Treatment of type III middle phalangeal neck fractures through a palmar approach: a case report
【Abstract】 Phalangeal neck fractures occur almost exclusively in children. We present the case of a 49 years old man with a dislocated fracture of the neck of the middle phalanx with the distal fragment rotated at 180°, due to a traumatic circular saw injury to the left index, which was solved...
| 發表在: | Chinese Journal of Traumatology |
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| Main Authors: | , |
| 格式: | Article |
| 語言: | 英语 |
| 出版: |
Elsevier
2013-04-01
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| 在線閱讀: | http://www.cjtrauma.com/apps/ojs/index.php/cjt/article/view/392 |
| 總結: | 【Abstract】 Phalangeal neck fractures occur almost
exclusively in children. We present the case of a 49 years
old man with a dislocated fracture of the neck of the middle
phalanx with the distal fragment rotated at 180°, due to a
traumatic circular saw injury to the left index, which was
solved by anatomical reduction and bone fixation with two
1.5 mm Synthes screws and a temporary transarticular K-wire at the distal interphalangeal joint. Zone I flexor digitorum
profundus repair was performed using a modification of the
Kessler 4-strands core suture and a full-thickness skin graft
from the hypothenar eminence was taken to cover the skin
gap. At 6-month follow-up the patient was pain-free and
with a total active movement equivalent to 190°. No radio-logical signs of avascular necrosis of the head of the middle
phalanx or nonunion of the distal fragment was detectable
with recovery to the previous manual work. Owing to the
position of the phalangeal head maintained in position by
the collateral ligaments an anatomic reduction from dorsal
approach is difficult to be performed and a longitudinal trac-tion can render the reduction harder too. The volar approach
permits an easier reduction of the fracture through a
derotation of the distal fragment facing palmar.
Key words: Finger phalanges; Fractures, bone;
Finger joint |
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| ISSN: | 1008-1275 |