Extra-articular mini-open proximal phalanx osteotomy with retrograde intramedullary headless screw under WALANT - Surgical technical

X Gueffier; E Gueffier; D Lalonde

doi:10.1016/j.hansur.2021.05.005

Extra-articular mini-open proximal phalanx osteotomy with retrograde intramedullary headless screw under WALANT - Surgical technical

Hand Surg Rehabil. 2021 Oct;40(5):687-691. doi: 10.1016/j.hansur.2021.05.005. Epub 2021 May 24.

Authors

X Gueffier¹, E Gueffier², D Lalonde³

Affiliations

¹ Artezieux Center, 40 Avenue des Alpes, 38300 Bourgoin Jallieu, France. Electronic address: xavier.gueffier@icloud.com.
² Université de Picardie - Jules Verne, 1-3 Rue des Louvels, 80000 Amiens, France. Electronic address: elisegueffier@icloud.com.
³ Dalhouisie University, Suite C204, 600 Main Street, Saint John, NB E2K 1J5, Canada. Electronic address: drdonlalonde@dnb.aibn.com.

PMID: 34033929
DOI: 10.1016/j.hansur.2021.05.005

Abstract

We report on the surgical technique for mini-open derotation osteotomy using retrograde osteosynthesis by headless compression screw under WALANT anesthesia (video attached). Preoperative CT showed the feasibility of this technique, with a 2.2 mm headless compression screw. The mechanical stability of the resulting constructs combined with intraoperative active motion testing under WALANT authorized immediate rehabilitation without immobilization, thus preventing stiffness. Joint range of motion recovered by day 4 and bone consolidation was achieved at 30 days.

Keywords: Anesthésie locale; Cal vicieux phalangien; Cal vicieux rotatoire; Intramedullary headless screw; Local anesthesia; Mini-open; Ostéotomie de phalange; Phalange proximale; Phalanx malunion; Phalanx osteotomy; Proximal phalanx; Retrograde; Rotational malunion; Rétrograde; Vis intramédullaire sans tête; WALANT.

MeSH terms

Bone Screws
Fracture Fixation, Internal / methods
Fractures, Bone* / surgery
Humans
Osteotomy
Range of Motion, Articular