Metacarpal DCP Plating for Transverse Fracture

0%
TECHNIQUE VIDEO
0%
TECHNIQUE STEPS
 
0
0
TECHNIQUE STEPS
Preoperative Patient Care
Operative Techniques
E

Preoperative Plan

1

Execute surgical walkthrough

  • describe the steps of the procedure verbally prior to the start of the case

2

Description of potential complications and steps to avoid them

F

Room Preparation

1

Surgical Instrumentation

  • DCP plating system

2

Room setup and Equipment

  • standard operating table
  • hand table

3

Patient Positioning

  • patient placed in the supine position with hand on hand table
  • place tourniquet high on the affected extremity
G

Dorsal Longitudinal Incision

1

Mark and make the incision

  • make a skin incision over the center of the fractured metacarpal

2

Identify the neurovascular structures

  • identify and protect the dorsal sensory nerve branches
H

Fracture Exposure

1

Expose the fracture extraperiosteally

  • identify the radial and ulnar margins
  • this helps in achieving appropriate reduction
I

Plate Placement

1

Measure the correct size DCP plate

2

Place the correct size plate

J

Provisional Fixation

1

Fix the plate

  • provisionally fix the plate by clamping the plate to the bone proximally
  • the most commonly used plates are 2.0 to 2.5 mm

2

Add a subtle concave bend to the plate before its application

  • this helps compress the volar cortices

3

Check the alignment

  • check the sagittal and coronal plane alignment by direct inspection of the fracture site
  • assess the rotation clinically with the aid of tenodesis
K

Definitive Fixation

1

Place screws in compression mode

  • achieve at least 4 cortices of fixation in both the proximal and distal fragments

2

Check the alignment and reduction

  • check the anatomic fracture reduction with fluoroscopy
L

Wound Closure

1

Close the periosteum and soft tissues

  • close the periosteum and the interosseous muscle fascia over the plate
  • this provides a smooth gliding surface for the extensor mechanism

2

Superficial closure

  • close the skin with 3-0 monocryl suture
Postoperative Patient Care
 

Please rate topic.

Average 5.0 of 1 Ratings

Thank you for rating! Please vote below and help us build the most advanced adaptive learning platform in medicine

The complexity of this topic is appropriate for?
How important is this topic for board examinations?
How important is this topic for clinical practice?
Topic COMMENTS (0)
Private Note