- Disscusion
- 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.
MR Belsky MD, RG Eaton MD, and LB Lane MD.
J. Hand Surgery. 9-A: 725-729, 1984.
