Addressing Multiple Hand Fractures.

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.