Spiral Oblique Proximal Phalanx Frx
- these frx are inherently unstable, and requires internal fixation;
- Percutaneous Fixation Technique:
- reduction is achieved w/ a tenaculum fracture reduction clamp;
- 2 or 3 0.28 inch K wires are inserted across fracture, perpendicular to long axis of phalanx & engage both cortices of the phalanx;
- wires are cut 2-3 mm from the skin edge (leave the wires protruding on the outside of the border digits);
- wires should be placed as far as possible from each other along length of the fracture line;
- after passing each wire, ask the patient to flex and extend the fingers to ensure that there is no transfixation of the lateral bands;
- well padded dressing is then applied to protect the pin sites, but it is important that there remains some PIP motion;
- post op:
- generally the cast is left on for upto 4 weeks (one week longer than is necessary for transverse fractures)
Closed Reduction and Internal Fixation of Proximal Phalangeal Fractures.
Original Text by Clifford R. Wheeless, III, MD.
Last updated by Data Trace Staff on Monday, November 26, 2012 2:37 pm