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Middle Phalanx Fracture

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2. Middle Phalanx Fracture

Middle Phalanx Fracture Middle Phalanx Fracture Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Middle Phalanx Fracture Middle Phalanx (...) Fracture Aka: Middle Phalanx Fracture From Related Chapters II. Signs Volar or dorsal angulation III. Management: Reduction Anesthesia: or Reduce by traction and manipulation of finger IV. Management: Post-Reduction of Fracture Immobilization after successful reduction Dorsal aluminum splint in extension for 6 weeks, then Buddy taping for an additional 6 weeks Post-Reduction Assessment Evaluate for even subtle rotation Methods Repeat finger XRay Flexed fingers should all point to (thenar eminence

2018 FP Notebook

3. Evaluation of Articular Surface Similarity of Hemi-Hamate Grafts and Proximal Middle Phalanx Morphology: A 3D Geometric Morphometric Approach. (Abstract)

Evaluation of Articular Surface Similarity of Hemi-Hamate Grafts and Proximal Middle Phalanx Morphology: A 3D Geometric Morphometric Approach. Hemi-hamate arthroplasty has been described as a viable treatment option for unstable proximal interphalangeal joint fracture-dislocations. The procedure uses a dorsal distal hamate osteochondral graft to recreate the injured volar middle phalanx (MP) proximal base. The purpose of this study was to evaluate the similarity in shape of these articular (...) surfaces using quantitative 3-dimensional methods.Three-dimensional virtual renderings were created from laser scans of the articular surfaces of the dorsal distal hamate and the volar MP bases of the index, middle, ring, and little fingers from cadaveric hands of 25 individuals. Three-dimensional landmarks were obtained from the articular surfaces of each bone and subjected to established geometric morphometric analytical approaches to quantify shape. For each individual, bone shapes were evaluated

2018 Journal of Hand Surgery - American

4. Percutaneous Cannulated Compression Screw Osteosynthesis in Phalanx Fractures: The Surgical Technique, the Indications, and the Results Full Text available with Trip Pro

with different types of phalangeal fractures undergoing a percutaneous cannulated compression screw osteosynthesis. Parameters such as average operation time and clinical outcome were evaluated postoperatively. Results: Forty-three patients were treated using a percutaneous cannulated compression screw fixation system for phalanx fractures of the proximal (n = 26), middle phalanx (n = 16), or distal phalanx (n = 1). All fractures healed after 6 to 8 weeks except in 1 patient with secondary loss of reduction (...) Percutaneous Cannulated Compression Screw Osteosynthesis in Phalanx Fractures: The Surgical Technique, the Indications, and the Results Objective: Fractures of metacarpals and phalanges are very common fractures, and there are a lot of treatment modalities. The purpose of the study was to describe the technique of percutaneous fixation of phalangeal fractures using a cannulated compression screw fixation system and its results. Methods: We conducted a prospective clinical study on 43 patients

2017 Eplasty

5. Erratum to: What Middle Phalanx Base Fracture Characteristics are Most Reliable and Useful for Surgical Decision-making? Full Text available with Trip Pro

Erratum to: What Middle Phalanx Base Fracture Characteristics are Most Reliable and Useful for Surgical Decision-making? 26842233 2016 06 30 2016 03 23 1528-1132 474 4 2016 Apr Clinical orthopaedics and related research Clin. Orthop. Relat. Res. Erratum to: What Middle Phalanx Base Fracture Characteristics are Most Reliable and Useful for Surgical Decision-making? 1080-1 10.1007/s11999-016-4728-0 Janssen Stein J SJ Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Yawkey

2016 Clinical Orthopaedics and Related Research

6. What Middle Phalanx Base Fracture Characteristics are Most Reliable and Useful for Surgical Decision-making? Full Text available with Trip Pro

What Middle Phalanx Base Fracture Characteristics are Most Reliable and Useful for Surgical Decision-making? Fracture-dislocations of the proximal interphalangeal joint are vexing because subluxation and articular damage can lead to arthrosis and the treatments are imperfect. Ideally, a surgeon could advise a patient, based on radiographs, when the risk of problems merits operative intervention, but it is unclear if middle phalanx base fracture characteristics are sufficiently reliable (...) to be useful for surgical decision making.We evaluated (1) the degree of interobserver agreement as a function of fracture characteristics, (2) the differences in interobserver agreement between experienced and less-experienced hand surgeons, and (3) what fracture characteristics and surgeon characteristics were associated with the decision for operative treatment.Ninety-nine (33%) of 296 hand surgeons evaluated 21 intraarticular middle phalanx base fractures on lateral radiographs. Eighty-one surgeons (82

