Fingertip injuries are frequently encountered by the hand surgeon, and often present with a combination of the following: avulsed or broken nail plate, nail bed disruption, and/or distal phalangeal fracture. Recommended management of these injuries consists of reduction of the fracture followed by repair of soft tissues. To achieve an anatomic reduction and sufficient stability of the fracture, current management consists of temporary Kirschner-wire stabilization. Hypodermic needles can be substituted to secure temporary transosseous fixation. We describe a technique for stabilizing open distal phalangeal fracture using hypodermic needles which are readily available. Eight patients over 12 months have been treated with this technique which has proven to be successful. We would advocate that providers consider this technique when Kirschner-wires or other necessary instruments are unavailable.
We present two rare microsurgical reconstructions. A case with phocomelia was treated with lengthening of soft tissues following vascularized fibula grafting with epiphysis, and a case with cleft hand was reconstructed with spare‐part toe transfer.
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