Search Our Scientific Publications & Authors

J Orthop Surg (Hong Kong) 2019 May-Aug;27(2):2309499019840771

Department of Orthopaedic Surgery, Nippon Medical School, Tokyo, Japan.

Purpose: We aimed to evaluate the clinical results using the pins and rubbers traction system (PRTS) as described by Suzuki et al. for unstable intra-articular fractures of the proximal interphalangeal (PIP) joint and to assess the efficacy and the indication of the technique of the PRTS.

Methods: Thirty-nine fingers in 39 patients (mean age 46. Read More

Ann R Coll Surg Engl 2019 Apr 11;101(4):e102-e104. Epub 2019 Mar 11.

Plastic and Reconstructive Surgery Department, Salisbury District Hospital, Salisbury , Salisbury , UK.

Collagenase injection was approved in Europe for use in the treatment of Dupuytren's disease in 2011. Reported adverse effects include skin tears, swelling, pain and complex regional pain syndrome. Here, we present a case of a rare complication of phalangeal fracture following treatment with collagenase clostridium and the resultant digital amputation. Read More

Plast Reconstr Surg 2019 03;143(3):800-810

Dayton, Ohio; and Rochester, Minn. From the Department of Orthopedic Surgery, Wright-Patterson Air Force Base; and the Division of Hand Surgery, Department of Orthopedic Surgery, Mayo Clinic.

Most unstable metacarpal and phalangeal fractures for which operative treatment is indicated can be reduced and stabilized with either open or closed techniques using local anesthetic with epinephrine instead of intravenous sedation or general anesthesia. With the patient wide-awake during surgery, the hand can be taken through active range of motion to assess fracture stability. In this article, the authors review the rationale and technique for wide-awake, local anesthesia, no tourniquet surgery in the treatment of phalangeal and metacarpal fractures and impart pearls to optimize the patient experience and illustrate common fixation techniques using percutaneous Kirschner wires. Read More

J Hand Surg Am 2019 Feb 22. Epub 2019 Feb 22.

Department of Orthopedic Surgery and Trauma, Suez Canal University Hospitals, Ismailia, Egypt.

Purpose: To compare clinical, radiological and functional outcomes of percutaneous K-wires and lateral titanium plates and screws in the management of unstable extra-articular proximal and middle phalangeal fractures.

Methods: In a randomized controlled clinical trial, 40 patients with unstable transverse, long oblique or spiral diaphyseal fractures of the proximal and middle phalanges were divided into 2 groups: the K-wire group (20 patients), which included 12 proximal and 8 middle phalangeal fractures fixed by percutaneous K-wires; and the plate group (20 patients), which included 13 proximal and 7 middle phalangeal fractures treated with open reduction and internal fixation with a lateral titanium plate and screws. The patients were observed for at least 6 months (mean [range], 6. Read More

J Hand Surg Asian Pac Vol 2019 Mar;24(1):60-64

* Royal Shrewsbury Hospital and Robert Jones Agnes Hunt Orthopaedic Hospital, Shropshire, UK.

Background: The increasingly fashionable sport of motocross is practiced worldwide by millions of people, but there is very little in the literature regarding its associated injuries and their prevention. We therefore present the first comprehensive, prospective study looking at hand and wrist injuries resulting from motocross injuries in the UK.

Methods: Data was prospectively collected over a 5-year period (from 2010 to 2015) at our regional trauma unit. Read More

J Hand Surg Asian Pac Vol 2019 Mar;24(1):123-126

1 Hand Unit, Sydney Hospital, Sydney, Australia.

We report a case of complete laceration of both flexor tendons in the dominant ring finger of a young male caused by a closed volar fracture fragment of the proximal phalanx. Careful clinical examination, reasonable index of suspicion and ultrasound confirmation play a pivotal role in the diagnosis and surgical planning of this rare yet consequential injury. Good outcomes can be achieved from the surgical management and rehabilitation of both soft tissue and bony injuries when planning of surgical approaches and fixation techniques are facilitated by an accurate pre-operative diagnosis. Read More

Handchir Mikrochir Plast Chir 2019 Feb 13;51(1):49-53. Epub 2019 Feb 13.

Klinika za djecje bolesti Zagreb Pediatric Surgery.

Introduction: Fractures of the phalanges in children can often be underappreciated by the physician of first contact. Therefore it is necessary to point out which of these fractures, because of the risk of possible future complications, need special mention.

