The management of delayed union and nonunion of the metacarpals and phalanges

Corrective Osteotomy for Isolated Malunion of the Palmar Lunate Facet in Distal Radius Fractures

“…Jupiter et al documented that extra-articular osteotomies may be performed as nascent malunions and successful outcomes may be achieved as late as 4 months after the injury. 21 We noted that the original fracture line was easiest to discern when it was fluoroscopically visible. This was easiest when accomplished within the first 3 months but may be possible up to 6 months after fracture.…”

“…1,8,11,12,[21][22][23] Nevertheless, there are few series with only small numbers that address intraarticular osteotomies specifically. Marx and Axelrod demonstrated good and excellent results after intraarticular osteotomy for articular incongruity in 4 patients.…”

Fixation of closed metacarpal shaft fractures: Transverse K-wires in 22 cases

“…Rigid internal fixation would allow early mobilization, albeit at the cost of a scar and the increased risk of infection. K-wire fixation fell into some disrepute when Jupiter et al (1985), studying delayed and non-union of metacarpal fractures, stated that most patients with this complication had an inadequate or improper percutaneous K-wiring technique.…”

Fractures of the Proximal Phalanx and Those Involving the Metacarpo-Phalangeal Joint

“…If non-union is to be treated operatively, then infection must be eradicated and any bony defi cit will require bone graft. A robust fi xation, such as a plate, may be necessary to allow more vigorous post-operative mobilisation [ 18 ].…”