Management of Proximal Phalangeal Fractures of the Hand Using Finger Nail Traction and a Digital Splint: A Prospective Study of 43 Cases
| Autor: | Shah Jehan, Sathya Thambiraj, Thangavel Chandraprakasam |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Adult
Male musculoskeletal diseases medicine.medical_specialty Adolescent medicine.medical_treatment Digital splint Hand fractures Finger Phalanges Fractures Bone Traction Deformity Humans Medicine Orthopedics and Sports Medicine Proximal phalangeal fractures Prospective Studies Malunion Range of Motion Articular Aged Orthodontics business.industry Soft tissue Middle Aged Phalanx Traction (orthopedics) medicine.disease Surgery Radiography Splints Treatment Outcome Nails Original Article Female Nail traction medicine.symptom Contracture business Range of motion Conservative treatment |
| Zdroj: | Clinics in Orthopedic Surgery |
| ISSN: | 2005-4408 2005-291X |
| DOI: | 10.4055/cios.2012.4.2.156 |
| Popis: | Phalanges are the most common sites for fractures in the hand.1,2) If not managed properly, these apparently minor fractures can result in long lasting deformity due to reduction in the range of motion in the adjacent joints.3) The annual incidence of phalangeal fractures is 2.9%.3) They are more common in the male age group 20-29 years.3-7) Proximal phalangeal fractures constitute about 13% of all hand fractures.4) Various mechanisms have been reported in literate to cause these fractures. The most common mechanisms include road traffic accidents, industrial injuries, falls and sport related injuries.3,4) Proximal phalangeal fractures are difficult to treat irrespective of the mode of treatment. Surgical stabilization can result in further tissue trauma resulting in adherence of soft tissues and reduction in the range of movement in the adjacent joints.5) In addition to that, the internal fixation devices can interfere with tendon gliding. The conservative techniques such as splints and braces on the other hand may not be able to maintain the reduced position. This can result in delayed union or malunion. Any prolonged immobilization can result in stiffness of the joints and require long-term physical therapy. The objective of treating hand fractures is to obtain fracture union in acceptable alignment and early mobilization to prevent stiffness.6,7) With metacarpophalangeal (MCP) joint flexed at 90 degrees, the proximal phalangeal fractures are usually held in reduction.5,8) The collateral ligaments of the MCP joint in flexed position are taut with minimal chances of stiffness due to contracture. The extension of proximal interphalangeal (PIP) joints prevents volar plate contracture.6) The longitudinal traction applied in this position makes the extensor and flexor tendons tense, which provides dorsal and volar stability. This study reports the results of 43 proximal phalangeal fractures which were managed by a nail traction technique. Longitudinal traction was applied through the finger nail. The soft tissues around the proximal phalanx were made tense with traction to provide stability and maintain reduction. |
| Databáze: | OpenAIRE |
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