RESEARCH ARTICLE


Post-Traumatic Malunion of the Proximal Phalanx of the Finger. Medium-Term Results in 24 Cases Treated by “In Situ” Osteotomy



Vito Potenza, Vincenzo De Luna, Pierluigi Maglione, Luca Garro, Pasquale Farsetti, Caterini Roberto
Department of Orthopaedic Surgery, University of Rome Tor Vergata, viale Oxford 81 - 00133 - Rome, Italy


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© Potenza et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Orthopaedic Surgery, University of Rome Tor Vergata, Viale Oxford 81, 00133 – Rome, Italy; Tel: +39 06.2090.3466; E-mail: vitopotenza2@virgilio.it


Abstract

We report the clinical and radiographic medium-term results obtained for 20 patients (24 fingers) treated surgically for post-traumatic malunion of the proximal phalanx of the finger. In all cases we performed a corrective osteoclasia or osteotomy at the site of malunion, followed by miniplate and screw fixation or by screw fixation only. The corrective osteoclasia was performed when malalignment was addressed within six weeks after injury. Two patients who had two fractures underwent additional surgery (tenolysis and/or capsulolysis) to improve function and ROM. At the final follow-up, at a mean of 24 months after corrective surgery, good or excellent clinical and radiographic results were obtained in all the patients. The pseudoclaw deformity disappeared in all cases in which a volar angulation deformity was present. An average improvement of about 30% in the range of motion of the MP and PIP joints was observed; only 4 patients complained of mild pain at the maximum degrees of articular excursion of the MP and PIP joints. All the patients presented an improvement in grip strength. The mean DASH score in our series was 5 points. In two of the four cases treated by an intra-articular corrective osteotomy, mild radiographic signs of osteoarthritis at the MP joint were present. The data for this study confirm that “in situ” osteotomy stabilized by miniplates and/or screws is an effective procedure to correct post-traumatic malunions of the proximal phalanges of the fingers.

Keywords:: Malunion, proximal phalanx of the finger, corrective osteotomy of malunion, osteoclasia, pseudoclaw deformity, miniplate and screw fixation.