2015 Clinical Orthopaedics and Related Research

7. Quantitative 3-dimensional CT analyses of fractures of the middle phalanx base Full Text available with Trip Pro

Quantitative 3-dimensional CT analyses of fractures of the middle phalanx base Quantitative 3-dimensional computed tomography (3DCT) analyses can provide a more detailed understanding of fracture morphology. For fracture-dislocation of the proximal interphalangeal joint, the extent of fragmentation of the volar lip of the middle phalanx-a factor that might influence treatment-is not always apparent from radiographs. We hypothesized that there is no correlation between number of fracture (...) fragments and the percentage of articular surface area involved in intra-articular fractures of the base of the middle phalanx using quantitative 3DCT analyses.We used 13 computed tomography scans with a slice thickness of 1.25 mm or less to create 3-dimensional models of 15 intra-articular fractures of the base of the middle phalanx in 13 patients. We resized 3-dimensional models of a non-fractured middle phalanx of the same hand to fit the fractured middle phalanx in order to approximate the size

2014 Hand (New York, N.Y.)

8. Antegrade Joint-Sparing Intramedullary Wiring for Middle Phalanx Shaft Fractures. (Abstract)

Antegrade Joint-Sparing Intramedullary Wiring for Middle Phalanx Shaft Fractures. To evaluate the outcome for surgical stabilization of middle phalanx shaft fractures with joint-sparing antegrade intramedullary K-wire fixation.We treated 15 extra-articular transverse or short oblique shaft fractures of the middle phalanx in 13 patients. All fractures were treated with closed reduction internal fixation with antegrade joint-sparing intramedullary K-wires. Patients had a minimum follow-up of 1 (...) intramedullary wiring for extra-articular transverse and short oblique shaft  fracture of middle phalanx is a simple, safe, inexpensive, and joint-sparing technique that provides enough fracture stability, even in cases of associated injuries, for early rehabilitation and functional recovery with the expectation of a good to excellent outcome.Therapeutic IV.Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

2014 Journal of Hand Surgery - American

9. Two Versus 3 Lag Screws for Fixation of Long Oblique Proximal Phalanx Fractures of the Fingers: A Cadaver Study. (Abstract)

Two Versus 3 Lag Screws for Fixation of Long Oblique Proximal Phalanx Fractures of the Fingers: A Cadaver Study. To compare 2- versus 3-screw fixation for oblique fractures of the proximal phalanx in a cadaver model that simulates active finger motion.We experimentally cut the proximal phalanges of the index, middle, and ring fingers of 9 cadaveric hands. Five fingers were assigned to a control group with no fixation, and 22 were fixed with either 2 or 3 lag screws. One digit was excluded (...) of these groups were equivalent with a power of 90%.Biomechanical stability during simulated active motion protocol did not differ in simulated proximal phalanx fractures treated with 2 lag screws or 3.Fracture fixation using 2 screws may be more cost and time effective and, therefore, more attractive to the surgeon, even when 3 screws can be placed. Furthermore, surgeons may consider using 2 screws rather than resorting to plate fixation when 3-screw fixation is not possible for these types

2015 Journal of Hand Surgery - American

10. Middle Phalanx Fracture

Middle Phalanx Fracture Middle Phalanx Fracture Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Middle Phalanx Fracture Middle Phalanx (...) Fracture Aka: Middle Phalanx Fracture From Related Chapters II. Signs Volar or dorsal angulation III. Management: Reduction Anesthesia: or Reduce by traction and manipulation of finger IV. Management: Post-Reduction of Fracture Immobilization after successful reduction Dorsal aluminum splint in extension for 6 weeks, then Buddy taping for an additional 6 weeks Post-Reduction Assessment Evaluate for even subtle rotation Methods Repeat finger XRay Flexed fingers should all point to (thenar eminence

2015 FP Notebook

11. Ununited Fracture of the Middle Phalanx Full Text available with Trip Pro

Ununited Fracture of the Middle Phalanx 19982071 2010 06 24 2010 06 24 0035-9157 14 Surg Sect 1921 Proceedings of the Royal Society of Medicine Proc. R. Soc. Med. Ununited Fracture of the Middle Phalanx. 142 Woolf A E AE eng Journal Article England Proc R Soc Med 7505890 0035-9157 2009 12 9 6 0 1921 1 1 0 0 1921 1 1 0 1 ppublish 19982071 PMC2152989

