[Conservative vs operative treatment of isolated fractures of phalanges: results of the prospective, randomized study].
OBJECTIVE
To compare outcomes of conservative and operative treatment of isolated fractures of phalanges.


METHODS
The results of the treatment of isolated fractures of phalanges in 22 patients, 18 men (82%) and 4 women (18%), aged a mean of 28 years, who were randomized to one of the two methods: close reduction and immobilization in a plastofit splint or percutaneous fixation by Kirschner-wires were assessed. Patients were followed-up at 2 and 6 months and measurements included active range of motion, total and pinch grip strength and DASH score.


RESULTS
Bone healing was achieved in all patients. No significant secondary displacements were noted in either group, requiring change of the treatment mode. At 2 months, all but one (DASH score) considered parameters were statistically significantly better in patients treated conservatively. At 6 months, the outcomes did not differ statistically significantly, however were hence better in conservative treatment group.


CONCLUSIONS
Our results indicate greater effectiveness of conservative, than operative by Kirschner-wiring treatment of phalangeal fractures. One may assume that withdrawal of immobilization of proximal interphalangeal joint and early mobilization might improve functional results after operative treatment.
Zyluk
Andrzej
A
Klinika Chirurgii Ogólnej i Chirurgii Reki, Pomorska Akademia Medyczna w Szczecinie. azyluk@hotmail.com
Budzyński
Tomasz
T
D000328:Adult; D001864:Bone Wires; D005260:Female; D050278:Finger Phalanges / Q000293:injuries* / Q000601:surgery; D005592:Fracture Fixation / Q000379:methods*; D005593:Fracture Fixation, Internal / Q000379:methods; D017102:Fracture Healing; D050723:Fractures, Bone / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007103:Immobilization / Q000379:methods; D008297:Male; D008875:Middle Aged; D013165:Splints; D016896:Treatment Outcome; D055815:Young Adult