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fracture shaft middle phalanx

Hiroyuki Fujioka, Yohei Takagi, Juichi Tanaka, Shinichi Yoshiya
Malunion at the shaft of the middle phalanx yields less functional problems compared with malunion at the shaft of the proximal phalanx and metacarpal bones. In the present report, the patient sustained a minimally displaced fracture at the distal portion of the distal middle phalanx of the ring finger spraining the finger during playing flag football. Fracture was treated conservatively and fracture union was completed. However, the patient complained of functional problems in activities of daily living due to the malrotational deformity of the finger...
June 2017: Journal of Hand Surgery Asian-Pacific Volume
Eirini Liodaki, Tobias Kisch, Eike Wenzel, Peter Mailänder, Felix Stang
Objective: Fractures of metacarpals and phalanges are very common fractures, and there are a lot of treatment modalities. The purpose of the study was to describe the technique of percutaneous fixation of phalangeal fractures using a cannulated compression screw fixation system and its results. Methods: We conducted a prospective clinical study on 43 patients with different types of phalangeal fractures undergoing a percutaneous cannulated compression screw osteosynthesis. Parameters such as average operation time and clinical outcome were evaluated postoperatively...
2017: Eplasty
Mark Henry
The more common dorsal fracture subluxations at the base of the middle phalanx have an intact dorsal buttress of articular surface in continuity with the shaft. Capitalizing on this foundation, various fixation methods have met with relatively equivalent success including Kirschner wires, screws only, nonlocking plate and screws, and external fixation. Pilon fractures are complete articular fractures, where the comminuted articular fragments lack any structural connection to the more distal shaft of the middle phalanx, and have largely relied upon external fixation traction systems...
March 2017: Techniques in Hand & Upper Extremity Surgery
G Prunières, S Gouzou, S Facca, A-S Matheron, N Maire, J-J Hidalgo Díaz, P Liverneaux
Unstable distal phalanx fractures are typically treated by pinning of the distal phalanx or the distal interphalangeal joint (DIP). Complications include unstable fixation, K-wire migration, septic arthritis and osteoarthritis. To limit these complications, we wanted to explore the benefits of using locked extra-articular DIP pinning. The cohort consisted of 12 patients (mean age 36.3 years) who had an extra-articular (6 cases) or intra-articular distal phalanx fracture (6 cases). All patients were treated surgically with a construct consisting of two connected K-wires: one was placed inside the shaft of the distal phalanx and the other was placed perpendicular to the middle phalanx...
October 2016: Hand Surgery and Rehabilitation
Kyle R Eberlin, Anna Babushkina, Juliana Rojas Neira, Chaitanya S Mudgal
PURPOSE: To review the results of periarticular pinning of extra-articular fractures of the proximal phalanx base and shaft. METHODS: A retrospective review was performed of the senior author's practice (C.S.M.) from 2006 to 2012. The inclusion criteria were patients older than 18 years of age who underwent periarticular pinning of base or shaft fractures of the proximal phalanx. Age, sex, fracture location, fracture pattern, and time to surgery were recorded. Outcome measures were range of motion, time to healing, and complication rate...
August 2014: Journal of Hand Surgery
Anoop C Dhamangaonkar, Hemant S Patankar
PURPOSE: To evaluate the outcome for surgical stabilization of middle phalanx shaft fractures with joint-sparing antegrade intramedullary K-wire fixation. METHODS: We treated 15 extra-articular transverse or short oblique shaft fractures of the middle phalanx in 13 patients. All fractures were treated with closed reduction internal fixation with antegrade joint-sparing intramedullary K-wires. Patients had a minimum follow-up of 1 year (range, 1-10 y). We assessed the objective outcome at 6 months by calculating total active range of motion...
