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Rev Esp Cir Ortop Traumatol 2022 Jun 13. Epub 2022 Jun 13.

Hand Surgery Unit, Orthopaedic Surgery Department, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain. Electronic address:

Introduction:  Phalangeal fractures are the most common hand fractures. In the last years, intramedullary compression screw (IMHCS) for instable transverse or short oblique proximal P1 fractures have been described. Although both anterograde (intraarticular or transarticular) and retrograde IMHCS techniques have shown good results, no comparison between anterograde and retrograde screw in P1 fractures has been published. Read More

Tech Hand Up Extrem Surg 2022 Apr 14. Epub 2022 Apr 14.

Florida Orthopaedic Institute/Department of Orthopaedic Surgery, University of South Florida, Tampa, FL.

Fractures of the phalanges can often be managed nonoperatively, but displaced phalangeal fracture patterns, including malrotation, are more amenable to operative treatment. There are several described methods for surgical management of phalanx fractures, but there remains no consensus on a clearly superior method of fixation. Percutaneous Kirschner wires, interfragmentary screws, plate and screw constructs, intramedullary nails, and cannulated intramedullary headless screws are all utilized in the treatment of these fractures. Read More

Ann Plast Surg 2022 05;88(3 Suppl 3):S309-S313

Department of Orthopaedic Surgery, University of Pennsylvania.

Background: Although occupational exposure to radiation has been previously studied in the hand surgery literature, there is a paucity of studies looking at radiation exposure to the patient during fluoroscopy-guided hand surgery. We aimed to describe the level of radiation experienced by patients undergoing common hand and wrist fracture fixation and to identify risk factors for increased radiation exposure.

Methods: We performed a retrospective review of patients at a single institution who underwent fracture fixation of the hand, wrist, or forearm requiring mini c-arm fluoroscopic guidance from 2016 to 2020. Read More

J Chiropr Med 2021 Dec 6;20(4):218-223. Epub 2022 Apr 6.

Radiology Department, Logan University, Chesterfield, Missouri.

Objective: The purpose of this report is to describe the clinical, radiographic, and diagnostic ultrasound findings in a patient who sustained a type III Salter-Harris fracture of the first proximal phalanx.

Clinical Features: A 14-year-old male baseball player presented to a chiropractic clinic with a 2-day history of proximal thumb pain, which began following a forceful hyperabduction injury while sliding into base. Thenar swelling was evident on clinical examination, and both active and passive thumb motions were painful in all directions. Read More

Front Vet Sci 2022 4;9:859667. Epub 2022 Apr 4.

Clinic for Ruminants, Vetsuisse Faculty, University of Bern, Bern, Switzerland.

Fracture of the digits is a well-known orthopedic condition in adult cattle, and mainly the distal phalanx (P3) is involved. To our knowledge, the treatment of fractures of the middle (P2) and proximal (P1) phalanges with orthopedic claw blocks has not yet been described in cattle and other ruminants. This report describes the first case of the successful management of a P1 fracture in an adult European bison. Read More

J Hand Surg Asian Pac Vol 2022 04 19;27(2):417-418. Epub 2022 Apr 19.

Surgical Department - Hand Surgery Unit EOC, Locarno's Regional Hospital, Locarno, Switzerland.

J Hand Surg Glob Online 2021 Nov 11;3(6):348-351. Epub 2021 Aug 11.

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

Purpose: The use of self-tapping cortical screws is indicated in patients with metacarpal and phalangeal fractures requiring formal stabilization. The aim of this study was to systematically compare and evaluate the design parameters of 4 commercially available self-tapping screw systems.

Methods: We measured various design parameters of self-tapping cortical screws of different lengths from several manufactures using scanning electron microscopy. Read More

J Wound Care 2022 Apr;31(4):340-347

Ninewells Hospital, Dundee, UK.

Objective: This study aimed to explore the efficacy of the IV3000 semi-occlusive, transparent adhesive film dressing in the non-surgical management of simple as well as more complex fingertip injuries.

Method: In this qualitative study, patients with fingertip injuries were prospectively recruited and treated conservatively with the dressing between 2015 and 2017. Inclusion criteria included any fingertip injury with tissue loss and patient consent for non-surgical treatment consistent with the study protocol. Read More

J Hand Surg Asian Pac Vol 2022 Apr 31;27(2):261-266. Epub 2022 Mar 31.

