A Simple, Easy, and Reliable Technique of Phalangeal Corrective Osteotomy for Overlapping Fingers

Abstract

Background:The theory that malrotation is best assessed by making a fist and looking for digital overlap was the basis for devising a simple, easy, and reliable technique for phalangeal corrective osteotomy.Methods:This study assessed the phalangeal corrective osteotomy technique in 7 digits, involving 7 cases in 6 patients; 1 patient required treatment bilaterally. This technique required the use of a small hologram 2-row plate and screws to maintain stable fixation during aggressive postoperative therapy. Evaluation of the clinical results was based on the total range of active motion (%TAM), the grading of results according to Büchler, and the severity of pain reported by patients using the visual analog scale. The disability of the arm, shoulder, and hand questionnaire was completed preoperatively and at final follow-up by patients.Results:Corrective osteotomy corrected the overlapping of digits in all of the patients. There were no perioperative complications. Bone union was obtained in all cases, on average 13.4 weeks after surgery. Two osteotomies required secondary tenocapsulolysis concomitant with implant removal surgery. In light of total range of active motion and Büchler’s grade, all the patients had excellent to good results for both criteria at final follow-up. No patient complained about pain. Mean disability of the arm, shoulder, and hand scores significantly decreased from 16.9 (range, 11.3–26.5) preoperatively to 3.9 (range, 0–7.6) postoperatively.Conclusions:Phalangeal corrective osteotomy was performed using a simple, easy, and reliable technique.

In vitro Biomechanical Analysis of Proximal Phalangeal Osteotomy Fixation

“…4 In a similar setting, Abe performed a tenolysis and implant removal in two out of seven patients. 7 As shown in a cadaver model, a dorsally applied plate will displace the extensor mechanism and reduce motion at the proximal interphalangeal joint. 8 The clinical application of IMHS for fixation of corrective osteotomies has not yet been published.…”

Percutaneous corrective osteotomy for rotational malunion of metacarpal and phalangeal fractures

“…Osteotomies at the site of the malunion allow the closest restoration of pre-injury anatomy, but are associated with a high risk of complications and the need for re-operation. Abe (2015) reported that 29% of osteotomies required tenocapsulodesis concomitant with implant removal. Trumble and Gilbert (1998) reported on 11 cases, which all required secondary plate and screw removal.…”