August 2014: Journal of Hand Surgery
R Glenn Gaston, Christopher Chadderdon
Nonsurgical management is the preferred treatment of stable, extra-articular fractures of the proximal and middle phalanx, most distal phalanx fractures, and, rarely, nondisplaced intraarticular fractures in elite athletes. Techniques that afford maximal strength with minimal dissection, thus allowing earlier return to play, are ideal. Open reduction with internal fixation with plate fixation is most often chosen for unstable phalangeal shaft fractures in high-demand athletes to provide rigid internal fixation and allow immediate range of motion and more rapid return to sport...
August 2012: Hand Clinics
Benjamin N Puckett, R Glenn Gaston, Allan E Peljovich, Gary M Lourie, Waldo E Floyd
PURPOSE: Distal condylar phalangeal (DCP) fractures in children are uncommon, but their periarticular location makes them problematic. Malunions are particularly difficult to treat. These fractures are generally thought to have a poor remodeling potential because their location is far from the phalangeal physis. We present 8 cases of DCP malunion in children with a mean 5-year follow-up demonstrating consistent remodeling. METHODS: In this study, DCP fractures were defined as those occurring at or distal to the collateral ligament recess of the proximal or middle phalanx in skeletally immature patients...
January 2012: Journal of Hand Surgery
Mohammad M Al-Qattan
A series of 35 adult male industrial workers with displaced unstable transverse fractures of the shaft of the proximal phalanx of the fingers were treated with reduction and K-wire fixation leaving the metacarpophalangeal and interphalangeal joints free to move immediately after surgery. At final follow-up, the total active motion score of the injured finger was graded as excellent, good, fair, or poor if it was greater than 240°, 220-240°, 180-219°, or less than 180°, respectively. Complications were also documented...
September 2011: Journal of Hand Surgery, European Volume
Mark Henry
Nonunions of the shaft of the distal phalanx, as opposed to the tuft, are usually symptomatic enough to warrant treatment. One method that has proven successful while minimizing complications is compression fixation using variable pitch headless screws inserted percutaneously. Eighteen patients (15 males, 3 females) with a mean age of 48 years were so treated under digital block anesthesia. Seven of 18 (39%) patients were smokers. All initial injuries were crush trauma to the distal phalanx with 10/18 (56%) initially open fractures...
December 2010: Techniques in Hand & Upper Extremity Surgery
R B Cook, C Curwen, T Tasker, P Zioupos
Osteoporosis defines a causal relationship between reduced bone density, reduced mechanical competence of the bone tissue of the sufferers and concomitantly an increased risk of fracture in life. The aims of the present study is: (1) to provide further evidence to support the use of Quantitative Ultrasound (QUS) results from peripheral sites to provide a prediction of the density of the proximal femur; and (2) to provide rational evidence for the well-proven ability of QUS to predict directly 'risk of fracture'...
November 2010: Medical Engineering & Physics
M M Al-Qattan
In a prospective study, 22 cases of extraarticular transverse/short oblique fractures of the shaft of the middle phalanx associated with extensor tendon injury had fixation of the fracture as well as immobilisation of the distal interphalangeal joint using a K-wire. Mobilisation of the proximal interphalangeal and metacarpophalangeal joints was started immediately after surgery. The wires were removed after 6 weeks. No post-operative complications were noted. At final follow-up (mean = 15 weeks, range = 12-24 weeks), 18 of 22 patients obtained excellent and good total active motion (TAM) scores...
October 2008: Journal of Hand Surgery, European Volume
M M Al-Qattan
Seventy-eight male industrial workers with displaced unstable transverse fractures of the shaft of the proximal phalanx of the fingers were divided into two groups: Group 1 (n = 40 men, mean age = 34 years, range = 22-46 years) was treated with closed reduction and percutaneous K-wires, and Group 2 (n = 38 men, mean age = 33 years, range = 20-48 years) was treated with open reduction and interosseous loop wire fixation. At final follow-up, the total active motion (TAM) score of the injured finger was graded as excellent, good, fair or poor if it was greater than 240 degrees , 220 degrees , 180 degrees or less than 180 degrees , respectively...