1921 Proceedings of the Royal Society of Medicine

12. Cartilage and extensor tendon defects after headless compression screw fixation of phalangeal and metacarpal fractures. (Abstract)

injuries were assessed by direct visualization and measurement after dissection. In the middle phalanx, the defect size in relation to the joint surface was significantly smaller after anterograde screw placement when compared with retrograde placement. Also, a mini-open approach was found to cause significantly less tendon injury than a percutaneous approach, but there was no difference in tendon damage between retrograde and antegrade screw insertion into the middle phalanx. (...) Cartilage and extensor tendon defects after headless compression screw fixation of phalangeal and metacarpal fractures. Osteosynthesis of metacarpal and phalangeal fractures with headless compression screws leads to a defect in the articular surface and possibly damage to the extensor tendons. This study aimed to quantify the articular surface defect and extensor tendon injuries after implant placement in cadaveric hands. Defect size was assessed with computed tomography. Extensor tendon

2020 Journal of Hand Surgery - European

13. Outcomes of Closed Reduction and Periarticular Pinning of Base and Shaft Fractures of the Proximal Phalanx. (Abstract)

Outcomes of Closed Reduction and Periarticular Pinning of Base and Shaft Fractures of the Proximal Phalanx. To review the results of periarticular pinning of extra-articular fractures of the proximal phalanx base and shaft.A retrospective review was performed of the senior author's practice (C.S.M.) from 2006 to 2012. The inclusion criteria were patients older than 18 years of age who underwent periarticular pinning of base or shaft fractures of the proximal phalanx. Age, sex, fracture location (...) , fracture pattern, and time to surgery were recorded. Outcome measures were range of motion, time to healing, and complication rate.A total of 43 patients with 50 fractures were identified. There were 19 men and 24 women with 16 shaft and 34 base fractures. Five fractures were open. The little finger was involved in 62%, the ring finger in 30%, and the index and middle fingers in 4% each. Most fractures were transverse or oblique, and just over half had comminution and/or impaction. Average follow-up

2014 Journal of Hand Surgery - American

14. Estimation of Base of Middle Phalanx Size Using Anatomical Landmarks. (Abstract)

size of the middle phalanx base to the proximal phalanx length of the same finger was 0.17. The ratio of articular surface size of the middle phalanx base to the size of the middle phalanx head of the same finger was 1.34. The intraclass correlation (ICC) among 3 raters was 0.99 for proximal phalanx length and 0.88 for size of the middle phalanx head.Knowledge of this relationship and ratios allow for accurate estimation of the percentage of articular surface involvement in a fracture of the middle (...) Estimation of Base of Middle Phalanx Size Using Anatomical Landmarks. To determine whether there is a measurable and reproducible relationship between the articular surface size of the middle phalanx base and the size of the middle phalanx head and proximal phalanx length of the same finger.Size of the articular surface of the middle phalanx base, size of the middle phalanx head, and proximal phalanx length were measured in 84 lateral radiographs by 3 observers.The ratio of articular surface

2014 Journal of Hand Surgery - American

15. The Central Slip Fracture: Results of Operative Treatment of Volar Fracture Subluxations/Dislocations of the Proximal Interphalangeal Joint. Full Text available with Trip Pro

The Central Slip Fracture: Results of Operative Treatment of Volar Fracture Subluxations/Dislocations of the Proximal Interphalangeal Joint. Fractures of the base of the middle phalanx are particularly challenging. Dorsal fracture-subluxations/dislocations of the proximal interphalangeal (PIP) joint are relatively common, but the volar fracture-subluxation/dislocation, the so-called "central slip fracture," is quite rare. The current study presents our experience with surgically treated (...) patients with central slip fracture subluxation/dislocation with a minimum of 1 year follow-up. We hypothesized that the majority of patients with a central slip fracture-subluxation/dislocation have poor outcomes.Thirteen patients with central slip fracture-subluxations/dislocation were identified from departmental billing records between 2003 and 2013. Nine patients completed the study follow-up examination and 8 were included in the final analysis. Clinical data assessed included age at injury, sex

2017 Journal of Hand Surgery - American

16. Accuracy in Screw Selection in a Cadaveric, Small-Bone Fracture Model. (Abstract)

Accuracy in Screw Selection in a Cadaveric, Small-Bone Fracture Model. Using a cadaveric model simulating clinical situations experienced during open reduction and internal fixation of proximal phalangeal fractures, the aim of this study was to evaluate the relationship between level of training and the rates of short, long, and ideal screw length selection based on depth gauge use without fluoroscopy assistance.A dorsal approach to the proximal phalanx was performed on the index, middle (...) , and ring fingers of 4 cadaveric specimens, and 3 drill holes were placed in each phalanx. Volunteers at different levels of training then measured the drill holes with a depth gauge and selected appropriate screw sizes. The rates of short, long, and ideal screw selection were compared between groups based on level of training. Ideal screws were defined as a screw that reached the volar cortex but did not protrude more than 1 mm beyond it.Eighteen participants including 3 hand fellowship-trained