The Leicester Royal Infirmary, University Hospitals of Leicester, Leicester, UK.

Management of hand trauma has evolved to incorporate assessment, treatment and rehabilitation of patients in a 'one-stop' clinic on initial presentation. Our aim was to evaluate the effect of coronavirus disease 2019 (COVID-19) on the choice of treatment for hand fractures using inter-rater agreement between surgeons. All patients with hand fractures during the COVID-19 lockdown from March to May 2020 were included in the study. Read More

Hand (N Y) 2022 Apr 7:15589447211043191. Epub 2022 Apr 7.

Orthopedic Hand and Upper Extremity Service, Massachusetts General Hospital - Harvard Medical School, Boston, MA, USA.

Background: Our primary aim was to develop a prediction model for return to the operating room (OR) after open finger fractures by studying the reoperation rate of open finger fractures based on patient demographics, injury mechanism, injury severity, and type of initial surgical fixation. The secondary aim was to study the predictors for secondary surgery due to nonunion, postoperative infection, and secondary amputation.

Methods: In the retrospective chart review, 1321 open finger fractures of 907 patients were included. Read More

Cureus 2022 Feb 23;14(2):e22515. Epub 2022 Feb 23.

Plastic and Reconstructive Surgery, Holy Family Hospital, Rawalpindi, PAK.

Introduction and objective The fracture of hand bones is very common among manual hand workers and a fractured hand imparts a great effect on a person's productivity both socioeconomically and from a body image point of view. The most common method of hand fractures fixation is with the help of Kirschner wires. Kirchner wires can be inserted in exposed or in buried manner. Read More

Orthop J Sports Med 2022 Mar 11;10(3):23259671221078308. Epub 2022 Mar 11.

Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.

Background: There is a paucity of information on rate and time to return to play (RTP) in elite-level soccer players who have sustained foot fractures.

Purpose: To (1) determine the rate and timing of RTP after foot fracture (eg, tarsal, metatarsal, or phalangeal), (2) investigate foot fracture reinjury incidence after RTP, and (3) evaluate performance after foot fracture as compared with matched, uninjured controls.

Study Design: Descriptive epidemiology study. Read More

Case Reports Plast Surg Hand Surg 2022 21;9(1):66-71. Epub 2022 Feb 21.

Hand and Trauma Microsurgery Center, Osaka Ekisaikai Hospital of Japan Seafarers Relief Association, Osaka city, Osaka, Japan.

Fragmented proximal phalangeal fractures are difficult to treat. Fixation with plate and screws often lead to contractures and extensor tendon adhesions. Interosseous wiring could prevent those complications by repairing the periosteum and avoiding direct contact between implants and extensor tendon, while a good total active motion can be achieved. Read More

Plast Reconstr Surg 2022 Mar;149(3):662-669

From the Division of Plastic Surgery, Saint Louis University School of Medicine; and SSM Health Cardinal Glennon Children's Hospital at Saint Louis University.

Background: Salter-Harris type II fractures are the most common pediatric phalangeal fracture. A juxtaepiphyseal fracture is a distinct fracture pattern that, although similar in radiographic appearance, occurs 1 to 2 mm distal to the growth plate. Although subtle, there are important differences in the behavior and management of these fracture types. Read More

J Hand Surg Eur Vol 2022 Jul 20;47(7):755-760. Epub 2022 Feb 20.

Orthopaedic Department, Tauranga Hospital, Tauranga, New Zealand.

We examined the MRI scans of 35 adult hands to assess the feasibility of the hamate and the capitate as potential donor grafts in the management of comminuted intra-articular fractures at the base of the middle phalanges. Essentially neither the hamate nor the capitate were perfect anatomic matches in most digits, but the capitate had the advantage of having more uniform facets, and the capitate facet shapes were similar to those of the little finger. The measurement of angles in the coronal and sagittal plane showed that in some respects the differences between the potential graft and the base of the middle phalanges were smaller for the capitate than for the hamate. Read More

J Hand Surg Asian Pac Vol 2022 Feb 17;27(1):209-212. Epub 2022 Feb 17.

