Liodaki E, MD, Kisch T, MD, Wenzel E, MD, Mailander P, Prof, Stang F, MD

ePlasty, 2017, Feb, Vol 17

Objective: Fractures of metacarpals and phalanges are very common fractures, and there are a lot of treatment modalities. The purpose of the study was to describe the technique of percutaneous fixation of phalangeal fractures using a cannulated compression screw fixation system and its results.

Methods: We conducted a prospective clinical study of 43 patients with different types of phalangeal fractures undergoing a percutaneous cannulated compression screw osteosynthesis. Parameters such as average operation time and clinical outcome were evaluated postoperatively.

Results: Forty-three patients were treated using a percutaneous cannulated compression screw fixation system for phalance fractures of the proximal (n=26), the middle phalanx (n=16), or distal phalanx (n=1). All fractures healed after 6 to 8 weeks except in 1 patient with secondary loss of reduction occuring 2.5 weeks after surgery. No infections were observed. The mean total active motion valued were 247.56* +/- 16.16* and 244.35* +/- 11.61* for the intra-articular fractgure and 251.25* +/- 19.86* for the shaft fractures; the mean Disabilities of the Arm, Shoulder, and Hand (DASH) score 3 months after the surgery was 1.67 +/- 2.74.

Conclusions: The advantages of this technique are the avoidance of an open procedure requiring extensive soft-tissue dissection with the risks of tendon adhesions and the achievement of interfragmentary compression. Because of the intergragmentary compression, it is superior to simple K-wires. With regard to indications, our primary focus was on unicondylar proximal interphalangeal joint fractures, shaft fractures, and simple oblique 2-fragment fractures.