Materials And Methods: A retrospective review of 512 fractures of the phalanges in children and adolescents during an one year period. Read More

Telemed J E Health 2019 Feb 8. Epub 2019 Feb 8.

Department of Orthopaedic Surgery, Galway University Hospitals, Galway, Ireland.

Background: Intra-articular phalangeal fractures involving the proximal interphalangeal joint (PIPJ) are notoriously difficult injuries to treat and often require regular follow-up to assess progress, guide treatment, and determine outcomes. Some patients often have to travel long distances for follow-up care. The aim of our study was to assess the clinical outcomes of intra-articular fractures of the PIPJ through use of clinical pictures sent through a mobile phone. Read More

J Hand Surg Eur Vol 2019 Mar 12;44(3):323-325. Epub 2019 Jan 12.

1 Department of Surgery, School of Medicine, National Yang-Ming University.

J Pediatr Orthop 2019 Jan 8. Epub 2019 Jan 8.

Children's Research Center.

Background: Phalangeal fractures of the hand are common in children, and most extra-articular fractures can be treated with nonoperative management. Minimally or nondisplaced fractures may simply be immobilized, whereas displaced fractures need closed reduction before immobilization. Although few of these fractures displace secondarily, most schemes currently recommend follow-up x-rays after initial diagnosis. Read More

J Biol Regul Homeost Agents 2018 Nov-Dec;32(6):1569-1572

AOU Careggi, Hand and Microsurgery Reconstruction Unit, Florence, Italy.

Phalangeal (P) and metacarpal (MC) fractures are very common injuries, with potentially disabling, residual impairment, deformities or stiffness. Conservative treatment represents the strategy of choice in most cases, but in unstable fractures and/or high-demanding patients, surgical fixation could be required. Ideally, the best treatment choice will be the intramedullary fixation systems, if possible without the implant protruding from the skin. Read More

Ochsner J 2018 ;18(4):398-401

Department of Orthopedics, Ochsner Clinic Foundation, New Orleans, LA.

Background: Metacarpophalangeal (MCP) joint dislocations are the result of a hyperextension injury. Complex MCP joint dislocations-those that are irreducible to closed maneuvers and require surgical intervention-are considered uncommon, even in the pediatric population. Although several structures have been identified that contribute to irreducible dislocations, the volar plate is the most significant barrier to reduction through interposition into the MCP joint. Read More

Am J Emerg Med 2019 Mar 24;37(3):489-493. Epub 2018 Nov 24.

Division of Pediatric Emergency Medicine, Department of Pediatric Emergency and Critical Care Medicine, Tokyo Metropolitan Children's Medical Center, Japan.

Although ultrasound-guided peripheral nerve block (UGPNB) has recently been introduced into pediatric emergency departments (EDs), knowledge of its use is still limited among pediatric emergency physicians. Ultrasound-guided ulnar nerve block (UGUNB) is a form of peripheral nerve block available for controlling the pain caused by phalangeal injuries, but studies of its use in pediatric patients are still scarce. The aim of this case series was to describe the experience of UGUNB use for pediatric phalangeal fractures in a pediatric ED setting. Read More

Arch Orthop Trauma Surg 2019 Jan 23;139(1):141-145. Epub 2018 Nov 23.

Department of Orthopaedic Surgery, Korea University Anam Hospital, 73, Inchon-ro, Sungbuk-gu, Seoul, 06334, South Korea.

Purpose: An articular depressed fragment at the base of the middle phalanx can be an obstacle to congruent reduction and stable fixation. This study assessed the outcomes of a transosseous reduction technique combined with locking plate fixation for the treatment of articular depressed middle phalangeal base fracture.

Methods: Between 2015 and 2017, seven patients (eight fingers) with intraarticular comminuted middle phalangeal base fracture were included in this study. Read More

Can Fam Physician 2018 Nov;64(11):803-810

Pediatric plastic surgeon at the Children's Hospital of Eastern Ontario in Ottawa.

Objective: To present a practical and evidence-based approach for primary care physicians to the diagnosis and initial management of common pediatric hand injuries, and to identify injuries requiring prompt referral.

Sources Of Information: Clinical evidence and expert recommendations were identified by using MEDLINE and EMBASE for each topic presented.

