In this episode of The Good GP, host Dr Tim Koh is joined by Dr Jeff Ecker, an orthopaedic surgeon with over 35 years of experience specialising in complex hand and wrist conditions. Focusing on the assessment and management of finger fractures, an injury commonly encountered by general practitioners, but often associated with diagnostic dilemmas and management challenges.

Dr Ecker highlights the potential seriousness of finger fractures, noting that even minor injuries can result in permanent impairment, significant hand dysfunction, and long-term complications if not managed appropriately. Discussing the importance of maintaining a high index of suspicion with finger injuries, recognising that early recognition and appropriate follow-up are essential to achieving optimal outcomes.

Providing the typical types of finger fractures and their clinical features. Subungual hematoma and associated terminal phalanx fractures. Mallet finger deformities (with and without fractures). PIP (proximal interphalangeal) joint injuries and their complications, such as boutonniere and swan neck deformities. Along with less common injuries around the MCP (metacarpophalangeal) joint

Dr Ecker provides practical tips for clinical assessment, stressing the importance of plain X-rays in all suspected cases, and the utility of CT scans or ultrasound if there is diagnostic uncertainty or persistent symptoms. He also addresses when to refer to a specialist, focusing on signs of instability, articular involvement, or tendon injury.

The episode concludes with practical advice on materials and techniques for conservative fracture management, with an emphasis on working closely with qualified hand therapists and prioritising early functional use.

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at www.talkinghealthtech.com/podcast/network

If you have any questions or would like to contact The Good GP, send an email to thegoodgp@gmail.com. Visit www.thegoodgp.com.au for previous episodes and more information.

In this episode of The Good GP Podcast, host Dr Tim Koh is joined by Dr Jeff Ecker, an experienced orthopaedic surgeon based in Perth, to discuss the complexities of assessing and managing wrist conditions in general practice.

Dr Ecker outlines the importance of a thorough history and clinical assessment in patients presenting with wrist pain, emphasising that pain may originate from structures beyond the wrist itself, such as the distal radioulnar joint or even referred from the neck. He highlights common causes of wrist pain that GPs are likely to encounter, including arthritis, ligament injuries, and overuse conditions, and discusses the challenges associated with diagnosis.

Focusing on wrist arthritis, as a common cause of pain in older patients. He described key clinical features and examination findings, alongside considerations for distinguishing arthritis from other conditions. The approach to imaging, including the use of CT scanning to detect bony changes and calcium pyrophosphate deposition, is covered. He also outlined management options, from conservative measures, through to surgical intervention.

Dr Ecker stresses the importance of patient-centred decision making, informed consent, and multidisciplinary collaboration between surgeons, therapists, and GPs. Surgical options including arthroscopy, joint replacement, and wrist fusion are explained, with considerations for patient selection and postoperative rehabilitation.

They conclude with practical advice for GPs supporting patients to maintain function and quality of life, emphasising resilience, adaptation, and the value of ongoing measurement and rehabilitation.

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at www.talkinghealthtech.com/podcast/network

If you have any questions or would like to contact The Good GP, send an email to thegoodgp@gmail.com. Visit www.thegoodgp.com.au for previous episodes and more information.

In this episode of The Good GP Podcast, host Dr Tim Koh is joined by Dr Jeff Ecker, an experienced orthopaedic surgeon based in Perth with over 35 years of expertise in complex hand and wrist conditions. Discussing the assessment and management of wrist fractures, with advice tailored for general practitioners.

Exploring the most common wrist fractures encountered in general practice, particularly among older adults after low-energy falls. Dr Ecker emphasises a careful history and examination, and attention to associated injuries to the elbow and shoulder. He also discusses the challenges of seemingly minor wrist injuries in younger patients and the need for an accurate and early diagnosis to prevent complications such as non-union and advanced arthritis.

Reviewing imaging strategies, with recommendations on when to use plain X-rays, CT scans, or MRIs based on clinical suspicion and fracture characteristics. Dr Ecker calls attention to the limitations of MRI, especially in detecting ligamentous wrist injuries, and the need for ongoing clinical vigilance.

They also talked about management principles for minimally displaced wrist fractures, and the practical use of back slabs, thermoplastic splints, ensuring proper hand function throughout immobilisation.

Effective analgesia choices and the critical role of rehabilitation in preventing stiffness and chronic pain syndromes were also discussed. Concluding with practical considerations for managing wrist fractures in aged care settings, reinforcing the need for individualised assessment and the avoidance of age-related bias in treatment planning.

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at www.talkinghealthtech.com/podcast/network

If you have any questions or would like to contact The Good GP, send an email to thegoodgp@gmail.com. Visit www.thegoodgp.com.au for previous episodes and more information.