October 2008: Journal of Hand Surgery, European Volume
H Chim, L C Teoh, F C Yong
Although most distal phalangeal fractures can be treated conservatively, there exists a subset of patients who are liable to develop symptomatic non-union, manifesting as pain and/or instability, and who may benefit from early fracture fixation. This group of patients includes those with displaced or comminuted fractures of the shaft or neck and those with oblique fractures prone to displacement. This paper reviews the use of a cortical miniscrew for fixation of fracture non-union in these patients and shows that this is an effective treatment modality with minimal morbidity...
February 2008: Journal of Hand Surgery, European Volume
Stephen Stacey, Richard Kent
This investigation centers on the case of an adult male whose finger was allegedly amputated by the steering wheel of his car during a crash. The subject claimed to have been driving with his left index finger inserted through a hole in the spoke of his steering wheel and was subsequently involved in an offset frontal collision with a tree. The finger was found to be cleanly severed at the mid-shaft of the proximal phalanx after the crash. This injury was alleged to have been caused by inertial loading from the rotation of the steering wheel during the crash...
July 2006: International Journal of Legal Medicine
T C Horton, M Hatton, T R C Davis
Patients with an isolated spiral or long oblique fracture of the proximal phalanx were randomized into two groups. One was treated by closed reduction and Kirschner wire fixation and the second treated by open reduction and lag screw fixation. An independent observer assessed function, pain, movement, grip strength and intrinsic muscle function. X-rays were assessed for malunion. Thirty-two patients were entered the study and 15 in the Kirschner wire and 13 in the lag screw group were reviewed at a mean follow-up of 40 months...
February 2003: Journal of Hand Surgery: Journal of the British Society for Surgery of the Hand
L Read
Fracture of the shaft of the distal phalanx is less common than more distal fractures involving the tuft: non-union in such a fracture is even more unusual. A case is described in which troublesome non-union of the shaft of the distal phalanx of the middle finger was successfully treated by open reduction and Kirschner wire fixation. The type of fracture and its treatment is discussed: it is emphasised that the principles applied to shaft fractures of the middle and proximal phalanges also apply to the distal phalanx...
February 1982: Hand
P Rommens
Fractures and fracture-dislocations of the hand can inhibit directly and indirectly the precision of the hand mobility. The fracture of the scaphoid mostly occurs through his middle third and is stable. In unstable fractures or fractures through the proximal third pseudarthrosis or aseptic necrosis of the proximal fragment is seen. The fracture of the trapezium can prevent the normal mobility of the thumb, and therefore an anatomical reduction is desirable. The most important fractures of the metacarpals are Bennett's fracture and Rolando's fracture of metacarpal I and the boxer's fracture of metacarpal V...
January 1988: Acta Chirurgica Belgica
G L Woods
Although any fracture of the proximal phalanx can potentially disrupt finger MCP and/or PIP motion, appropriate consideration based on sound principles of biomechanics and biology of healing will delineate the options available. Applying the risk/benefit associated with any particular mode of treatment is more challenging. Perhaps the most difficult thing is to anticipate and recognize failure of a treatment mode sufficiently early and then to act concisely to rectify the situation. The physician and patient must recognize what goal is realistic for each patient's injury...
February 1988: Hand Clinics
R M Campbell
The indications for open treatment of skeletal injury of the pediatric hand and wrist region are limited, but failure to surgically treat these fractures and dislocations will cause later morbidity. Irreducible dislocations of the small joints of a child's hand require open reduction. Angulated fractures of the middle and proximal phalanx in the region of the neck or distal shaft also require exact reduction because of the poor remodeling capacity in that region. Irreducible Salter-Harris II fractures of the distal radius and unstable Galeazzi type fracture-dislocations of the distal radius in the older child should also be treated using open methods if a satisfactory closed reduction cannot be obtained...
April 1990: Orthopedic Clinics of North America
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