Main Message: Pediatric hand injuries are a common reason for physician consultation. Read More

J Hand Surg Asian Pac Vol 2018 Dec;23(4):441-449

1 Brighton and Sussex Medical School, University of Brighton, London, UK.

Background: Within hand trauma, the management of unstable, intra-articular fractures of the base of the middle phalanx remains highly controversial. The objective of this research was to determine which operation gives the best outcome in the management of displaced, intra-articular fractures of the base of the middle phalanx causing instability of the proximal interphalangeal joint.

Methods: A scoping study was performed to determine the evidence available and the terminology used. Read More

Eur J Orthop Surg Traumatol 2019 Apr 13;29(3):597-604. Epub 2018 Nov 13.

Department of Orthopedics and Traumatology, Gölcük State Hospital, Kocaeli, Turkey.

Background: We aimed to present the radiological and clinical results of Kirschner-wire (K-wire) fixation and low-profile plate-screw fixation applied to unstable proximal phalangeal fractures without extension to the joint.

Methods: Clinical and radiological data of 22 patients who underwent fixation with open reduction and low-profile 1.5-mm titanium mini plate and unlocked screws and 18 patients who underwent fixation with K-wire due to closed, unstable extra-articular proximal phalangeal fractures were retrospectively examined. Read More

Vet Surg 2018 Oct 14;47(7):908-915. Epub 2018 Sep 14.

Institute of Chronic and Ageing Disease, University of Liverpool, Liverpool, United Kingdom.

Objective: To compare the outcome following conservative vs surgical management of sports horses with a diagnosis of subchondral bone trauma of the proximal aspect of the proximal phalanx (PP) by low-field MRI.

Study Design: Retrospective case series.

Animals: Twenty-one mature sports horses with evidence of high water signal within the proximal sagittal groove of the PP according to low-field MRI of the fetlock, with no definitive radiographic evidence of fracture. Read More

J Pediatr Orthop 2019 Mar;39(3):e222-e226

Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD.

Background: Phalangeal neck fractures are commonly dorsally displaced and angulated. Surgical treatment is often necessary to restore the retrocondylar recess. The purpose of this study was to determine whether radiographic landmarks can serve as a reference tool for assessing phalangeal neck fracture alignment based on age and sex. Read More

Ugeskr Laeger 2018 Aug;180(32)

Phalangeal fractures are common in all ages. Stable, extra-articular fractures can be treated non-operatively by closed reduction and buddy taping, while surgical fixation should be considered for unstable and displaced extra-articular fractures and most intra-articular fractures. The treatment should aim at early, active mobilisation in order to achieve the optimal functional outcome. Read More

Ann Plast Surg 2018 Oct;81(4):407-410

From the Department of Plastic Surgery, New York University School of Medicine, New York, NY.

Purpose: Phalangeal fractures represent a significant portion of upper extremity injuries but are not well studied as a single entity. We define our approach at a level 1 trauma center and determine whether plating or lag screws (ie, rigid fixation) have superior functional outcomes compared with Kirschner wire fixation for phalangeal or metacarpal fractures.

Methods: We performed a systematic review of all surgically managed hand fracture cases at Bellevue Hospital during 2012 and 2013. Read More

Hand (N Y) 2018 Jul 1:1558944718787859. Epub 2018 Jul 1.

2 University Hospital of Pisa, Italy.

Background: Complex periarticular fractures of the metacarpophalangeal joint (MCPJ) are often challenging to treat. Conservative and operative treatments are often burdened with stiffness, loss of function, and poor clinical outcome. These phenomena could be a direct consequence of long period of immobilization. Read More

J Hand Surg Am 2019 Jan 13;44(1):65.e1-65.e7. Epub 2018 Jun 13.

Department of Orthopaedic Surgery, Hospital for Joint Diseases, New York University Langone Medical Center, New York, NY.

Purpose: To establish and compare the incidence of 30-day postoperative infection in surgically managed open and closed metacarpal and phalangeal fractures, and to determine whether open fractures treated urgently had a lower incidence of postoperative infection.

Methods: We conducted a retrospective analysis of patient demographics, comorbidities, and 30-day infection rates of patients undergoing operative fixation 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. Read More

Adv Clin Exp Med 2018 Jun;27(6):759-764

Department of Medical Simulation, University of Opole, Poland.