Department of Orthopaedics Surgery, Sanjay Gandhi Institute of Orthopaedics and Trauma, Byrasandra, Jayanagar, Bangalore, India.

Irreducible phalangeal fractures are uncommon, and if neglected can cause fracture non-union or functional deficits of the affected digit. We present two patients with irreducible phalangeal fractures - one in a child with a juxta-epiphyseal middle phalanx fracture incarcerated into the triangular ligament of the extensor apparatus and another in an adult following incarceration of a fractured proximal phalanx into the common intrinsic tendon on the radial side. Both required open reduction to extricate the incarcerated fracture ends, achieving good union and excellent functional outcomes. Read More

J Hand Surg Am 2022 Jan 27. Epub 2022 Jan 27.

Private Practice, Madrid, Spain.

Purpose: Extra-articular malunions of metacarpals and phalanges may cause palmar pain, finger scissoring, and splaying, and interfere with function. Current treatment involves open osteotomy and fixation with plates and screws. We present a minimally invasive method using cannulated headless screws for correction of malunions and examine the outcomes in a series of patients. Read More

Hand Surg Rehabil 2022 Apr 16;41(2):220-225. Epub 2021 Dec 16.

Service de Chirurgie Orthopédique, Hôpital Avicenne - Université Sorbonne Paris Nord, 125 Rue de Stalingrad, 93000 Bobigny, France; MOVEO Institute, University Paris Seine-Saint-Denis, 11 Rue de Cambrai, Immeuble 028, 75019 Paris, France.

Wide Awake Local Anesthesia No Tourniquet (WALANT) is an anesthetic method which uses a local injection of anesthetic and epinephrine, avoiding use of a tourniquet. During the COVID-19 pandemic, human and logistic resources had to be reorganized, and WALANT ensured resilience in our department to maintain access to surgical care. The objective of the present study was to compare hand function recovery 3 months after surgery for unstable metacarpal or phalangeal fracture under regional anesthesia versus WALANT. Read More

J Hand Surg Am 2021 Dec 8. Epub 2021 Dec 8.

Leni and Peter W. May Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address:

Purpose: Hand and wrist injuries are common among competitive athletes and can have a substantial impact on playing time and future participation. The purpose of this study was to provide epidemiological data from the National Collegiate Athletic Association Injury Surveillance Program to correlate injury diagnosis with the need for surgery and time loss.

Methods: Using the National Collegiate Athletic Association Injury Surveillance Program, this retrospective study extracted data of hand and wrist injuries for all 25 National Collegiate Athletic Association sports from the academic years 2004-2005 to 2013-2014. Read More

J Am Vet Med Assoc 2021 12 9;260(3):350-356. Epub 2021 Dec 9.

Department of Clinical Sciences, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK.

Objective: To characterize clinical findings and outcomes for cattle with nonpathological phalangeal fractures.

Animals: 17 cattle with nonpathological phalangeal fractures.

Procedures: Medical records of a teaching hospital were reviewed to identify cattle treated for nonpathological phalangeal fracture between May 2004 and May 2020. Read More

J Hand Surg Am 2021 Nov 28. Epub 2021 Nov 28.

Department of Orthopedic Surgery, Tel Aviv Medical Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Purpose: To perform an analysis of electric scooter (e-scooter)-related upper limb fractures (ULFs), which have increased dramatically in parallel with the rapid rise in the use of e-scooters and shared e-scooter services in recent years.

Methods: We retrospectively reviewed the medical charts of e-scooter-related emergency department visits between January 2017 and January 2020 at a level I trauma center. All patients with ULFs were included in the study, and their data were analyzed for demographics, fracture diagnosis, associated injuries, and required surgical treatment. Read More

BMC Musculoskelet Disord 2021 Nov 29;22(1):996. Epub 2021 Nov 29.

Department of Physical Therapy, University of Toronto, Toronto, ON, M5G 1V7, Canada.

Background: Understanding the profiles of different upper extremity fractures, particularly those presenting as a 1st incident can inform prevention and management strategies. The purpose of this population-level study was to describe first incident fractures of the upper extremity in terms of fracture characteristics and demographics.

