Ergebnisse osteosynthetisch versorgter Grundphalanxfrakturen der Finger

Abstract

The aim of the study was to retrospectively present and analyse the functional results of surgically treated extraarticular fractures of the proximal phalanx.From 1/2005-4/2008 we operated on 49 patients with 52 closed, extraarticular fractures of the proximal phalanx of the long fingers with either pins, screws or plates. 30 patients were male, 19 were female, the mean age was 35 years. Open fractures, fractures of the thumb and those with injuries to neurovascular structures or tendons were excluded. Postoperative physiotherapy was started on day 1 after surgery. Postoperative finger function and complications were analysed based on the total active motion (TAM) regarding the Belsky score and the classification of Page and Stern. In addition, patients were contacted by phone in 4/2009 to verify the subjective functional results at the end of the observation period.Three different operative procedures were employed: internal fixation by Kirschner wires (n=25), and open fixation by screws (n=8) or plates (n=19). The entire treatment period amounted to 12 (4-28) weeks, the observation time was 33 (11-50) months. Two patients, both after plate osteosynthesis, had to be reoperated because of functional deficits due to adhesions. In both a tenolysis and removal of the plate was performed. The functional result was excellent in 20 of 25 patients treated by Kirschner wires, in seven of the eight in the screw-fixation group and in 13 of the 19 patients treated by plate ostheosynthesis (TAM > 240°); the result was judged fair in 1 after plate osteosynthesis (TAM 215°). The remaining 11 patients showed a good outcome with a TAM between 220° and 239°. These favourable results remained subjectively stable at the end of the observation period, when all patients could be contacted by phone.Osteosynthesis by kirschner wires, screws and plates for closed extraarticular fractures of the proximal phalanx of the long fingers gives good to excellent results with few complications.

Treatment of hand and finger fractures with the Stryker Hand Plating System

“…Compared with the collectives in the literature, the patients in our study are older, which may be country-specific. In comparison, the patients in the study by Egloff et al were around 35 years old [ 10 ]. Pandey et al report an average of 29 years in their Italian study [ 11 ], and Ahmed et al have an average age in Pakistan of around 25 years [ 12 ].…”

DendroPrime as an adhesion barrier on fracture fixation plates: an experimental study in rabbits

“…Open reduction and plate fixation of phalangeal fractures often results in adhesion formation and finger stiffness (Brei-Thoma et al, 2015;Egloff et al, 2012;Kurzen et al, 2006;Onishi et al, 2015;Page and Stern, 1998;von Kieseritzky et al, 2017). The short distance between bone and tendons is further reduced by the osteosynthesis materials, and overgrowth of callus can also affect tendon gliding (Brei-Thoma et al, 2015).…”

Einfluss von Weichteilverletzungen auf die Ergebnisse operativ versorgter intraartikulärer Mittelphalanx – Basisfrakturen

“…In der Literatur wird die Inzidenz für das CRPS unterschiedlich angegeben und variiert zwischen 0,03-40 %[ 26 ] . Interessant ist, dass in der bereits durch Egloff et al[ 27 ] veröff entlichten Studie über die postoperativen Resultate bei 52 geschlossenen extraartikulären Phalanxfrakturen, welche zur gleichen Zeit in unserer Klinik behandelt wurden, kein Patient ein CRPS entwickelte. Die Therapie wurde durch nahezu das gleiche ärztliche und ergotherapeutische Behandlungsteam durchgeführt.…”