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...

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Main Authors: Lucchina Stefano, Fusetti Cesare
Format: Article
Language:English
Published: Elsevier 2013-04-01
Series:Chinese Journal of Traumatology
Online Access:http://www.cjtrauma.com/apps/ojs/index.php/cjt/article/view/392
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author Lucchina Stefano
Fusetti Cesare
author_facet Lucchina Stefano
Fusetti Cesare
author_sort Lucchina Stefano
collection DOAJ
description 【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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spelling doaj.art-38d02e44908f43f2b034734f6f5a37b22022-12-22T03:15:42ZengElsevierChinese Journal of Traumatology1008-12752013-04-01162107109215Treatment of type III middle phalangeal neck fractures through a palmar approach: a case reportLucchina StefanoFusetti Cesare【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 jointhttp://www.cjtrauma.com/apps/ojs/index.php/cjt/article/view/392
spellingShingle Lucchina Stefano
Fusetti Cesare
Treatment of type III middle phalangeal neck fractures through a palmar approach: a case report
Chinese Journal of Traumatology
title Treatment of type III middle phalangeal neck fractures through a palmar approach: a case report
title_full Treatment of type III middle phalangeal neck fractures through a palmar approach: a case report
title_fullStr Treatment of type III middle phalangeal neck fractures through a palmar approach: a case report
title_full_unstemmed Treatment of type III middle phalangeal neck fractures through a palmar approach: a case report
title_short Treatment of type III middle phalangeal neck fractures through a palmar approach: a case report
title_sort treatment of type iii middle phalangeal neck fractures through a palmar approach a case report
url http://www.cjtrauma.com/apps/ojs/index.php/cjt/article/view/392
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