“Bi-cortical” periarticular K-wire fixation for displaced unstable transverse extra-articular fractures of the base of the proximal phalanx of the fingers

Injury ◽  
2020 ◽  
Author(s):  
Mohammad M. Al-Qattan
Keyword(s):  
Proximal Phalanx ◽  
Articular Fractures ◽  
Wire Fixation

Trans-metacarpal Screw Fixation for Extra-articular Proximal Phalangeal Base Fractures

2017 ◽  
Vol 22 (01) ◽  
pp. 35-38 ◽  
Author(s):  
Eichi Itadera ◽  
Takahiro Yamazaki
Keyword(s):  
Screw Fixation ◽  
Proximal Phalanx ◽  
Metacarpophalangeal Joint ◽  
Fixation Method ◽  
Compression Screw ◽  
Metacarpal Head ◽  
Headless Compression Screw ◽  
Articular Fractures ◽  
Intramedullary Canal ◽  
Cannulated Drill

We developed a new internal fixation method for extra-articular fractures at the base of the proximal phalanx using a headless compression screw to achieve rigid fracture fixation through a relatively easy technique. With the metacarpophalangeal joint of the involved finger flexed, a smooth guide-pin is inserted into the intramedullary canal of the proximal phalanx through the metacarpal head and metacarpophalangeal joint. Insertion tunnels are made over the guide-pin using a cannulated drill. Then, a headless cannulated screw is placed into the proximal phalanx. All of five fractures treated by this procedure obtained satisfactory results.

Correction of Fixed Hammertoe Deformity with Resection of the Head of the Proximal Phalanx and Extensor Tendon Tenodesis

1995 ◽  
Vol 16 (7) ◽  
pp. 449-451 ◽  
Author(s):  
Shahan K. Sarrafian
Keyword(s):  
Proximal Phalanx ◽  
Extensor Tendon ◽  
Surgical Correction ◽  
Wire Fixation

A method of surgical correction of a fixed hammertoe deformity is presented. It incorporates the resection of the head of the proximal phalanx with an extensor tendon tenodesis to the dorsum of the proximal phalanx. The controlled tension in the extensor tendon provides the necessary stability. It alleviates the use of K-wire fixation.

scholarly journals Tethering the Extensor Apparatus Limits PIP Flexion Following K-wire Placement for Pinning Extra-articular Fractures at the Base of the Proximal Phalanx

Hand ◽  
2016 ◽  
Vol 11 (4) ◽  
pp. 433-437 ◽  
Author(s):  
Yaron Sela ◽  
Caitlin Peterson ◽  
Mark E. Baratz
Keyword(s):  
Insertion Site ◽  
Proximal Phalanx ◽  
Extensor Tendon ◽  
Metacarpophalangeal Joint ◽  
Minimally Invasive Surgical ◽  
Articular Fractures ◽  
Pip Joint ◽  
Joint Flexion ◽  
The Mean ◽  
K Wires

Background: Closed reduction with percutaneous Kirschner wires (K-wires) is the most minimally invasive surgical option for stabilizing phalanx fractures. This study examines the effect of K-wire placement on proximal interphalangeal (PIP) joint motion. Methods: PIP joint flexion was measured in the digits of 4 fresh-frozen cadaver hands after placing a suture loop through the flexor tendons and placing tension on the flexors via a mechanical scale. The load necessary to flex the PIP joint to 90° or to maximum flexion was recorded. The load was removed and K-wires were inserted in 3 locations about the metacarpophalangeal joint (MPJ): through the extensor tendon and across the MPJ, adjacent to the extensor tendon insertion site and across the MPJ, and through the sagittal band and into the base of the proximal phalanx (P1). The load on the tendons was reapplied, and angles of PIP joint flexion were recorded for each of the 3 conditions. Results: The mean angle of PIP joint flexion prior to K-wire insertion was 87°, and the mean load applied was 241 g. The angles of flexion were 53° when the K-wire was placed through the extensor tendon, 70° when the K-wire was placed adjacent to the tendon, and 75° when the K-wire was placed into the base of P1 by going through the sagittal band, midway between the volar plate and the extensor tendon. Conclusions: K-wires placed remote from the extensor tendon create less of an immediate tether to PIP joint flexion than those placed through or adjacent to the extensor tendon.

Arthroplasty of the Proximal Interphalangeal Joint Using Costal Cartilage Grafts

1992 ◽  
Vol 17 (5) ◽  
pp. 583-585 ◽  
Author(s):  
T. HASEGAWA ◽  
Y. YAMANO
Keyword(s):  
Costal Cartilage ◽  
Proximal Phalanx ◽  
Functional Results ◽  
Clinical Results ◽  
Proximal Interphalangeal Joint ◽  
Range Of Movement ◽  
Cartilage Grafts ◽  
Articular Fractures ◽  
Pip Joint ◽  
Bony Ankylosis

Seven intra-articular fractures in five patients with partial bone loss at the PIP joint were reconstructed using a graft of costal cartilage. In all cases there were total or partial cartilagenous defects of the proximal phalangeal side of the joint. Early treatment of two joints, using only costal cartilage grafts, resulted in bony ankylosis due to necrosis of the grafted cartilage. In five joints the grafted cartilage included osseous portions using the costo-osteochondral junction, leading to an average range of movement of 64° with satisfactory clinical results. The technique is a useful alternative to other forms of arthroplasty or arthrodesis, and can provide satisfactory functional results when there is a partial defect of the head of the proximal phalanx.

