[Open reduction and plate/screw osteosynthesis of proximal phalanx fractures].
OPERATIVE ORTHOPADIE UND TRAUMATOLOGIE 2019;
31:408-421. [PMID:
30980086 DOI:
10.1007/s00064-019-0598-4]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 03/17/2018] [Accepted: 03/23/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE
Anatomical open reduction and internal fixation using screw/plate osteosynthesis.
INDICATIONS
Extra-articular fractures with clinically evident malrotation of the finger, comminution fracture and/or loss of length, which cannot be treated non-operatively; fracture instability; intra-articular fracture with step off greater than 1 mm, which cannot be treated percutaneously but openly using plate/screw osteosythesis; failure of conservative treatment.
CONTRAINDICATIONS
General operative limitations.
SURGICAL TECHNIQUE
Dorsal, mediolateral, or palmar approach, temporary reduction using pincers or optional Kirschner wires; screw/plate osteosynthesis for internal fixation.
POSTOPERATIVE MANAGEMENT
Immediate mobilization facilitated by buddy loops for the first 4-6 weeks, prevention of edema using elastic dressing, physiotherapy.
RESULTS
Open reduction and internal fixation using screw/plate osteosynthesis provides good results in combination with immediate mobilization. Nevertheless, adhesion of tendons or capsule tissue with restriction of range of motion is observed.
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