Long-term objective results of proximal phalanx fracture treatment

Abstract

BACKGROUND Proximal phalanx fractures are common. In this study, our preferred methods regarding the treatment of proximal phalanx fractures and their long-term objective results are presented. METHODS Between October 2001 and March 2010, in the Plastic Reconstructive and Aesthetic Surgery Department of Düzce Medical Faculty, we treated 23 patients with 32 proximal phalanx fractures. Stable fractures (n=5) were treated with splints, while unstable fractures (n=27) were stabilized with 1.0 mm percutaneous intramedullary Kirschner wires following open reduction. RESULTS At follow-ups, ranging from 3 months to 9 years, patients were evaluated with radiologic efficiency, range of motion (ROM), total active movements (TAM), and grip power of the digit. TAM scores of 20 fingers were perfect (≥220° for D2-5, ≥150° for D1), for 7 fingers were good (180- 220° for D2-5, 120-150° for D1), and for 5 fingers were either moderate or poor. No difference was observed between grip strength of broken fingers and that of healthy fingers. As a major complication, non-union occurred in one finger. CONCLUSION We concluded that Kirschner wire fixation is a reliable and simple method of treating unstable proximal phalangeal fractures, and excellent long-term results can be obtained in suitable cases. In stable proximal phalanx fractures, splints provide sufficient treatment.