeon. Surgeon have to be very clever and make adaptations when necessary. For example, in a recent report, one hand surgeon from Spain described (and showed photos) of his use of carabiners to help suspend a patient's hand who had a comminuted and impacted wrist fracture. In case you aren't familiar with the term, carabiners are metal clips used by rock climbers to hold things. Everything down to how to maintain sterility had to be considered. So if you like a good puzzle, you like to be challenged, and you are good with your hands -- becoming a surgeon might be just the thing for you! Francisco del Piñal, MD, DrMed. Technical Tips for (Dry) Arthroscopic Reduction and Internal Fixation of Distal Radius Fractures. In The Journal of Hand Surgery. October 2011. Vol. 36A. No. 10. pp. 1694-1705.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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