Background: Studies using dual energy X-ray absorptiometry (DXA) demonstrate a reduction in bone mineral density (BMD) in children and adolescents with Turner syndrome (TS). However, these studies do not take into account changes in bone size, which influence BMD in the case of short-statured patients. Phalangeal quantitative ultrasound (phQUS) measurements have shown an ability to reveal changes due to skeletal growth, aging, and bone and mineral disorders. Read More

Hand (N Y) 2018 Jun 1:1558944718777831. Epub 2018 Jun 1.

3 The Roosevelt Hand to Shoulder Center, New York, NY, USA.

Background: A cadaveric study was performed to evaluate the accuracy and reliability of radiographic estimation of the volar lip fragment size in proximal interphalangeal joint fracture-dislocations.

Methods: Middle phalangeal base volar lip fractures of varying size and morphology were simulated in 18 digits. Radiographs and digital photographs of the middle phalangeal joint surface were obtained pre- and postinjury. Read More

Musculoskelet Surg 2019 Apr 31;103(1):99-105. Epub 2018 May 31.

Department of Orthopedic, AIIMS Rishikesh, Rishikesh, India.

Purpose: No study in literature clearly gives advantage of one method of surgical fixation of fracture over the other in metacarpal and phalangeal bones of hand comparing wider outcome measures.

Materials And Methods: A randomized controlled trial between closed reduction and percutaneous Kirschner wire fixation or open reduction and internal fixation with mini fragment plates was conducted. A total of 32 patients with 16 in each group were taken in tertiary-level teaching hospital from 2014 to 2016. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2017 10;31(10):1245-1249

Department of Burns and Plastic Surgery, the Affiliated Hospital of Zunyi Medical College, Zunyi Guizhou, 563000, P.R.China.

Objective: To evaluate the effectiveness of anterolateral thigh polyfoliate perforator flap plus pedicle with one foliate flap for repairing extremities soft tissue defect.

Methods: Between January 2014 and January 2017, 24 patients with extremities soft tissue defects were treated by anterolateral thigh polyfoliate perforator flap plus pedicle with one foliate flap. There were 15 males and 9 females, with a median age of 33. Read More

J Hand Surg Am 2018 Dec 22;43(12):1138.e1-1138.e8. Epub 2018 May 22.

Department of Orthopaedics, University of North Carolina School of Medicine, Chapel Hill, NC. Electronic address:

Purpose: 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.

Methods: 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. Read More

Pediatr Emerg Care 2018 May 23. Epub 2018 May 23.

Objectives: The objective of this study was to assess proper indications a nonsurgical treatment regime for pediatric fractures of the proximal phalanx based on principles of early functional treatment.

Methods: A case series (evidence level 4) of 30 pediatric patients with fractures of the proximal phalanx were treated nonsurgically using protective dynamic splinting techniques and fiberglass casting material. Assessments were performed clinically and by x-ray within 4 to 8 weeks of commencement of treatment. Read More

Hand (N Y) 2018 May 1:1558944718777868. Epub 2018 May 1.

1 Northwell Health, New Hyde Park, NY, USA.

Background: Intra-articular middle phalangeal base fractures with volar instability are rare injuries with scant literature on optimal management. Our purpose is to describe our method of dorsal plating and report postoperative outcomes.

Methods: This study is a retrospective case review of 5 patients with intra-articular middle phalangeal base fractures with volar proximal interphalangeal joint instability, measuring subjective, clinical, and radiographic outcomes. Read More

J Hand Microsurg 2018 Apr 20;10(1):16-21. Epub 2018 Mar 20.

Orthopaedic and Trauma Unit, University Hospital of Pisa, Pisa, Italy.

Metacarpal fractures constitute 7.8% of the upper extremity fractures. The common treatments remain nonsurgical procedure, but high-demanding patients or unstable fractures require fixation with Kirschner wire (K-wires), plate, and screws. Read More

Vet Comp Orthop Traumatol 2018 May 16;31(3):222-228. Epub 2018 Apr 16.

Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, United States.

Objective:  The aim of this article was to describe the surgical re-alignment technique and stabilization of a distal femoral deformity in a 6-week-old, male, Foxhound.

Methods:  A healing metaphyseal fracture, resulting in a valgus deformity with internal rotation, was observed just proximal to the distal femoral physis. The deformity was treated by an opening wedge osteotomy with lateral translation and external rotation of the distal epiphysis using a guide-wire technique; a corticocancellous allograft bridged the defect, which was stabilized with a 2. Read More

Clin Endocrinol (Oxf) 2018 Jul 8;89(1):46-55. Epub 2018 May 8.

