Purpose: To evaluate the outcome for surgical stabilization of middle phalanx shaft fractures with joint-sparing antegrade intramedullary K-wire fixation.
Methods: We treated 15 extra-articular transverse or short oblique shaft fractures of the middle phalanx in 13 patients. All fractures were treated with closed reduction internal fixation with antegrade joint-sparing intramedullary K-wires. Patients had a minimum follow-up of 1 year (range, 1-10 y). We assessed the objective outcome at 6 months by calculating total active range of motion.
Results: All fractures healed. Based on the total active motion score at 6 months, 10 digits showed excellent results, 3 digits were good, 1 was fair, and 1 was poor. Among 3 patients with an associated flexor tendon injury, 2 had excellent outcomes and one had a poor outcome. For 2 patients with an associated extensor tendon injury, 1 had a good outcome and the other had a fair outcome.
Conclusions: Antegrade intramedullary wiring for extra-articular transverse and short oblique shaft fracture of middle phalanx is a simple, safe, inexpensive, and joint-sparing technique that provides enough fracture stability, even in cases of associated injuries, for early rehabilitation and functional recovery with the expectation of a good to excellent outcome.
Type of study/level of evidence: Therapeutic IV.
Keywords: Antegrade; intramedullary; middle; phalanx; wire.
Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.