scholarly journals Kirschner Wire Fixation for Immobilization of the Thenar Flap in an Uncooperative Pediatric Patient: A Case Report

2020 ◽  
Vol 25 (4) ◽  
pp. 287-291
Author(s):  
Hyokyung Yoo ◽  
Yunghoon Kim ◽  
Sung Tack Kwon ◽  
Byung Jun Kim
Keyword(s):  
Pediatric Patients ◽  
Kirschner Wire ◽  
Proximal Phalanx ◽  
Ring Finger ◽  
Soft Tissue Reconstruction ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
Tissue Reconstruction ◽  
Two Stages ◽  
Fingertip Reconstruction

Thenar flap is a commonly used operational method in fingertip reconstruction. It should be maintained for two to three weeks before flap division until the neovascularization is established from the fingertip to the flap. However, immobilization between two stages of operation is challenging especially in uncooperative pediatric patients. A 47-month-old female with a ring fingertip amputation underwent soft tissue reconstruction with thenar flap. Two days postoperatively, the flap’s proximal margin was found disrupted. Flap revision was performed, followed by applying a trans-phalangeal Kirschner wire (K-wire) between the thumb proximal phalanx and ring finger middle phalanx. The flap was successfully divided two weeks after the original operation. The result was aesthetically pleasing, and no complication was observed, including dehiscence, necrosis, limitation of range of motion, and visible scar of the pinning sites. In conclusion, K-wire fixation is a safe and effective method to immobilize thenar flap in uncooperative pediatric patients.

Open Reduction and Cerclage Wire Fixation for Long Oblique/Spiral Fractures of the Proximal Phalanx of the Fingers

2008 ◽  
Vol 33 (2) ◽  
pp. 170-173 ◽  
Author(s):  
M. M. AL-QATTAN ◽  
K. AL-ZAHRANI
Keyword(s):  
Open Reduction ◽  
Full Range ◽  
Proximal Phalanx ◽  
Pain Syndrome ◽  
Flexion Contracture ◽  
Proximal Interphalangeal Joint ◽  
Active Motion ◽  
Cerclage Wire ◽  
Wire Fixation ◽  
Total Active Motion

Fifteen cases of long oblique/spiral fractures of the shaft of the proximal phalanx of the fingers treated by open reduction, cerclage wire fixation and immediate postoperative mobilisation were studied prospectively. Twelve patients presented early (within 24 hour of injury) and the remaining three cases were treated initially elsewhere by closed reduction and percutaneous oblique K-wire fixation with failure of the fixation. The latter three patients presented to our clinic late (10–14 days after injury). Following internal fixation with cerclage wires, no cases of infection, complex regional pain syndrome (CRPS) Type 1, fracture re-displacement, wire migration or extrusion were noted. One patient complained of a palpable wire which was removed 4 months after surgery. All fractures united and all patients returned to work at a mean of 8 (range 7–11) weeks after surgery. Twelve patients obtained a full range of motion (total active motion–TAM = 260°) and the remaining three patients had a mild (5–15°) flexion contracture of the proximal interphalangeal joint. Cerclage wire fixation is an acceptable technique of fixation for these fractures.

The Additional Use of External Fixator after Percutaneous K-Wire Fixation for Intra-articular fractures of The Distal Radius

2000 ◽  
Vol 13 (1) ◽  
pp. 139
Author(s):  
Chang Woo Kim ◽  
Ja Seong Gu ◽  
Gi Tae Jeong ◽  
Su Yeong Jeon ◽  
Tae Hoon Jeong ◽  
...  
Keyword(s):  
Distal Radius ◽  
External Fixator ◽  
Articular Fractures ◽  
Wire Fixation

Juxta-Epiphyseal Fractures of the Base of the Proximal Phalanx of the Fingers in Children and Adolescents

2002 ◽  
Vol 27 (1) ◽  
pp. 24-30 ◽  
Author(s):  
M. M. AL-QATTAN
Keyword(s):  
Children And Adolescents ◽  
Closed Reduction ◽  
Kirschner Wire ◽  
Proximal Phalanx ◽  
Fracture Site ◽  
Pattern Of Injury ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
Epiphyseal Fractures

A series of 34 juxta-epiphyseal fractures of the base of the proximal phalanx of the fingers of children and adolescents are presented. The pattern of injury appeared identical in all these fractures, with a lateral angulation force separating a small triangular metaphyseal fragment from the base of the phalanx on the side of angulation and the fracture line then continuing through the metaphysis, 1–2mm distal to the growth plate. Fractures were classified into two types according to the degree of displacement. Type 1 fractures ( n=18) were mildly displaced and were all successfully treated with closed reduction and splinting. Type 2 fractures ( n=16) were severely displaced and problems with obtaining an adequate reduction and long-term residual deformities were encountered. One patient with a severely displaced fracture required open reduction and Kirschner-wire fixation because of flexor tendon entrapment at the fracture site. Another five cases required Kirschner-wire fixation after closed manipulation in order to maintain the reduction. The remaining 10 patients with Type 2 fractures were treated by closed reduction and splinting, and two patients healed with malunion causing a “pseudo-claw” deformity.

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