CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo)
DOI: 10.1055/s-0041-1739405
Relato de Caso

Closed-Reduction Intramedullary Screw in Fractures of the Proximal Phalanges of the Digits of the Hand: A Series of Three Cases[*]

Article in several languages: português | English
1   Departamento de Ortopedia e Traumatologia, Faculdade de Medicina, Universitas Indonesia, Koja Public Regional Hospital, Jacarta, Indonésia
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1   Departamento de Ortopedia e Traumatologia, Faculdade de Medicina, Universitas Indonesia, Koja Public Regional Hospital, Jacarta, Indonésia
,
1   Departamento de Ortopedia e Traumatologia, Faculdade de Medicina, Universitas Indonesia, Koja Public Regional Hospital, Jacarta, Indonésia
› Author Affiliations

Abstract

The most frequent skeletal injuries are hand fractures, which constitute around 20% of all fractures. Fractures of the phalanx are usual, comprising 6% of all fractures. Proximal phalanx fractures arise more often. The main goals of the care are to repair the anatomy, reduce the damage to soft tissue, and mobilize the damaged fingers as soon as stabilization of the fracture allows it. The present report is intended to examine the clinical and radiation effects of proximal phalanx fractures in patients treated with intramedullary screw fixation who underwent closed reduction. We report three consecutive cases of proximal phalanx fracture: two basal fractures and one simple shaft fracture. They were treated surgically with closed reduction with intramedullary headless compression screws. The preoperative magnitude of the angulation of the proximal phalanx averaged 30.3° (range: 13° to 42°). Two patients presented rotational deformity. The clinical findings were measured using the abbreviated version of the Disabilities of the Arm, Shoulder and Hand (Quick-DASH) questionnaire, and the range of motion and functional results were assessed. Complications were observed over a span of at least 3 months. The patients displayed complete active flexion-extension proximal interphalangeal joint and flexion-extension metacarpophalangeal joint without rotative deformity. The scores on the QuickDASH were satisfactory (mean: 2.3; range: 0 to 4.5). No secondary surgeries were performed, and complications were not observed. Intramedullary fixation of proximal phalanx fractures with cannulated tension screws has been shown to be a safe operation, resulting in outstanding functional performance and an early recovery. The fracture is minimized and properly consolidated by the patients.

Financial Support

There was no financial support from public, commercial, or non-profit sources.


* Work developed at the Department of Orthopedics and Traumatology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.




Publication History

Received: 30 December 2020

Accepted: 11 February 2021

Article published online:
13 December 2021

© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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