Comparison Between Intramedullary Nail and Percutaneous Pin Fixation in Proximal Phalanx Fractures.

Autor:	Hollins AW; Division of Hand Surgery, Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA., Dunworth K; Division of Hand Surgery, Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA., Mithani SK; Division of Hand Surgery, Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA., Pidgeon TS; Division of Hand Surgery, Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA., Klifto CS; Division of Hand Surgery, Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA., Ruch DS; Division of Hand Surgery, Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA., Richard MJ; Division of Hand Surgery, Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA.
Jazyk:	angličtina
Zdroj:	Hand (New York, N.Y.) [Hand (N Y)] 2024 Feb 27, pp. 15589447241232009. Date of Electronic Publication: 2024 Feb 27.
DOI:	10.1177/15589447241232009
Abstrakt:	Background: Percutaneous pinning has been the predominant technique for fixation of proximal phalanx fractures, but stiffness is a reported complication. The introduction of intramedullary (IM) nail fixation of proximal phalanx fractures provides a stronger biomechanical fixation for amenable fracture patterns with the added benefit of not tethering the soft tissue. The goal of this study was to compare the surgical outcomes of IM nail and percutaneous pin fixation in isolated proximal phalanx fractures. Methods: A retrospective review was performed at our institution between the years 2018 and 2022 for patients treated for proximal phalanx fractures. Patients that underwent fixation with IM nails or percutaneous fixation for isolated extraarticular proximal phalanx fractures were included. Patients were excluded if they had concomitant hand fractures, tendon injury, or intraarticular extension. Results: A total of 50 patients were included in this study. Twenty-eight patients received percutaneous pin fixation, and 22 patients underwent IM nail or screw fixation. There was no significant difference in injury patterns or demographics between these two groups. Patients that underwent IM nail fixation had a significantly quicker return to active motion, shorter duration of orthosis treatment, and fewer occupational therapy visits. In addition, patients in the IM fixation group had significantly improved range of motion (ROM) at 6 weeks postoperatively. Conclusions: This study demonstrates that patients receiving percutaneous pin or IM nail fixation have equivocal union and complication rates. The IM nail fixation group was able to have quicker return to mobilization, fewer required occupational therapy visits, and improved early ROM. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: D.S.R. has received royalties from Acumed and Zimmer and serves as a consultant for Acumed and Depuy Synthes. M.J.R. has received royalties from Acumed and Field Orthopaedics and serves as a consultant to Acumed, DJO Global, restor3d, and Zimmer Biomet. All other authors have no conflicts of interest.
Databáze:	MEDLINE
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