Fractures of the phalanges

Heifner, John J.; Rubio, Francisco

doi:10.1177/17531934231185219

Cited by 4 publications

(2 citation statements)

References 31 publications

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Section: Introductionmentioning

confidence: 99%

“…Common surgical methods for treating unstable proximal phalanx fractures include fixation with Kirschner wires (K-wires), plates and screws, as well as intramedullary screws [7]. Among these, K-wires are prevalent due to their cost-effectiveness, simplicity of application, and better aesthetic outcomes [7][8][9]. Another advantage of K-wires is their minimally invasive nature, which grants them superiority over other internal fixation devices in the region of the proximal phalanx base, an area covered by the extensor tendon [9].…”

Section: Introductionmentioning

confidence: 99%

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A comparative analysis of antegrade and retrograde Kirschner wire fixation for proximal phalanx base fractures

Koh,

Kim,

Kim

et al. 2024

Arch Hand Microsurg

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Purpose: We aimed to determine whether the clinical outcomes of antegrade and retrograde extra-articular Kirschner wire (K-wire) pinning differed in proximal phalanx base fractures.Methods: This retrospective study investigated 73 patients aged ≥18 years with extra-articular proximal phalanx base fractures that were treated by closed K-wire pinning between January 2014 and June 2023. Patients were analyzed according to whether the K-wire fixation was antegrade or retrograde. We analyzed demographics, injury characteristics, the number of K-wires applied, surgical duration, the interval before implant removal, and when physical therapy was started. Radiological outcomes included the amount of time required for radiographically confirmed bone union. Clinical outcomes consisted of complications, total active motion (TAM), and the Michigan Hand Outcomes Questionnaire (MHQ).Results: We treated 29 and 44 patients using antegrade and retrograde K-wire fixation, respectively. The overall complication rate was higher in the antegrade group than in the retrograde group (13.8% vs. 9.1%), although this difference was not statistically significant. Similarly, no significant between-group differences were detected in the length of time required for bone union and implant removal, TAM, and MHQ scores.Conclusion: Proximal phalanx base fractures were equally and effectively treated by antegrade and retrograde K-wire fixation. Therefore, the direction of K-wire fixation can be chosen based on surgeons’ preferences and experience.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A comparative analysis of antegrade and retrograde Kirschner wire fixation for proximal phalanx base fractures

Koh,

Kim,

Kim

et al. 2024

Arch Hand Microsurg

View full text Add to dashboard Cite

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Combining double antegrade intramedullary pinning with proximal interphalangeal joint transfixation in a bicondylar proximal phalangeal fracture

Wang,

Huang,

Wang

2024

J Hand Surg Eur Vol

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Volar Plate Fixation for Extra-Articular Proximal Third Phalangeal Fractures of proximal phalanx: A Comparative Study of Tendon-to-Bone Distances and Functional Outcomes

Lee,

Lin,

Yeh

et al. 2024

Preprint

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Background Phalangeal fractures, especially those of the proximal phalanx, account for approximately 25% of hand and wrist fractures. Plating is generally associated with severe tendon-related complications and unsatisfactory hand function. Recently, volar plating has been used to fix intra-articular fractures at the base of the proximal phalanx, and it has been reported to result in excellent finger motion and grip strength. We proposed that volar plating has a lower risk of tendon irritation compared to dorsal plating due to the larger tendon-to-bone distances on the volar side. The purpose of this study was to: 1) present the surgical outcomes of 9 cases of extra-articular fractures in the proximal third of the proximal phalanx treated with volar plating, and 2) compare the tendon-to-bone distances between the volar and dorsal sides of the proximal phalanx. Methods A prospective cohort of nine patients with proximal third fractures of the proximal phalanx was recruited. Each patients underwent an MRI of the healthy middle finger on either hand to evaluate the distances between the flexor and extensor tendons and the proximal phalanx. The distances were measured using our in-built measurement tool. Demographics including age, gender, dominant hand, diabetes, smoking, affected fingers were collated. Complications such as extensor lag, wound infections, delayed wound healing, malunion, non-union, delayed union and tendon rupture were recorded. Total active motion (TAM) was also calculated by addition of ROM at the metacarpophalangeal joint, proximal interphalangeal joint and distal interphalangeal joint. Results Nine patients (6 males, 3 females) with fractures of the proximal third of the proximal phalanx were included in this study. All nine patients achieved good bone healing and recovery of functional range of motion (235 ± 24 degrees) after 1 year of follow-up. No major complications were reported, except for one patient with delayed wound healing. The measurements of the distances between the bone and the flexor and extensor tendons were reported as follows. There were significant differences in the average distance from the tendons to the bone cortex for the middle (volar: 1.07 cm, dorsal: 0.21 cm) and distal (volar: 2.96 cm, dorsal: 0.64 cm) third of the proximal phalanx (p = < 0.001). Conclusions The increased tendon-to-bone distance on the volar side may be an important factor contributing to the excellent hand function observed with volar plating in the treatment of proximal phalangeal extra-articular fractures

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Fractures of the phalanges

Cited by 4 publications

References 31 publications

A comparative analysis of antegrade and retrograde Kirschner wire fixation for proximal phalanx base fractures

A comparative analysis of antegrade and retrograde Kirschner wire fixation for proximal phalanx base fractures

Combining double antegrade intramedullary pinning with proximal interphalangeal joint transfixation in a bicondylar proximal phalangeal fracture

Volar Plate Fixation for Extra-Articular Proximal Third Phalangeal Fractures of proximal phalanx: A Comparative Study of Tendon-to-Bone Distances and Functional Outcomes

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