Corrective Osteotomy of Malunited Fractures of Phalanges and Metacarpals

Gollamudi, Srikanth; Jones, W. A.

doi:10.1016/s0266-7681(00)80007-8

Cited by 21 publications

(13 citation statements)

References 14 publications

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“…Surgeons have debated about whether it is preferable to correct the malunion at the site of the fracture 4,12 or to perform a corrective procedure at a separate site 10,13 . For instance, malrotation of a phalangeal fracture can be addressed with a rotational osteotomy of the metacarpal [13][14][15][16] .…”

Section: Fig 4-cmentioning

confidence: 99%

Malunion and Nonunion of the Metacarpals and Phalanges

Ring¹

2005

The Journal of Bone and Joint Surgery-American Volume

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Section: Fig 4-cmentioning

confidence: 99%

Malunion and Nonunion of the Metacarpals and Phalanges

Ring¹

2005

The Journal of Bone and Joint Surgery-American Volume

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“…Malunion is a frequent complication of fractures of the phalanges of the hand, especially when the proximal phalanx is involved [5, 8-10]. Malunion of the phalanx can cause functional and aesthetic problems such as crossing or scissoring of the fingers, disturbance of tendon balance such as extensor lag, and reduction of grip strength.…”

Section: Discussionmentioning

confidence: 99%

“…Reports of corrective osteotomy for malunited fractures of the phalanges of the hand are infrequent and often limited to small series with a short follow-up [2, 3, 5, 12]. Malunited fractures of the phalanges can be corrected at the site of malunion or at the base of the metacarpal.…”

Section: Discussionmentioning

confidence: 99%

Post-Traumatic Malunion of the Proximal Phalanx of the Finger. Medium-Term Results in 24 Cases Treated by “In Situ” Osteotomy

Potenza¹,

Luna²,

Maglione³

et al. 2012

TOORTHJ

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We report the clinical and radiographic medium-term results obtained for 20 patients (24 fingers) treated surgically for post-traumatic malunion of the proximal phalanx of the finger. In all cases we performed a corrective osteoclasia or osteotomy at the site of malunion, followed by miniplate and screw fixation or by screw fixation only. The corrective osteoclasia was performed when malalignment was addressed within six weeks after injury. Two patients who had two fractures underwent additional surgery (tenolysis and/or capsulolysis) to improve function and ROM. At the final follow-up, at a mean of 24 months after corrective surgery, good or excellent clinical and radiographic results were obtained in all the patients. The pseudoclaw deformity disappeared in all cases in which a volar angulation deformity was present. An average improvement of about 30% in the range of motion of the MP and PIP joints was observed; only 4 patients complained of mild pain at the maximum degrees of articular excursion of the MP and PIP joints. All the patients presented an improvement in grip strength. The mean DASH score in our series was 5 points. In two of the four cases treated by an intra-articular corrective osteotomy, mild radiographic signs of osteoarthritis at the MP joint were present. The data for this study confirm that “in situ” osteotomy stabilized by miniplates and/or screws is an effective procedure to correct post-traumatic malunions of the proximal phalanges of the fingers.

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“…The various potential deformities are termed rotational, flexion, extension, and impaction. These deformities result in functional deficits and aesthetic problems, in many cases [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…Corrective osteotomy in hand surgery represents a possible treatment option in patients with malpositioned metacarpals and phalangeal bones, but only data from small case series are currently available in the literature [ 1 , 2 , 8 – 10 ]. Several osteotomy techniques have been proposed in past years, including transverse, oblique, open-wedge, closing wedge, pivot, and step-cut osteotomies.…”

Section: Introductionmentioning

confidence: 99%

Multiple drill-hole osteotomy in hand surgery – description of a novel application and proof of feasibility

Haider

Geisler

Thalhammer

et al. 2017

BMC Musculoskelet Disord

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BackgroundMalunion of phalangeal and metacarpal bones are often associated with impairment of hand function and pose a challenging task for treating surgeons in most cases. When applicable, corrective osteotomy is the treatment of choice, where the affected bone is cut to correct malalignment using chisels or saws. The use of these instruments is associated with several drawbacks especially in hand surgery. We aimed to determine whether a multiple drill-hole (MDH) osteotomy technique was suitable for performing corrective osteotomies of metacarpal and phalangeal bones.MethodsThis case series included 11 patients with malalignments or malunions of phalangeal or metacarpal bones. Corrective osteotomy was performed with the MDH technique. Follow-up examinations included clinical evaluations and radiography at frequent intervals, between 2 and 22 months postoperatively.ResultsIn all cases, planned osteotomies were technically feasible with the MDH technique. Apart from one case of a broken drillbit, no intraoperative or postoperative complication was recorded. All performed osteotomies healed within a mean of 6 weeks to radiological consolidation. In all cases, satisfactory results were achieved.ConclusionThe present study was the first to test MDH osteotomy for hand surgery. We demonstrated that MDH was feasible for corrective osteotomies of metacarpal and phalangeal deformities. Advantages included excellent feasibility for osteotomies performed at varying angles, precise execution, reduced risk of collateral damage, and flexibility for performing intra-articular osteotomies.

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Corrective Osteotomy of Malunited Fractures of Phalanges and Metacarpals

Cited by 21 publications

References 14 publications

Malunion and Nonunion of the Metacarpals and Phalanges

Malunion and Nonunion of the Metacarpals and Phalanges

Post-Traumatic Malunion of the Proximal Phalanx of the Finger. Medium-Term Results in 24 Cases Treated by “In Situ” Osteotomy

Multiple drill-hole osteotomy in hand surgery – description of a novel application and proof of feasibility

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