+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Treatment of proximal phalanx fractures: transarticular pinning the metacarpophalangeal joint or cross pinning from the base of the proximal phalanx-a prospective study



Treatment of proximal phalanx fractures: transarticular pinning the metacarpophalangeal joint or cross pinning from the base of the proximal phalanx-a prospective study



European Journal of Trauma and Emergency Surgery 45(4): 737-743



For extraarticular proximal phalanx fractures, two methods are employed, transarticular fixation in which the metacarpophalangeal joint is crossed and the extraarticular method in which the pins are introduced through the base of the proximal Phalanx. This study was a prospective one on patients with proximal phalanx transverse or short oblique fractures. In one of the groups we used parallel pins from metacarpal head through MCP joint to proximal phalanx. In the second, we used two cross pins from proximal phalanx the base of the proximal phalanx to fix the fracture. We evaluated metacarpophalangeal, proximal and distal interphalangeal joints active range of motion and how long it took the patient to resume their daily activities and work without difficulty, as well as post-operative complications such as wound infection, malunion, and nonunion in 3 and 6 months follow-up. Ultimately, 61 people entered the study, 29 in the parallel pins and 31 in the cross pins group. There was no significant difference between the two groups, but the improvement in all of the joints range of motion showed a statistically significant difference (P < 0.0001) from the 3 to 6 months follow-up. The final range of motion showed an inverse correlation with age of the patient (P < 0.05). Most of the patients were in the excellent grade of range of motion class and no serious complication was observed in any of them. The results of treatment in proximal phalangeal fractures with both methods were comparable and so the surgeon may select each based on the experience and training.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 065639018

Download citation: RISBibTeXText

PMID: 29487957

DOI: 10.1007/s00068-018-0927-6


Related references

Outcomes of closed reduction and periarticular pinning of base and shaft fractures of the proximal phalanx. Journal of Hand Surgery 39(8): 1524-1528, 2014

Percutaneous pinning of fractures in the proximal third of the proximal phalanx: complications and outcomes. Journal of Hand Surgery 37(7): 1342-1348, 2012

Tethering the Extensor Apparatus Limits PIP Flexion Following K-wire Placement for Pinning Extra-articular Fractures at the Base of the Proximal Phalanx. Hand 11(4): 433-437, 2016

Treatment of fractures of proximal phalanx of fingers by Eiffel Tower percutaneous pinning method. A review of 45 cases. Chirurgie de la Main 29(2): 88-93, 2010

Closed reduction and percutaneous pinning of fractures of the proximal phalanx. Journal of Hand Surgery 26(1): 45-49, 2001

Troublesome shaft fractures of the proximal phalanx. Early treatment to avoid late problems at the metacarpophalangeal and proximal phalangeal joints. Hand Clinics 4(1): 75-85, 1988

Repair of dorsal defects over the middle phalanx and proximal interphalangeal joint with a transposition flap from the dorsum of the proximal phalanx. Journal of Hand Surgery 36(5): 864-869, 2011

Complete ostectomy of middle phalanx and partial ostectomy of proximal phalanx in a Brown Swiss calf for treatment of purulent arthritis of the proximal interphalangeal joint and adjacent severe osteomyelitis. Berliner und Munchener Tierarztliche Wochenschrift 129(3-4): 138-143, 2016

The use of percutaneous pinning and a silicone splint for a fractured proximal phalanx. Athletic Training 25(1): 55-56, 1990

Displaced unstable transverse fractures of the shaft of the proximal phalanx of the fingers in industrial workers: reduction and K-wire fixation leaving the metacarpophalangeal and proximal interphalangeal joints free. Journal of Hand Surgery European Volume 36(7): 577-583, 2011

Pinning technique for shoulder fractures in adolescents: computer modelling of percutaneous pinning of proximal humeral fractures. Canadian Journal of Surgery. Journal Canadien de Chirurgie 52(6): E222-E228, 2009

Non-operative treatment of displaced avulsion fractures of the ulnar base of the proximal phalanx of the thumb. Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery 37(4): 225-227, 2003

Pilon Fractures of the Base of the Proximal Phalanx: Direct Intraosseous Joint Reduction with Bone-Grafting and Mini-Screws: A Case Report. Jbjs Case Connector 7(1): E5, 2018

Treatment of unstable distal phalanx fractures by extra-articular DIP pinning: A series of 12 cases. Hand Surgery and Rehabilitation 35(5): 330-334, 2016

Arthroscopic surgery for osteochondral fractures of the proximal phalanx of the metacarpophalangeal and metatarsophalangeal (fetlock) joints in horses. Journal of the American Veterinary Medical Association 188(3): 273-279, 1986