Treatment of unstable distal phalanx fractures by extra-articular DIP pinning: A series of 12 cases

Prunières, Guillaume; Gouzou, S.; Facca, S.; Matheron, A.-S.; Maire, N.; Díaz, J.J. Hidalgo; Liverneaux, P.

doi:10.1016/j.hansur.2016.06.006

Cited by 10 publications

(4 citation statements)

References 17 publications

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“…Th e most common procedures are closed reduction with a percutaneous K-wire and open reduction with internal fixation using mini-plate screw systems. 11,18 In a retrospective study including 60 patients, Senesi et al 19 showed that a 23-gauge needle was a favorable alternative to K-wire in the treatment of distal In another study comparing the results of displaced mallet fractures treated with an extension block pin and transarticular fixation of the distal interphalangeal joint, Hofmeister et al 22 reported a 4° extension loss at ≥1-year follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…Th ey found a significantly shorter time tounion in the needle group. In a case series, including 12 patients with an extra-articular or intra-articular distal phalangeal fracture, Pruniereset al18 showed complete union with K-wire and the wires were removed at four weeks. In our study, six patients underwent closed reduction with percutaneous K-wire fixation and complete union was achieved in all patients during follow-up.…”

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Distal falanks kırığı olan erişkin hastalarda kapalı redüksiyon ve perkutan Kirschner teli uygulaması ile açık redüksiyon internal fiksasyon uygulaması sonuçları karşılaştırılması

Acar¹,

Bezirgan²,

Armangil³

2021

Sakarya Medical Journal

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Objective We aimed to compare functional and radiological results of closed reduction with percutaneous Kirschner wire (K-wire) fixation versus open reduction with internal fixation in adult patients with distal phalangeal fractures. Materials and MethodsA total of 13 patients (8 males, 5 females) who were operated for distal phalangeal fractures in our center between February 2019 and December 2020 were retrospectively reviewed.The patients were divided into two groups according to the type of surgery:Group 1 (n=6) undergoing closed reduction with percutaneous K-wire fixation and Group 2 (n=7) undergoing open reduction with internal fixation.Functional results were evaluated using the total active range of motion (TAROM) scale.Demographic and clinical characteristics and operative data were recorded.The time to return to work was assessed between the groups. ResultsThe median age was 37 (range, 24 to 51) years and the median follow-up was 13 (range, 10 to 18) months.According to the TAROM scale, excellent and good results were achieved in 11 and two patients, respectively.The median time to complete union was 4 (range, 3 to 6) weeks.There was no significant difference in the functional and radiological results between the groups.However, the median time to return to work was significantly shorter in Group 2 (p=0.03).None of the patients had postoperative complications such as infection, reduction loss, nonunion or complex regional pain syndrome. Conclusion Although both treatment methods yield satisfactory and comparable functional and radiological results in patients with distal phalangeal fractures, open reduction with internal fixation is significantly associated with a shorter time to return to work. Keywords Distal phalangeal fracture; adult; Kirschner wire; open reduction; internal fixation Öz Amaç Çalışmada; kapalı redüksiyon ve perkutan Kirschner teli (K teli) ile açık redüksiyon internal fiksasyon uyguladığımız distal falanks kırığı olan erişkin hastaların fonksiyonel ve radyolojik sonuçlarının değerlendirilmesi amaçlandı. Gereç ve Yöntemle Şubat 2019 ile Aralık 2020 tarihleri arasında 13 hasta (8 erkek, 5 kadın), iki ayrı gruba ayrılarak retrospektif olarak değerlendirildi. 1. gruba kapalı redüksiyon ve perkutan K teli ( 6 hasta) ve 2. gruba açık redüksiyon internal fiksasyon (7 hasta) uygulandı. Fonksiyonel sonuçlar total aktif eklem hareket açıklığı (TAEHA) skalasına göre değerlendirildi. Analiz Statistical Package for the Social Sciences (SPSS) ve Student t-testine göre yapıldı. p<0.05 olması anlamlı kabul edildi.Gruplarda işe dönüş zamanı karşılaştırıldı. Bulgular Hastaların ortalama yaşı 37 (24-51) ve ortalama takip süresi 13 (10-18) aydı. TAEHA skalasına göre 11 hasta mükemmel ve 2 hastada iyi sonuç elde edildi. Ortalama 4 (3-6) hafta içinde tüm hastalarda tam kaynama görüldü. Radyolojik ve fonksiyonel açıdan anlamlı fark saptanmadı. İşe dönüş zamanı açısından 2. grup anlamlı bulundu (p=0.03). Enfeksiyon, redüksiyon kaybı, kaynamama ve kompleks bölgesel ağrı sendromu gibi komplikasyonlar görülmed...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Distal falanks kırığı olan erişkin hastalarda kapalı redüksiyon ve perkutan Kirschner teli uygulaması ile açık redüksiyon internal fiksasyon uygulaması sonuçları karşılaştırılması

