Antegrade joint-sparing intramedullary wiring for middle phalanx shaft fractures.

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.

RESULTS: All fractures healed. Based on the total active motion score at 6 months, 10 digits showed excellent results, 3 digits were good, 1 was fair, and 1 was poor. Among 3 patients with an associated flexor tendon injury, 2 had excellent outcomes and one had a poor outcome. For 2 patients with an associated extensor tendon injury, 1 had a good outcome and the other had a fair outcome.

CONCLUSIONS: Antegrade intramedullary wiring for extra-articular transverse and short oblique shaft  fracture of middle phalanx is a simple, safe, inexpensive, and joint-sparing technique that provides enough fracture stability, even in cases of associated injuries, for early rehabilitation and functional recovery with the expectation of a good to excellent outcome.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.