2018 Journal of Hand Surgery - American

17. The Relationship Between Hemihamate Graft Size and Proximal Interphalangeal Joint Flexion for Reconstruction of Fracture-Dislocations: A Biomechanical Study. (Abstract)

The Relationship Between Hemihamate Graft Size and Proximal Interphalangeal Joint Flexion for Reconstruction of Fracture-Dislocations: A Biomechanical Study. The purpose of this study was to determine the relationship between hemihamate graft size and proximal interphalangeal (PIP) joint flexion in a biomechanical fracture-dislocation model.We simulated middle finger PIP fracture-dislocations in 5 cadaver hands by resecting 50% of the palmar articular surface of the middle phalanx (P2) base (...) . Fluoroscopy was used to confirm dorsal subluxation of the middle phalanx base after resection. A 10-mm osteochondral hamate graft was contoured to reconstruct the volar lip of the middle phalanx and was progressively downsized by 2-mm increments for each trial. A computer-controlled articulator and jig simulated active flexion and extension of the fingers. Maximum PIP flexion was measured at each graft size using fluoroscopy and digital imaging software. Clinically significant flexion block was defined

2018 Journal of Hand Surgery - American

18. Comparison of Open and Closed Hand Fractures and the Effect of Urgent Operative Intervention. Full Text available with Trip Pro

of metacarpal, proximal, or middle phalanx fractures from 2008 to 2015 using the American College of Surgeons' National Surgical Quality Improvement Program database. A total of 3,506 patients were identified and patient variables and infection incidence were compared between open and closed injuries, as well as open injuries managed within 1 day of admission and those treated on an elective basis or treated more than 1 day after admission. Bivariate analysis was used to determine independent risk factors (...) for postoperative infection.Although 34.2% of open hand fractures were taken urgently to the operating room, the diagnosis of open fractures along with nonurgent surgical treatment for open fractures was associated with a low incidence of postoperative infection. In addition, smoking was a risk factor for postoperative infection although anatomic location (phalanx vs metacarpal) was not.Patients undergoing surgery for metacarpal or proximal/middle phalangeal fractures are not at greater risk for infection based

2018 Journal of Hand Surgery - American

19. Surgical Management of Proximal Interphalangeal Joint Repetitive Stress Epiphyseal Fracture Nonunion in Elite Sport Climbers. (Abstract)

Surgical Management of Proximal Interphalangeal Joint Repetitive Stress Epiphyseal Fracture Nonunion in Elite Sport Climbers. Repetitive stress fracture of the middle phalanx epiphysis is an injury specific to elite adolescent sport climbers. As sport climbing becomes increasingly popular in younger age groups, an increased number of these injuries have been reported in recent years. To date, treatment of these fractures has been nonsurgical, with strict rest and physiotherapy prescribed until (...) fracture union. However, when these patients present in a delayed fashion with an established nonunion, nonsurgical treatment may fail, leading to disabling chronic pain and/or digital deformity in some cases. In this article, we present 2 cases of surgical treatment for finger middle phalanx repetitive stress epiphyseal fracture nonunion, using a percutaneous spot drilling epiphysiodesis technique.Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

2017 Journal of Hand Surgery - American

20. Treatment of unstable proximal interphalangeal joint fractures with hemi-hamate osteochondral autografts. (Abstract)

Treatment of unstable proximal interphalangeal joint fractures with hemi-hamate osteochondral autografts. The primary aim of this study was to assess the clinical and radiological results after hemi-hamate resurfacing arthroplasty in patients with acute or chronic unstable fractures of the base of the middle phalanx and to describe technical features that can facilitate the surgical procedure. Hemi-hamate arthroplasties were done in 19 patients (mean age 39 years) with an isolated fracture (...) at the base of the middle phalanx that involved more than 40% of the articular surface. We assessed ten chronic cases (treated >6 weeks after fracture) and nine acute ones (<6 weeks) at a mean of 24 months. Pain scores, QuickDASH scores, grip strengths, range of motion and radiological findings were recorded at follow-up. At follow-up, the mean active flexion at the proximal interphalangeal joint was to 83° with a mean fixed flexion of 17° (active range of motion 66°). The mean active distal

2016 Journal of Hand Surgery - European

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