Acar¹,

Bezirgan²,

Armangil³

2021

Sakarya Medical Journal

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“…There are studies reporting that treatment with a splint is sufficient in eligible patients with distal phalanx fractures [24]. In the literature, fixation is recommended in the treatment of tuft fractures to promote fracture healing, to maintain reduced position and to provide support for the healing of nail bed [25,26]. As in most pediatric upper extremity fractures, surgical treatment may be recommended in open fractures and fractures in which stable fixation cannot be achieved [27,28].…”

Section: Discussionmentioning

confidence: 99%

Fixation of open, unstable tuft fractures in toddlers and preschool-aged children using a 25-gauge hypodermic needle

Kılınçoğlu

Gönder

Demir

et al. 2021

Journal of Pediatric Orthopaedics B

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This study aimed to assess the treatment process of open, unstable tuft fractures occurring in toddlers and preschool-aged children treated using a 25-gauge hypodermic needle in the emergency department, and the cosmetic and functional results achieved by this treatment. This retrospective cohort study included a total of 72 patients. Children aged two to six years were included in the study. Van Beek classification was used for the evaluation of nail bed injuries. Cosmetic results were evaluated on the basis of Zook classification whereas functional results were evaluated according to the Buck-Gramko score simplified by Nietosvaara et al. The patient population consisted of 52 men and 20 women. The mean age was 4 ± 1.33 years. The operating time was 19.17 ± 3.66 minutes and the time to union was 46.68 ± 4.84 days. While excellent and good functional results were obtained in 65 (90.2%) of the patients, excellent and very good cosmetic results were obtained in 51 (70.8%) patients. Unless there is an accompanying extremity fracture, unstable pediatric tuft fractures can be successfully fixed with a hypodermic needle in the emergency department. Gentle and precise repair of the nail bed may provide cosmetically and functionally satisfactory results.

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“…Some authors also described locked extra-articular pinning of the DIP joint, to reduced complications associated with current extra-articular and intra-articular techniques because the joint is not breached. Therefore, external connection of the two k-wires improves the stability of fixation [13].…”

Section: Complicationsmentioning

confidence: 99%

K-wire fixation vs 23-gauge percutaneous hand- crossed hypodermic needle for the treatment of distal phalangeal fractures

Senesi

Marchesini

Pangrazi

et al. 2020

BMC Musculoskelet Disord

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Background: Distal Phalanx (DP) fractures are the most common hand injuries. Bone fixation associated with soft tissue reconstruction, is often required to ensure more effective outcomes. The aim of the present study is to compare functional outcomes of DP fractures surgically treated with crossed manual drilled 23 Gauge needles vs crossed Kirschner-wires (k-wire). Methods: Clinical data included analysis of patient demographics, range of motion (ROM), and complications. Radiographic assessment considered fracture type, location, fracture displacement, and radiographic union. Functional outcomes analysis was performed.The statistical significance was assessed at the level of probability lower than 5%. Results: A total of 60 patients from 2012 to 2015 were retrospectively enrolled and among them 12 patients suffering from diabetes or current smokers. A total of 60 DP fractures were treated, 32 with needles (group A) and 28 with k-wire fixation (group B). Time to union, showed in different time points, was significantly lower in group A (≤ 40 days, p = 0.023*) compared to group B. ROM of the distal interphalangeal joint at six months follow-up was 60°in group A and 40°in group B. A significant improvement was observed (p = 0.001*) in the 23 G needle treated group. Functional outcome analysis showed that VAS was significantly lower in group A compared to group B (p = 0.023*). Conclusion: Our study showed that the 23 G needle yielded satisfactory results in terms of time to union and range of motion compared to k-wire fixation especially for tuft and shaft DP fractures. Therefore, should be a valid alternative to k-wire fixation in selected patients.

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Treatment of unstable distal phalanx fractures by extra-articular DIP pinning: A series of 12 cases

Cited by 10 publications

References 17 publications

Distal falanks kırığı olan erişkin hastalarda kapalı redüksiyon ve perkutan Kirschner teli uygulaması ile açık redüksiyon internal fiksasyon uygulaması sonuçları karşılaştırılması

Distal falanks kırığı olan erişkin hastalarda kapalı redüksiyon ve perkutan Kirschner teli uygulaması ile açık redüksiyon internal fiksasyon uygulaması sonuçları karşılaştırılması

Fixation of open, unstable tuft fractures in toddlers and preschool-aged children using a 25-gauge hypodermic needle

K-wire fixation vs 23-gauge percutaneous hand- crossed hypodermic needle for the treatment of distal phalangeal fractures

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