• J Hand Surg Am · Sep 1995

    Case Reports

    Intramedullary nailing of proximal phalangeal fractures.

    • M H Gonzalez, C M Igram, and R F Hall.
    • Department of Orthopaedics, University of Illinois, Chicago 60612-7342, USA.
    • J Hand Surg Am. 1995 Sep 1;20(5):808-12.

    AbstractA retrospective review of 25 consecutive patients with 28 proximal phalangeal fractures was performed. Fractures of the thumb were excluded. Twenty-five fractures were closed and three were open. All fractures were reduced, closed, and fixed using flexible intramedullary fixation with 0.8-mm prebent nails. Fractures amenable to flexible intramedullary fixation include short oblique and transverse fractures. Contraindications include long oblique, spiral, and bicortical comminuted fractures. The average follow-up time was 10 months (range, 2-20). Five patients with six fractures were lost to follow-up evaluation. All of the remaining 23 fractures healed and there were no infections. An average of 2 degrees angulation was seen on anteroposterior x-ray films. One patient showed 4 degrees of angulation on the lateral x-ray film. No shortening was noted. One fracture showed appreciable malrotation of 10 degrees. Flexible intramedullary rodding of specific proximal phalangeal fractures provides excellent results with a low complication rate. Proper selection of fractures and good surgical technique are necessary to avoid complications.

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