Division of Endocrinology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Objective: Osteoporosis is considered a comorbidity of adult women with Turner syndrome (TS). Limited data are available on fracture prevalence in girls and women with this diagnosis. We aimed to determine the prevalence of fractures in individuals with TS in the United States and identify risk factors for fracture. Read More

Injury 2018 Jun 22;49(6):1126-1130. Epub 2018 Mar 22.

Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark.

Background: Burying Kirschner wires (K-wires) under the skin after metacarpal and phalangeal fracture osteosynthesis may reduce risk of infection, but it might also complicate later removal.

Purpose/aim Of Study: To examine infection and reoperation rates after metacarpal and phalangeal fracture osteosynthesis with buried versus exposed K-wires.

Materials And Methods: Metacarpal and phalangeal fractures treated with K-wire osteosynthesis at our institution from 1st of January, 2009 to 1st of February, 2015 were identified retrospectively. Read More

J Hand Surg Eur Vol 2018 Jun 27;43(5):506-512. Epub 2018 Mar 27.

Department of Trauma & Orthopaedic Surgery, University Hospital of Wales, Cardiff, UK.

We describe the treatment of 101 patients with 113 fractures of the proximal phalanx at the junction of the diaphysis with the proximal metaphysis. Fractures were stabilized using a single extra-articular percutaneous Kirschner wire passed lateral to the metacarpal head into the base of the phalanx base and across the fracture to engage the lateral cortex. Patients were treated semi-electively on a day surgery unit. Read More

J Hand Surg Eur Vol 2018 Jun 19;43(5):560-561. Epub 2018 Mar 19.

Department of Hand Surgery, Töölö Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland.

Tech Hand Up Extrem Surg 2018 Jun;22(2):51-56

Department of Trauma and Orthopedics, Hand and Microsurgery Unit, Rashid Hosiptal, Dubai Health Authority, Oud Metha, Dubai.

Multiple methods have been described for treating unstable proximal and middle phalangeal fractures. Irrespective of using an open or closed technique of fixation, stiffness and extensor lag at the proximal/distal interphalangeal joint almost always occur. This issue can be avoided by allowing the patients to mobilize the fingers out of plaster or splint as early as possible from the day of surgery. Read More

Ortop Traumatol Rehabil 2017 Dec;19(6):531-536

Chelsea and Westminster Hospital NHS Trust, London.

Background: Most hand injuries in children can be managed non-operatively and are associated with excellent outcomes. Whilst the majority of our patients are discharged to the care of hand therapists, there is no literature to support this protocol. Our aim was to ensure this is safe and effective practice. Read More

Eur J Trauma Emerg Surg 2018 Feb 27. Epub 2018 Feb 27.

Medical Informatics Research Center, Kerman University of Medical Sciences, Kerman, Iran.

Introduction: For extraarticular proximal phalanx fractures, two methods are employed, transarticular fixation in which the metacarpophalangeal joint is crossed and the extraarticular method in which the pins are introduced through the base of the proximal Phalanx.

Materials And Methods: This study was a prospective one on patients with proximal phalanx transverse or short oblique fractures. In one of the groups we used parallel pins from metacarpal head through MCP joint to proximal phalanx. Read More

Tech Hand Up Extrem Surg 2018 Mar;22(1):3-9

Christine M. Kleinert Institute for Hand and Microsurgery, Louisville, KY.

We describe a technique of interlocking Kirschner wires to improve stability after fixation of fractures of the hand. This enables immediate mobilization of the injured fingers thus reducing the need for prolonged postoperative physical therapy and consequently diminishing chances of posttraumatic stiffness. This study analyzes outcomes in 83 fractures in 70 patients including 26 metacarpal and 57 phalangeal fractures. Read More

Asia Pac J Sports Med Arthrosc Rehabil Technol 2017 Oct 12;10:12-16. Epub 2017 Oct 12.

Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Japan.

Background: Adolescent athletes are a high-risk population for stress fractures. We report four cases of stress fractures of the second proximal phalanx, which had not been previously diagnosed as the location of the stress fracture of the foot, in teenage athletes.

Case Report: All fractures were on the plantar side of the proximal phalangeal base, and the oblique images of the plain radiograph clearly depicted the fractures. Read More

Zhongguo Gu Shang 2016 Dec;29(12):1110-1113

Department of Orthopaedics, Fuyang Chinese Medical Orthopaedics Hospital, Hangzhou 311400, Zhejiang, China.

