Journal of Musculoskeletal Trauma

Use of a Distraction Dynamic External Fixator in the Treatment of Comminuted Middle Phalanx Base Fractures: Sang Woo Kim, Chae Chil Lee, Sang Hun Ko, Il Yeong Hwang, Min Seok Kim, Woo Young Jin; J Korean Fract Soc 2019;32(1):1-5. Published online January 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.1.1

PURPOSE
This paper suggests the use of distraction dynamic external fixators (DDEF) for the treatment of proximal middle phalanx fractures.
MATERIALS AND METHODS
Seven patients, who were diagnosed with comminuted intra-articular fractures at the base of the middle phalanx from February 2014 to November 2016, were enrolled in this study (volar aspect 6 cases, dorsal aspect 1 case). They underwent a closed reduction under a C-arm image intensifier, and DDEF was applied with general anesthesia. Range of motion (ROM) exercise was encouraged after 3 to 5 days postoperatively, and DDEF was removed after 5 weeks. Subluxation, angulation and displacement were evaluated 6 weeks postoperatively.
RESULTS
The patients who were treated with DDEF showed a normal proximal interphalangeal joint ROM (100Â°), and there was no subluxation or displacement on the X-ray film 6 weeks postoperatively. In addition, there were no signs of infection, such as local heat, redness, and pus-like discharge.
CONCLUSION
DDEF helps maintain the reduction and reducing forces through the ligamentotaxis. The joint stiffness is reduced, which it makes early return to daily life easier.

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Treatment of Neglected Proximal Interphalangeal Fracture Dislocation Using a Traction Device: A Case Report
Yongun Cho, Jai Hyung Park, Se-Jin Park, Ingyu Lee, Eugene Kim
Journal of the Korean Fracture Society.2019; 32(4): 222. CrossRef

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Osteochondral Autograft Using Head of Proximal Phalanx of Toe for Partial Osteochondral Defect of Proximal Interphalangeal Joint: A Case Report: Tong Joo Lee, Kyung Ho Moon, Yoon Sang Jeon, Do Seung Kwon; J Korean Fract Soc 2010;23(3):321-325. Published online July 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.3.321

Abstract PDF: Osteochondral injury due to the trauma of the hand is relatively common. If the size of the osteochondral fracture fragment is large, open reduction and internal fixation are often feasible in treating these problems. However, arthroplasty using osteochondral graft is more preferred when the particle is small and articular surface is comminuted or fully defected. There are many reports of osteochondral graft using the costal osteochondral graft but the osteochondral graft using the interphalangeal joint of the toe is rarely reported. Thoroughly reviewed with relevant articles, this report presents a case of a 33 year old male who was successfully treated with osteochondral autograft using the proximal interphalangeal joint of the toe due to the traumatic osteochondral defect in the head of the second proximal phalanx.

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Percutaneous Kirschner Wire Fixation of Acute Mallet Fractures Percutaneousely Reduced by Towel Clip: Chung Soo Han, Duke Whan Chung, Bi O Jeong, Hyun Chul Park, Jin Young Kim, Cheol Hee Park, Jin Sung Park; J Korean Fract Soc 2009;22(4):283-287. Published online October 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.4.283

Abstract PDF

PURPOSE
To analyze the treatment of clinical results of the percutaneous Kirschner wire fixation of acute mallet fractures percutaneousely reduced by towel clip. MATERIALS AND METHODS: From August 2005 to April 2009, we evaluated nine fingers in eight patients, more than three months follow up. The type of injury was a axial loading in seven cases and direct blow in two. The average follow-up period was 10.1 months (range: 3~41 months). The indication of operative treatment was the presence of large bony fragment or the palmar subluxation of the distal phalnx. RESULTS: The range of motion was 3.7degrees (0~10degrees) in extension lag and 76.7degrees (60~90degrees) of flexion of the distal interphalangeal joint. CONCLUSION: The percutaneous Kirschner wire fixation of acute mallet fractures percutaneousely reduced by towel clip is one of the easy and simple method to stabilizing of bony mallet fracture.

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Comparison of Surgical Outcomes of Percutaneous K-Wire Fixation in Bony Mallet Fingers with Use of Towel Clip versus 18-Gauge Needle
Ho-Seung Jeon, Chan-Sam Moon, Seo-Goo Kang, Kyeong-Seop Song, Uk-Hyun Choi
Journal of the Korean Society for Surgery of the Hand.2013; 18(1): 1. CrossRef

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The Results of Surgical Treatment for Nonunion of Phalanges in the Hand: Hee Dong Kim, Yoon Hong Kim, Yong Soo Choi, Heun Guyn Jung; J Korean Fract Soc 2008;21(2):140-144. Published online April 30, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.2.140

Abstract PDF: PURPOSE
To evaluate the results of internal fixation and autogenous bone graft for the phalangeal nonunion in the hand.
MATERIALS AND METHODS
From Feb. 2000 until May 2006, thirteen cases that had been treated for non-union of phalanges in the hand were investigated retrospectively. Seven cases were treated with mini-plate fixation and autogenous cancellous graft and six cases with Kirschner wire fixation and autogenous cancellous graft. We analyzed bony union period radiographically and clinical results according to Belsky's score.
RESULTS
Thirteen cases obtained bony union. Seven cases of mini-plate fixation and bone graft, and six cases of K-wire fixation and bone graft achieved the bony union postoperatively on average 7.9 weeks and 6.3 weeks, respectively. Clinical results were "good" in four cases and "poor" in nine cases according to the Belsky's score. Only one of ten cases with associated injuries, such as tendon, nerve, arterial injuries and other finger fractures in the injured hand, had the good clinical result, but all three cases without associated injuries had the good one.
CONCLUSION
Internal fixation and autogenous bone graft can be a successful treatment of phalangeal nonunion. However, more careful choice of surgical treatment methods and preoperative explanation of poor post-operative results or complications should be made for phalangeal nonunion with associated injuries in the finger because of poor outcome in those cases.

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Miniplate and Miniscrew Fixation for the Metacarpal and Phalangeal Fractures: Bu Hwan Kim, Jong In Yim, Deog Jeong Kang; J Korean Soc Fract 1997;10(1):150-155. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.150

Abstract PDF: The functional end result is more important than fracture healing in the hand fracture treatment. Accurate open reduction and internal fixation with miniplate and miniscrew for metacarpal and phalangeal fractures of hand provides firm fixation and allows early postoperative mobilization which reduce the incidence of joint stiffness and tendon adhesion. The authors have reviewed 17 cases of metacarpal and phalangeal fractures of the hand in 13 patients which were treated with miniplate and miniscrew fixations in the department of orthopaedic surgery, Dae Dong General Hospital from Mar. 1994 to Feb. 1996. The following results were obtained. 1.The firm fixation allowed range-of-motion exercises in most patients between 3-14 days. 2.The roentgenographic union was obtained within 14.8 weeks in average. 3.The mean TAM(total active motion) range at last follow up was 247 in the metacarpal fracture and 226 in the phalangeal fracture. 4. The complications(tendon adhesion & loss of reduction) occurred in 2 cases(11.8%). In conclusion, fixation with miniplate and miniscrew for metacarpal and phalangeal fractures of the hand is considered to be an effective method in the treatment of metacarpal & phalangeal fractures.

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