The Use of Small Bone Screws in the Treatment of Metacarpal, Metatarsal, and Phalangeal Fractures

Kilbourne, Burton C.; Paul, E

doi:10.2106/00004623-195840020-00010

“…Screw fixation was described by Kilbourne and Paul (1958) and used in seven phalangeal fractures with only fair or poor (including one amputation) results, causing the authors to warn against its indiscriminate use. However, a retrospective review of 14 phalangeal fractures (ten were spiral or oblique fractures of the proximal phalanx) treated by AO techniques reported that 13 achieved a full painless range of movement (Crawford, 1976).…”

Section: Discussionmentioning

confidence: 99%

A Prospective Randomized Controlled Study of Fixation of Long Oblique and Spiral Shaft Fractures of the Proximal Phalanx: Closed Reduction and Percutaneous Kirschner Wiring Versus Open Reduction and Lag Screw Fixation

Horton

¹

,

Hatton

²

,

Davis

³

2003

Journal of Hand Surgery

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Patients with an isolated spiral or long oblique fracture of the proximal phalanx were randomized into two groups. One was treated by closed reduction and Kirschner wire fixation and the second treated by open reduction and lag screw fixation. An independent observer assessed function, pain, movement, grip strength and intrinsic muscle function. X-rays were assessed for malunion. Thirty-two patients were entered the study and 15 in the Kirschner wire and 13 in the lag screw group were reviewed at a mean follow-up of 40 months. There was no significant difference in the functional recovery rates or in the pain scores for the two groups. X-rays showed similar rates of malunion and there were no statistically significant differences in range of movement or grip strength.

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“…[40] In addition to proper AP and lateral, an oblique view may be needed in subtly displaced fractures. The fracture itself may be classified into undisplaced, partialy displaced and completely displaced.…”

Section: Metacarpal Fracturesmentioning

confidence: 99%

Current concepts in managing fractures of metacarpal and phalangess

Kamath¹,

Harshvardhan²,

Naik³

et al. 2011

Indian J Plast Surg

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Fractures of the metacarpal and phalanges constitute 10% of all fractures. No where in the body, the form and function are so closely related to each other than in hand. Too often these fractures are treated as minor injuries resulting in major disabilities. Diagnosis of skeletal injuries of the hand usually does not pose major problems if proper clinical examination is supplemented with appropriate radiological investigations. Proper preoperative planning, surgical intervention wherever needed at a centre with backing of equipment and implants, selection of appropriate anaesthesia and application of the principle of biological fixation, rigid enough to allow early mobilisation are all very important for a good functional outcome. This article reviews the current concepts in management of metacarpal and phalangeal fractures incorporating tips and indications for fixation of these fractures. The advantages and disadvantages of various approaches, anaesthesia, technique and mode of fixation have been discussed. The take-home message is that hand fractures are equally or more worthy of expertise as major extremity trauma are, and the final outcome depends upon the fracture personality, appropriate and timely intervention followed by proper rehabilitation. Hand being the third eye of the body, when injured it needs a multidisciplinary approach from the beginning. Though the surgeon's work appears to be of paramount importance in the early phase, the contribution from anaesthetist, physiotherapist, occupational therapist, orthotist and above all a highly motivated patient cannot be overemphasised.

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“…Unstable long oblique fractures of shaft of the phalynges often need ORIF with K wire (composite or supplementary wiring) or interfragmentary screw fixation(mini or micro plates when used are preferably Fracture neck of the phalynges are mainly seen in children and are notoriously missed for want of properly focussed X ray. [40] In addition to proper AP and lateral, an oblique view may be needed in subtly displaced fractures. The fracture itself may be classified into undisplaced, partialy displaced and completely displaced.…”

Section: Metacarpal Fracturesmentioning

confidence: 99%

Current concepts in managing fractures of metacarpal and phalangess

Kamath

¹

,

Naik

²

,

Bansal

³

2011

Indian J Plast Surg

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Fractures of the metacarpal and phalanges constitute 10% of all fractures. No where in the body, the form and function are so closely related to each other than in hand. Too often these fractures are treated as minor injuries resulting in major disabilities. Diagnosis of skeletal injuries of the hand usually does not pose major problems if proper clinical examination is supplemented with appropriate radiological investigations. Proper preoperative planning, surgical intervention wherever needed at a centre with backing of equipment and implants, selection of appropriate anaesthesia and application of the principle of biological fixation, rigid enough to allow early mobilisation are all very important for a good functional outcome. This article reviews the current concepts in management of metacarpal and phalangeal fractures incorporating tips and indications for fixation of these fractures. The advantages and disadvantages of various approaches, anaesthesia, technique and mode of fixation have been discussed. The take-home message is that hand fractures are equally or more worthy of expertise as major extremity trauma are, and the final outcome depends upon the fracture personality, appropriate and timely intervention followed by proper rehabilitation. Hand being the third eye of the body, when injured it needs a multidisciplinary approach from the beginning. Though the surgeon's work appears to be of paramount importance in the early phase, the contribution from anaesthetist, physiotherapist, occupational therapist, orthotist and above all a highly motivated patient cannot be overemphasised.

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The Use of Small Bone Screws in the Treatment of Metacarpal, Metatarsal, and Phalangeal Fractures

Cited by 40 publications

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A Prospective Randomized Controlled Study of Fixation of Long Oblique and Spiral Shaft Fractures of the Proximal Phalanx: Closed Reduction and Percutaneous Kirschner Wiring Versus Open Reduction and Lag Screw Fixation

A Prospective Randomized Controlled Study of Fixation of Long Oblique and Spiral Shaft Fractures of the Proximal Phalanx: Closed Reduction and Percutaneous Kirschner Wiring Versus Open Reduction and Lag Screw Fixation

Current concepts in managing fractures of metacarpal and phalangess

Current concepts in managing fractures of metacarpal and phalangess

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