Intramedullary nailing of proximal phalangeal fractures

Gonzalez, Mark H.; Igram, Cassim; Hall, R

doi:10.1016/s0363-5023(05)80436-8

Cited by 31 publications

(12 citation statements)

References 9 publications

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“…In the present series we got 100% excellent results which was similar to Hwa et al 2 and Gonzalez et al ,78. Moreover, our complication rate was less ( n = 1, 3.33%), probably due to strict patient selection with only closed isolated proximal phalangeal fracture included in our series.…”

Section: Discussionsupporting

confidence: 89%

“…The construct was stable enough and none of our patients had angulation at fracture site at the end of six months. None of the fractures lost reduction originally obtained in the operation theatre 278. Cutting the nails flush with the bone avoided soft tissue tethering and without the need for implant removal except in one case with adventitious bursitis due to backing of nails.…”

Section: Discussionmentioning

confidence: 89%

“…The use of multiple intramedullary nailing for small long bones of the hand was first described by Foucher G 6. Subsequently, the same was suitably modified for proximal phalangeal fractures of the hand by Hwa et al 2 and Gonzalez et al 78…”

Section: Introductionmentioning

confidence: 99%

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Multiple intramedullary nailing of proximal phalangeal fractures of hand

Patankar

Meman

2008

Indian J Orthop

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Background:Proximal phalangeal fractures are commonly encountered fractures in the hand. Majority of them are stable and can be treated by non-operative means. However, unstable fractures i.e. those with shortening, displacement, angulation, rotational deformity or segmental fractures need surgical intervention. This prospective study was undertaken to evaluate the functional outcome after surgical stabilization of these fractures with joint-sparing multiple intramedullary nailing technique.Materials and Methods:Thirty-five patients with 35 isolated unstable proximal phalangeal shaft fractures of hand were managed by surgical stabilization with multiple intramedullary nailing technique. Fractures of the thumb were excluded. All the patients were followed up for a minimum of six months. They were assessed radiologically and clinically. The clinical evaluation was based on two criteria. 1. total active range of motion for digital functional assessment as suggested by the American Society for Surgery of Hand and 2. grip strength.Results:All the patients showed radiological union at six weeks. The overall results were excellent in all the patients. Adventitious bursitis was observed at the point of insertion of nails in one patient.Conclusion:Joint-sparing multiple intramedullary nailing of unstable proximal phalangeal fractures of hand provides satisfactory results with good functional outcome and fewer complications.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 89%

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Multiple intramedullary nailing of proximal phalangeal fractures of hand

Patankar

Meman

2008

Indian J Orthop

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“…11 Gonzalez et al reported excellent results in 28 transverse and short oblique proximal phalangeal fractures treated by Hall's technique, using multiple pre-bent flexible intramedullary pins. 12 After indirect fracture reduction, the pins were inserted under image intensification in an antegrade fashion through a hole in the dorsal cortex of the proximal phalanx. 4 Some similar techniques have been reported in literature.…”

Section: Discussionmentioning

confidence: 99%

Intramedullary Fixation of Proximal Phalangeal Fractures Through a Volar Extra-Tendon Sheath Approach

Itadera¹,

Oikawa²,

Shibayama³

et al. 2011

Hand Surg.

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We present an operative technique and the results of intramedullary fixation of proximal phalangeal shaft fractures through a volar extra-tendon sheath approach. A J-shaped nail, which is a curved Kirschner wire sharply bent at the proximal end, was inserted from the palmar aspect of the proximal phalangeal base. Six fingers of the six patients (all male) were treated with this method. The mean age of the patients was 51 years (range, 20-69 years). There were four open and two closed fractures. All fingers attained successful fracture union and one of them had correction loss. No patient complained of pain at the final follow-up, and the average of total active motion was 223° (190° - 255°). This method may be an alternative for treatments of the proximal phalangeal shaft fractures because of its less invasive nature, although it does not offer anatomical reduction.

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“…Intramedullary wiring was attempted in the manner described by Foucher and modified by Liew et al, Gonzales et al, and Gonzales and Hall. [2][3][4][5] However, at each attempt, the wires followed the previous K-wire track and penetrated the DIP joint. Therefore, a 1 mm K-wire was bent into a U-shape like a hairpin.…”

Section: Case Reportmentioning

confidence: 99%

Salvage of Delayed Union of a Phalangeal Fracture With "A Hairpin Wire"

Dhamangaonkar

Patankar

2013

Hand Surg.

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The advantages of using multiple joint sparing antegrade intramedullary wiring for displaced, transverse and short oblique fractures of the small long bones of the hand has been well documented. This technique provides stable three-point fixation and permits early range of motion exercises to prevent hand stiffness. But in some revision cases where there is a breach or deficiency of subchondral bone due to previous intramedullary wiring or in old neglected juxta articular fractures of the metacarpal, proximal phalanx or middle phalanx with disuse osteopenia, there is a high chance of inadvertent joint penetration with intra medullary wiring, inspite of using blunt tipped bent K wires. This could happen intraoperatively or later in the follow up due to collapse of the fracture ends. We describe an innovative fixation technique which ensures stable fixation, no joint penetration and enables early range of motion to prevent hand stiffness.

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Intramedullary nailing of proximal phalangeal fractures

Cited by 31 publications

References 9 publications

Multiple intramedullary nailing of proximal phalangeal fractures of hand

Multiple intramedullary nailing of proximal phalangeal fractures of hand

Intramedullary Fixation of Proximal Phalangeal Fractures Through a Volar Extra-Tendon Sheath Approach

Salvage of Delayed Union of a Phalangeal Fracture With "A Hairpin Wire"

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