A review of phalangeal neck fractures in children

Al‐Qattan, Mohammad M.; Al-Qattan, Ahmed M.

doi:10.1016/j.injury.2015.02.018

Cited by 37 publications

(51 citation statements)

References 36 publications

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“…When considering the type of treatment for a phalangeal neck fracture one must consider the degree of displacement and the age of the child. While some authors recommend conservative treatment for most fractures with closed reduction a pinning reserved only for displaced fractures in patients who are approaching skeletal maturity and in whom it is unlikely that an unacceptable alignment will remodel [3], most literature reports advocate operative treatment for a displaced fracture regardless of the age of the patient [3,[6][7][8]. Avulsion fractures of the volar plate is a frequent injury that does not require an operative treatment.…”

Section: Discussionmentioning

confidence: 99%

The patterns of phalangeal fractures in children and adolescents: a review of 512 cases

Kralj

Barčot

Vlahović³

et al. 2019

Handchir Mikrochir plast Chir

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Introduction Fractures of the phalanges in children can often be underappreciated by the physician of first contact. Therefore it is necessary to point out which of these fractures, because of the risk of possible future complications, need special mention. Materials and Methods A retrospective review of 512 fractures of the phalanges in children and adolescents during an one year period. Fractures were subdivided into the following categories – physeal fractures, intraarticular (phalangeal neck and condylar) fractures, shaft fractures, tuft fractures, “mallet finger” fractures, volar plate avulsion injuries and collateral ligament avulsion injuries. Main outcome measures was the necessity for operation while the average age at which the injury has occured, the cause of the injury, the frequency of injury of each finger, the necessity for reduction, and the duration of splinting were the secondary outcome measures. Results Collateral ligament avulsion injuries and intraarticular (phalangeal neck and condylar) fractures were injuries which most often necessitated operative treatment. Physeal injuries were the most common injuires with avulsions of the volar plate being the second most common. Accidents during sport was by far the most common cause of injuires in all categories apart from tuft injuries. Conclusion The findings regarding the incidence and the cause of these injuries in this study support the already published dana in the literature. The physician of first contact has to be capable to recognise the problematic fractures – intraarticular (phalangeal neck and condylar), significantly displaced Salter-Harris type III and IV fractures and collateral ligament avulsion injuries and Seymour fractures.

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Section: Discussionmentioning

confidence: 99%

The patterns of phalangeal fractures in children and adolescents: a review of 512 cases

Kralj

Barčot

Vlahović³

et al. 2019

Handchir Mikrochir plast Chir

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“…Hence, we were unable to compare fractures of the middle versus the proximal phalanx. Furthermore, the placement of K-wires varies according to the site of the fracture: fractures of the middle phalanx are usually fixed with K-wires crossing the interphalangeal joint, 4 while those of the proximal phalanx are best fixed with K-wires avoiding all joints as previously described. 18 Weaknesses of the current study include the retrospective nature of the study, the relatively small study group, and the relatively short follow-up in some cases since a minimum of 6 months of follow-up was one of the inclusion criteria.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, type II D fractures carry a high risk of iatrogenic comminution of the distal fracture fragment during manipulation and K-wire fixation. 4 A review of the literature did not reveal any study investigating the outcome of management of type II D fractures.…”

Section: Introductionmentioning

confidence: 99%

Type II D Phalangeal Neck Fractures in Children: A Series of 20 Cases Treated According to a Preset Stepwise Algorithm

Al‐Qattan

Almohrij

Alaskar

et al. 2021

Journal of Hand and Microsurgery

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Introduction Type II phalangeal neck fractures are defined as displaced fractures with bone-to-bone contact at the fracture site. In the type II D subtype, the distal fracture fragment is thin. A review of the literature did not reveal any study investigating the outcome of management of these fractures. Patients and Methods This is a retrospective study of 20 consecutive children with type II D phalangeal neck fractures treated over the past 4 years. Demographic data were reviewed. All cases were managed according to the preset stepwise algorithm. The outcome of management at final follow-up was documented using Al-Qattan’s grading system. Results The mean age was 30 months (range 12–80 months). There were 12 males and 8 females. The mean follow-up was 2 years (range 7 months to 3 years). The largest two categories within the management algorithm were patients with minimally displaced fractures treated conservatively (n = 8) and those with displaced fractures treated with closed reduction and percutaneous K-wire fixation (n = 9). Fischer exact test was used to compare the outcome in these two groups and the p value was significant (p = 0.015), indicating a significantly better outcome in the former group. Conclusion Several conclusions were made from the study. Type II D of phalangeal neck fractures tend to occur in young children and the majority involve the middle phalanx. The thinness of the distal fracture fragment makes standard techniques of closed reduction more difficult. However, flexion of the proximal and distal joints appears to be effective in reducing dorsally displaced type II D fractures by closed means. Finally, a more conservative approach to minimally displaced type II D fractures results in a better outcome compared with closed reduction and percutaneous K-wire fixation.

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“…The periarticular K-wire technique in the management of fractures of the proximal phalanx was first introduced in the literature by Joshi in 1976 [13] . However, the technique did not gain popularity until its recent utilization by Al-Qattan in transverse fractures of the neck, shaft and base of the proximal phalanx [6] , [7] , [14] . Al-Qattan recommended the use of a single periarticular K-wire and immediate postoperative active mobilization of all joints.…”

Section: Discussionmentioning

confidence: 99%

Closed reduction and percutaneous “periarticular” single K-wire fixation for displaced unstable transverse fractures of the proximal phalanx in elderly osteoporotic women: A case series of five patients

A review of phalangeal neck fractures in children

Cited by 37 publications

References 36 publications

The patterns of phalangeal fractures in children and adolescents: a review of 512 cases

The patterns of phalangeal fractures in children and adolescents: a review of 512 cases

Type II D Phalangeal Neck Fractures in Children: A Series of 20 Cases Treated According to a Preset Stepwise Algorithm

Closed reduction and percutaneous “periarticular” single K-wire fixation for displaced unstable transverse fractures of the proximal phalanx in elderly osteoporotic women: A case series of five patients

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