Methods: Cases with a first adult upper extremity (UE) fracture from the years 2013 to 2017 were extracted from administrative data in Ontario. Read More

J Hand Surg Asian Pac Vol 2021 Dec;26(4):747-750

Department of Plastic Surgery, Queen Victoria Hospital, East Grinstead, UK.

: Phalangeal fractures are common in hand injuries which: comprising of 23% of all hand and forearm fractures. The current consensus is that focus of treatment should be on prompt irrigation and debridement to reduce infection risk. These infections are significant as they can lead to serious sequelae including osteomyelitis. Read More

Plast Reconstr Surg Glob Open 2021 Oct 28;9(10):e3871. Epub 2021 Oct 28.

University of Iowa, Iowa City, Iowa.

Fractures of the phalangeal or metacarpal bones of the hand are common. Many of these fractures are treated without surgery. However, both conservative and operative management of fractures of the hand can result in stiffness. Read More

Plast Reconstr Surg Glob Open 2021 Oct 26;9(10):e3895. Epub 2021 Oct 26.

The Institute for Advanced Reconstruction, Shrewsbury, N.J.

Background: Phalangeal and metacarpal fractures are the second and third most common upper extremity fractures after distal radius fractures with varying methods of fixation techniques. Intramedullary screw fixation is an increasingly preferred method of fixation. Benefits include early range of motion, faster recovery, limited dissection, and reduced complications. Read More

Handchir Mikrochir Plast Chir 2021 Sep 28;53(5):467-474. Epub 2021 Sep 28.

BG Unfallklinik Tübingen an der Eberhard Karls Universität Tübingen; Klinik für Hand-, Plastische, Rekonstruktive und Verbrennungschirurgie.

Purpose: This retrospective study compares the functional outcome after early active postoperative motion with the outcome after 6 weeks of immobilization by splinting in patients with proximal phalangeal fractures treated by percutaneous, antegrade pinning.

Patients And Methods: 46 out of 90 patients treated by closed reduction and percutaneous antegrade pinning of isolated fractures of the proximal phalanges were re-evaluated on average after 18.5 months. Read More

Plast Reconstr Surg Glob Open 2021 Sep 17;9(9):e3797. Epub 2021 Sep 17.

Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia.

Background: Hand injury in general and fractures in particular are among the most common complaints of hand trauma patients presenting to our emergency department. Depending on fracture types, geometry, locations, and stability, treatment options may vary from close reduction and splinting to close reduction and K-wire fixation, and finally, to open reduction and internal fixation. The aim of the study was to prove that premarking of K-wire trajectory helps reduce procedure and fluoroscopy time, as well as the number of wire-insertion attempts, and minimize bone and soft tissue injury in the management of phalangeal finger fractures. Read More

Tech Hand Up Extrem Surg 2022 Jun 1;26(2):110-113. Epub 2022 Jun 1.

Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Health Care, London, ON, Canada.

Extra-articular unstable proximal and middle phalanx fractures are typically managed with surgical means with common complications of tendon tethering, stiffness, and secondary hand dysfunction. As a result, alternative conservative measures are being explored. The use of static linear traction through the application of an orthosis allows for fracture reduction and anatomic healing, with successful range of motion outcomes. Read More

J Hand Surg Asian Pac Vol 2021 Sep;26(3):485-489

Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore.

The use of wide-awake local anesthesia with no tourniquet (WALANT) in surgical procedures of the hand is well described and extends to tendon surgery, carpal tunnel release, trapeziectomy and phalangeal fracture fixation. Its use has not been described in corrective osteotomies of phalangeal or metacarpal fracture malunion. In our series of five patients who underwent phalangeal and metacarpal osteotomies under WALANT, all of the patients achieved union at a mean of 3. Read More

Hand (N Y) 2021 Jul 26:15589447211030690. Epub 2021 Jul 26.

St Andrews Centre for Burns and Plastic Surgery, Broomfield, UK.

Background: Intramedullary screw fixation is a relatively new technique for fixation of metacarpal and phalangeal fractures. The objective of this study was to compare health care-associated costs and outcomes for intramedullary screw versus Kirschner wire (K-wire) fixation of hand fractures.

Methods: A retrospective review of patients undergoing intramedullary screw fixation of hand fractures at a single center during 2016-2019 inclusive was conducted. Read More