[Pseudarthrosis and delayed union of the distal phalanx of the long fingers. Apropos of 13 cases].
OBJECTIVE
The authors present 13 cases of delayed or non-union of the distal phalanx of the long fingers treated surgically.


METHODS
The patients were all men aged from 41 years to 60 years. The involved digits were 4 second, 2 long, 5 ring, and 2 little fingers. The operated side was the right side 5 times, the left one 8 times, the dominant one 4 times. Ten cases were due to inadequate treatment of the initial fracture. The three others cases had no clear explanation. Three types of incisions were used: transverse distal, lateral or an extended one combining the two previous. Bone stabilisation was made either, by longitudinal K wires or with a small cancellous screw. In 7 cases, bone grafting was needed.


RESULTS
Bone healing was obtained in 9 cases in an average time of 9 weeks. Further procedures included: 2 distal amputations after septic conditions, 2 removals of distal bone fragment and 2 fusions of the distal interphalangeal joint. Overall results evaluated by the patients themselves were fair, including 2 excellent, 6 good (but 2 after distal interphalangeal joint arthrodesis), 2 mild (1 after distal interphalangeal joint arthrodesis), 1 poor and 2 failures.


CONCLUSIONS
The type of skin incision was chosen according to the bone condition; distal in cases of fibrous nonunion when fibrous tissue removal and bone grafting were needed. Neither the type of bone stabilisation (pinning or screwing) nor the donor site of bone grafting influenced the final result.


CONCLUSIONS
The authors would like to stress the importance of an adequate treatment of finger injuries in a emergency situation, considering the difficulties to restore secondarily a satisfactory functional outcome.
Voche
P
P
Service de Chirurgie Plastique et Reconstructrice de l'Appareil Locomoteur, CHRU Nancy, Hôpital Jeanne d'Arc, Toul.
Merle
M
M
Pillot
D
D
D000328:Adult; D005383:Finger Injuries / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary; D017759:Fractures, Malunited / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011542:Pseudarthrosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D011859:Radiography; D016059:Range of Motion, Articular
Pseudarthroses et retards de consolidation de la phalange distale des doigts longs. A propos de 13 cas.