Principles of management of hand fractures.
Neophytos Christodoulou, Dimitrios Asimakopoulos, Konstantinos Kapetanos and 2 others
PMID 36408867WHAT IT FOUND
For adult hand fractures, early pain, wound and neurovascular checks, antibiotics for open fractures, and hand therapy five to seven days after surgery are core principles.
Key findings
01For open hand fractures, the review recommends immediate intravenous antibiotics in A&E and tetanus vaccination when vaccination history is incomplete.
02A cited prospective trial of 85 patients with open fractures found infection in less than 3% of those given antibiotics and 30% of those without antibiotics.
03Hand therapy usually starts five to seven days after surgery, and the aim is functional capacity within eight to 12 weeks from injury.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
This is a narrative review, not a systematic review or trial, so it does not report a search method, study selection, or pooled results. The recommendations are not tested outcomes from this paper. The patient numbers quoted, such as 85 in the antibiotic trial, come from cited older studies. It focuses on adult hand fractures and perioperative care, so it does not address children, specific fracture subtypes in detail, or long-term outcomes. Some recommendations depend on local trust antibiotic policy, surgeon choice or local analgesia protocols, so they cannot be applied as a single fixed protocol.
The easy way to misread this
Do not treat this review as proof that these steps improve outcomes. It reports no original patient outcomes; the antibiotic figures come from a cited trial of 85 patients with open fractures.