Old principles revisited—traction splinting for closed proximal phalangeal fractures

Collins, A. L.; Timlin, Marcus; Thornes, B; O’Sullivan, T

doi:10.1016/s0020-1383(01)00138-3

Cited by 15 publications

(10 citation statements)

References 5 publications

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“…Most phalangeal fractures can be treated successfully with conservative methods (Greene et al, 1987;Ouellette and Freeland, 1996;Thakore, 1986), but unstable ones may require surgical management (Collins et al, 2002;Greene et al, 1987;Pun et al, 1991;Safoury, 2001;Thakore, 1986). Any surgical procedure should allow early motion because of the risks of joint contracture and tendon adhesion (Agee, 1992;Ebinger et al, 1999;Greene et al, 1987;Ouellette and Freeland, 1996;Page and Stern, 1998;Safoury, 2001).…”

Section: Discussionmentioning

confidence: 99%

Tension Band Wiring of Unstable Transverse Fractures of the Proximal and Middle Phalanges of the Hand

Pehlivan

Kiral

Solakoğlu

et al. 2004

Journal of Hand Surgery

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Twenty-three isolated, unstable and closed transverse middle and proximal phalangeal shaft fractures in 23 patients were treated by tension band wiring. The tension band was applied with two transverse Kirschner wires that did not cross the fracture line. All of the fractures united and achieved satisfactory functional outcomes. No patient required either physiotherapy or tenolysis or capsulotomy surgery.

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Section: Discussionmentioning

confidence: 99%

Tension Band Wiring of Unstable Transverse Fractures of the Proximal and Middle Phalanges of the Hand

Pehlivan

Kiral

Solakoğlu

et al. 2004

Journal of Hand Surgery

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“…Unstable fractures were treated by dynamic traction,18 where after achieving CR, a cloth hanger was molded in position of immobilization, and fixed to the forearm with POP. Suture bite was taken from the nail, and dynamic traction was secured with a rubber band.…”

Section: Methodsmentioning

confidence: 99%

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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“…2,29 Instability can be met in asthichhallita (volar and dorsal base fractures of P3); 13 atipatita (complete fracture is grossly displaced/rotated); ashwakarna (long oblique or spiral fracture of shaft of P2); churnitta bhagna (Pilon fracture); 23 and kanda bhagna (transverse fracture of P1 which is inherently unstable). 30 Sushruta has also mentioned "nakhsandhimsamutpishtamraktanugatamaryaa" (formation of a Sub-ungual hematoma when the nail-skin junction is subjected to a crushing injury) which usually occurs in a churnitta bhagna (comminuted fracture of the tuft of P3). 31,32 One should also assess if there is any wound (vrana) present with the fracture (bhagna), i.e., if it is a savrana bhagna or not.…”

Section: Clinical Features Of Anguli Bhagnamentioning

confidence: 99%

A Review on Anguli Bhagna: An Exploratory Study

Bharmauria¹,

Verma²

2020

Int J Res Ayurveda Pharm

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Anguli bhagna (phalangeal fractures) is a very common musculoskeletal injury. Anguli bhagna is commonly caused by falls, direct blows (ball sports) and various other reasons. Management of anguli bhagna requires sound techniques to provide the best functional outcome. To date, literature on anguli bhagna is scarce and unexplored. Ayurvedic treatises, especially 'Sushruta Samhita', have provided excellent description of bhagna at different sites including anguli bhagna. The present article explores various etiological factors, classification, clinical features, treatment principles, prognosis, and complications specifically mentioned in the context of anguli bhagna along with modern surgical concepts. Various adjuvant therapies like oral medications, local applications, dietary regimes, panchakarma (five purification procedures) and other important modalities which are useful for better functional outcome are also explored. Even though sophisticated diagnostic procedures and treatment modalities are currently available for phalangeal fractures, the age-old concepts available in Sushruta Samhita still remain relevant and valid.

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Old principles revisited—traction splinting for closed proximal phalangeal fractures

Cited by 15 publications

References 5 publications

Tension Band Wiring of Unstable Transverse Fractures of the Proximal and Middle Phalanges of the Hand

Tension Band Wiring of Unstable Transverse Fractures of the Proximal and Middle Phalanges of the Hand

Outcome of closed proximal phalangeal fractures of the hand

A Review on Anguli Bhagna: An Exploratory Study

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