Multiple intramedullary nailing of proximal phalangeal fractures of hand

Patankar, Hemant; Meman, Fayaz W

doi:10.4103/0019-5413.39573

Cited by 10 publications

(18 citation statements)

References 24 publications

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“…We found equal percentage of basal and shaft fractures (42% each). Transverse fracture pattern (29 phalanges, 35%) was most common and was consistent with the findings in other studies 61015…”

Section: Discussionsupporting

confidence: 91%

“…Combination patterns have not been reported earlier. The mean patient age was comparable to that in other studies 41015. In our study, the male to female ratio was 8.7:1, while Muhammad et al 15.…”

Section: Discussionsupporting

confidence: 85%

“…When compared to the study by Hornbach et al 9. 83% of the patients had excellent results, while 100% of the patients treated by Patankar et al 10. had excellent results.…”

Section: Discussionmentioning

confidence: 70%

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Outcome of closed proximal phalangeal fractures of the hand

Singh

Jain

Mruthyunjaya

et al. 2011

IJOO

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Background:The proximal phalanx (PP) of the fingers is fractured more frequently than the middle or even distal phalanges. The problems of malunion, stiffness and sometimes loss of skin or other soft tissues associated with PP fracture increases the disability. The optimum treatment depends on fracture location, fracture geometry and fracture stability. The objective of the study was to analyse the treatment outcome in a series of closed proximal phalangeal fractures of the hand.Materials and Methods:Eighty-four proximal phalangeal fractures in 68 patients were enrolled from 2007 to 2009. The treatment modalities were broadly categorised into two groups, Group A consisted of conservative treatment, and Group B consisted of surgical treatment. Group A included 47 digits treated with closed reduction (CR) with immobilization (n=43), extension block cast and dynamic traction (n=4), while 37 digits were treated in Group B, which included closed or open reduction (OR) and internal fixation (IF) with K-wires (n=31), OR and IF with stainless-steel wiring (n=2), and mini external-fixator (n=4). Belsky's criteria and Gingrass’ criteria were used for assessment of finger injuries and to assess the efficacy of conservative and surgical modalities for closed proximal phalangeal fractures of the hand.Results:Average period of follow-up was 1 year (range 10-14 months). The excellent to good results seen in Groups A and B were 89% and 92%, respectively. Six complications were seen in Group A, which included four cases with malunion and two cases with digital stiffness. Three complications were seen in Group B, which included one each of malunion, digital stiffness and extensor lag. Overall, maximum poor results (n=4) were seen with CR and buddy strapping.Conclusion:Conservative treatment is an inexpensive method, particularly suitable for stable fractures, and in patients who are poor candidates for surgery, Surgical modalities have distinct advantage of stable fixation, but with added risk of digital stiffness. Percutaneous pinning is a reliable, most commonly used surgical modality and technically easier. Both conservative and surgical modalities have good efficacy when used judiciously

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 85%

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Outcome of closed proximal phalangeal fractures of the hand

Singh

Jain

Mruthyunjaya

et al. 2011

IJOO

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“…One RCT [19], one cohort study [20] and two case series [24, 26] reported on CRIF and ORIF. The outcomes per study are depicted in Table 3, and the pooled results of all studies are depicted in Table 4.…”

Section: Resultsmentioning

confidence: 99%

Treatment of extra-articular proximal and middle phalangeal fractures of the hand: a systematic review

Verver¹,

Timmermans²,

Klaassen³

et al. 2017

Strategies in Trauma and Limb Reconstruction

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The aim of the study was to systematically review the patient reported and functional outcomes of treatment for extra-articular proximal or middle phalangeal fractures of the hand in order to determine the best treatment options. The review methodology was registered with PROSPERO. A systematic literature search was conducted in electronic bibliographic databases. Two independent reviewers performed screening and data extraction. The evaluation of quality of the included studies was performed using the Structured Effectiveness Quality Evaluation scale. The initial search yielded 2354 studies. The full text manuscripts of 79 studies were evaluated of which 16 studies met the inclusion criteria. In total, 513 extra-articular proximal and middle phalangeal fractures of the hand were included of which 118 (23%) were treated non-operatively, 188 (37%) were treated by closed reduction internal fixation (CRIF) and 207 (40%) by open reduction internal fixation. It can be recommended that closed displaced extra-articular phalangeal fractures can be treated non-operatively, even fractures with an oblique or complex pattern, provided that closed reduction is possible and maintained. Conservative treatment is preferably performed with a cast/brace allowing free mobilization of the wrist. No definite conclusion could be drawn upon whether closed reduction with extra-articular K-wire pinning or transarticular pinning is superior; however, it might be suggested that extra-articular K-wire pinning is favoured. When open reduction is necessary for oblique or spiral extra-articular fractures, lag screw fixation is preferable to plate and screw fixation. But, similar recovery and functional results are achieved with transversally inserted K-wires compared to lag screw fixation.Type of study/level of evidence: therapeutic III.

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“…The extensor tendon over the phalangeal shaft may adhere to the fracture site during union causing stiffness of the proximal interphalangeal joint, as well as an extensor lag. 6 Early mobilization helps in preventing the adhesion. A rigid fixation is a prerequisite for early mobilization.…”

Section: Discussionmentioning

confidence: 99%

Open proximal phalangeal shaft fractures of the hand treated by theta fixation

Thomas

Raveendran

Pallapati

2015

IJOO

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Background:Many implants and techniques are used for the treatment of open phalangeal fractures with varying grades of stability. The ubiquitous and simple Kirschner (K) wiring does not provide adequate stability to allow early mobilization of fingers. Lister described a combination of coronal interosseous wire and oblique K-wire technique for phalangeal fracture fixation with a stable construct that allowed early mobilization. Due to the fancied resemblance of this construct to the Greek alphabet θ (theta), we have referred to this as the theta fixation.Materials and Methods:Ten patients with open proximal phalangeal shaft (transverse) fractures were treated with theta fixation between January and June 2010. Outcome was analysed in terms of stability, early mobilization, fracture healing and function of hand. They were graded according to the Belsky score.Results:90% patients were graded excellent and 10% good, with none having fair or poor results. All fractures allowed the mobilization at a mean of 2.9 days and all healed at an average of 6.1 weeks. No loss of stability was seen on followup X-rays. All patients returned to their old profession.Conclusion:The theta fixation technique is a safe, simple and effective method for open transverse phalangeal fractures with results comparable to other techniques. This method gives superior fracture stability to allow early mobilization of joints and thus early return of function. It is also a cost effective way of management for the developing world.

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Multiple intramedullary nailing of proximal phalangeal fractures of hand

Cited by 10 publications

References 24 publications

Outcome of closed proximal phalangeal fractures of the hand

Outcome of closed proximal phalangeal fractures of the hand

Treatment of extra-articular proximal and middle phalangeal fractures of the hand: a systematic review

Open proximal phalangeal shaft fractures of the hand treated by theta fixation

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