Percutaneous Intramedullary Reduction Technique for Impacted Middle Phalanx Base Fractures

Abstract

Proximal interphalangeal joint injuries are common and are a major risk for functional deficits of the finger that affect range of motion and grip strength. Impacted intra-articular fractures and fracture dislocations of the middle phalanx base are challenging to treat because of troublesome joint reduction and difficulties in achieving articular congruity. Although treatment algorithms have been published, the anatomically delicate proximal interphalangeal joint often remains incomplete in function and may result in post-traumatic pain, stiffness, and osteoarthritis. This article describes a percutaneous intramedullary reduction technique for impacted middle phalanx fractures as a treatment option to achieve articular congruity with minimal surgical trauma. The reduction technique may be considered for selected patients with impacted fractures of the base of the middle phalanx with or without joint dislocation.

Long-term outcomes after extension block pinning for fracture-dislocations of the proximal interphalangeal joint

“…Intraoperative reduction of the joint was achieved in all 55 cases. In 13 of the cases, the impacted central articular fracture fragments were percutaneously tamped with a blunt intramedullary K-wire to improve joint congruency (Nordback and Waris, 2021; Waris and Alanen, 2010). In two of the cases, open fracture reduction and K-wire fixation of the bony fragments was done through an anterior approach.…”