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MP Transarticular Fixation of Fractures of the Proximal Phalanx Base
André Bastos Duarte Eiras, MD; Jorge Ribamar Bacellar Costa, MD; José Maurício Morais Carmo, MD
Unit of Hand and Microsurgery/Orthopaedics and Traumatology, Hospital Universitario Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil

Introduction: We evaluated the efficacy of the transarticular fixation of fractures of the base of the proximal phalanx by the technique originally described by Belsky et al. A total of 12 patients presenting 16 fractures of the proximal phalanx base or of the shaft were operated between 2001 and 2010.

Methods: Twelve patients presenting a total of 16 fractures were retrospectively evaluated. All patients presented extra-articular fractures of the base of the proximal phalanx, classified as displaced and unstable fractures, regardless of the fracture line type. There were eight men and four women, with age ranging from 20 to 65 years old (avg 40.5 y.o.). The patients were submitted to surgery on average at 3.5 days from the trauma (range 0-9 days). There were nine fractures on the right side and seven on the left. The most frequent injured finger was the little finger (8 cases). There was one open fracture. All patients were submitted to a local wrist block under sedation prior to surgery. The fractures were reduced by closed means and fixed percutaneously under fluoroscopy accordingly to the technique originally described by Belsky et al.

Results: There were 83.3% (ten patients) of excellent / good results and 16.7% poor results (two patients). The results were similar to other studies using this technique. It may offer advantages over other methods of fixation, as it seems to have a lower incidence of complications. There were no complications regarding the MP joint due to its transfixation.

Conclusion: The percutaneous transarticular fixation of fractures of the proximal phalanx base is a simple method, and provides good results when compared to other methods of treatment. It can be used for comminuted fractures and for shaft fractures, and the transfixation of the flexed MP joint does not cause joint limitation.

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