Objective: To explore the method and therapeutic effect of minor external fixation combined with Kirschner Treatment for open comminuted fracture of metacarpophalangeal joint.

Methods: From January 2013 to December 2014, 13 patients with open comminuted fracture of metacarpophalangeal joint were treated by minor external fixation combined with Kirschner wire, including 9 males and 4 females, aged from 18 to 56 years old with an average of 35 years old.According to Gustilo classification, 8 cases were type II, 4 cases were type IIIA, and 1 case was type IIIB. Read More

Clin Cases Miner Bone Metab 2017 May-Aug;14(2):254-257. Epub 2017 Oct 25.

Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy.

Wolfram Syndrome (WS) is a rare and lethal disease characterized by optic atrophy, diabetes mellitus, diabetes insipidus, and hearing loss. To date, osteoporotic related fractures have not been reported in affected patients. Here, we describe the case of a man affected by WS complicated by several bone fragility fractures. Read More

BMC Musculoskelet Disord 2017 Dec 13;18(1):529. Epub 2017 Dec 13.

Department of Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria.

Background: Malunion of phalangeal and metacarpal bones are often associated with impairment of hand function and pose a challenging task for treating surgeons in most cases. When applicable, corrective osteotomy is the treatment of choice, where the affected bone is cut to correct malalignment using chisels or saws. The use of these instruments is associated with several drawbacks especially in hand surgery. Read More

Ann R Coll Surg Engl 2018 May 28;100(5):419-420. Epub 2017 Nov 28.

Trauma and Orthopaedic department, Doncaster Royal Infirmary, Doncaster and Bassetlaw Hospitals NHS Foundation Trust , Doncaster , UK.

Hand (N Y) 2018 07 27;13(4):376-383. Epub 2017 Oct 27.

2 University of Pittsburgh Medical Center, PA, USA.

Background: The goal of proximal phalangeal fracture management is to allow for fracture healing to occur in acceptable alignment while maintaining gliding motion of the extensor and flexor tendons.

Methods: We reviewed the most current literature on various treatment methods of proximal phalanx fractures, focusing on the indications and outcomes of nonoperative as well as operative interventions.

Results: Stable fractures can be successfully treated nonoperatively, whereas unstable injuries benefit from surgery. Read More

Foot Ankle Spec 2018 Feb 27;11(1):77-81. Epub 2017 Oct 27.

Foot and Ankle Clinic, Department of Orthopedic Surgery, Hospital do Servidor Público Municipal de São Paulo, São Paulo, SP, Brazil (DRCN, FAD, ACM, FCPF).

Phalangeal fractures of the toes represent common injuries of the forefoot. In the hallux, most fractures occur at the distal phalanx and frequently result from a direct crushing type of injury. Intra-articular fractures of the hallux are usually treated nonoperatively, except when the fragments are displaced and the joint is incongruent. Read More

Injury 2018 Feb 9;49(2):351-358. Epub 2017 Oct 9.

Department of Hand Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, China.

Background: The objective of this report is to introduce an external-fixation technique using the combination of K-wires and cement.

Methods: From February 2009 to January 2015, 51 patients with shaft fractures of middle phalanges were treated with cemented K-wire fixation. The mean age of patients at surgery was 41 years. Read More

J Orthop Trauma 2017 Nov;31 Suppl 6:S1-S5

*Orthopedic Surgery, University of Maryland Medical Center, University of Maryland School of Medicine, Baltimore, MD; and †Division of Pediatric Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH.

Pediatric phalangeal fractures are extremely common, especially among toddlers and older children/adolescents involved in sporting activities. The physical examination must include an assessment for deviation and malrotation. In addition, concomitant injuries must be assessed for such as tendon and/or neurovascular injuries. Read More

Sci Rep 2017 09 12;7(1):11359. Epub 2017 Sep 12.

Department of Orthopaedic Surgery, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, 200233, China.

The optimal timing for surgical stabilization after open fractures of proximal and middle phalangeal shaft remained unclear. Total 147 patients with single open fracture in proximal or middle phalangeal shaft (arrived within 8 hours) who received K-wire fixation from June 2012 to June 2015 were included for analysis. The timing for surgical stabilization of fractures (immediate or delayed) was decided according to the surgeons' preferences. Read More