Intramedullary Compression Screw Fixation of Proximal Phalangeal Fractures: A Systematic Literature Review

Author:

Sivakumar Brahman S.1ORCID,An Vincent V. G.2,Graham David J.3ORCID,Ledgard James1,Lawson Richard D.1,Furniss Dominic4

Affiliation:

1. Royal North Shore Hospital, St Leonards, NSW, Australia

2. Royal Prince Alfred Hospital, Camperdown, NSW, Australia

3. Gold Coast University Hospital, Southport, QLD, Australia

4. Nuffield Orthopaedic Centre, Oxford, United Kingdom

Abstract

Proximal phalangeal fractures have traditionally been fixed via either Kirschner wires or dorsal plating. Concerns regarding lack of compression and potential for infection with wire fixation, and adhesion formation and stiffness with plating, have lead to alternative fixation methods, such as intramedullary screw fixation. However, the literature regarding this modality is limited. Methods: A systematic review was performed to review the literature regarding intramedullary screw fixation for proximal phalangeal fractures. English language studies that reported original data and commented on at least one postoperative measure of function were eligible for inclusion. 4 studies were eligible for inclusion, with a further 3 studies assessing proximal and middle phalanges analysed separately. Total active motion was greater than 240° in all proximal phalangeal studies; mean post-operative DASH was 3.62. 6% of patients sustained a major complication. Intramedullary screw fixation of proximal phalangeal fractures is safe, providing stable fixation to allow early motion.

Publisher

SAGE Publications

Subject

Orthopedics and Sports Medicine,Surgery

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