Correction of distal phalangeal nonunion using peg bone graft.
OBJECTIVE
To evaluate the outcome of a peg bone graft for treatment of distal phalangeal nonunion, in terms of safety and effectiveness.


METHODS
We performed grafts using bone pegs in 13 patients who reported pain and instability of the fingertip as a result of distal phalanx nonunion. Surgical procedures included harvesting cancellous and cortical bone from ilium, radius, or ulna. We made a small incision in the fingertip and placed the bone pegs through the canal created for this access. In a few cases in which the bone peg did not offer mechanical stability, we used K-wires for additional support.


RESULTS
All patients had successful union of the distal phalanx without serious complications in either donor or recipient areas. Range of motion improved postoperatively. An additional operation was needed in 1 case.


CONCLUSIONS
The use of a peg bone graft in the treatment of distal phalanx nonunion offers easy access to the nonunion area and allows for effortless internal fixation. The bone contact area was increased, resulting in bone union and stability. Therefore, bone peg graft could be considered a potential method for the treatment of distal phalanx nonunion.


METHODS
Therapeutic IV.
Department of Plastic Surgery, Inha University School of Medicine, Incheon; and the Department of Plastic and Reconstructive Surgery, Gwang Myung Sung Ae General Hospital, Gwang Myung, Korea.
Jinsoo
J
Kim
Department of Plastic Surgery, Inha University School of Medicine, Incheon; and the Department of Plastic and Reconstructive Surgery, Gwang Myung Sung Ae General Hospital, Gwang Myung, Korea. Electronic address: mdki1967@gmail.com.
Sae Hwi
SH
Ki
Department of Plastic Surgery, Inha University School of Medicine, Incheon; and the Department of Plastic and Reconstructive Surgery, Gwang Myung Sung Ae General Hospital, Gwang Myung, Korea.
Youngjin
Y
Cho
D000328:Adult; D000368:Aged; D000673:Amputation, Traumatic / Q000503:physiopathology / Q000601:surgery; D016025:Bone Transplantation; D001864:Bone Wires; D005260:Female; D005383:Finger Injuries / Q000503:physiopathology / Q000601:surgery*; D050278:Finger Phalanges / Q000293:injuries* / Q000502:physiology / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods; D005599:Fractures, Ununited / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology / Q000601:surgery; D016059:Range of Motion, Articular / Q000502:physiology; D012086:Reoperation; D012189:Retrospective Studies
Distal phalanx; graft; nonunion; peg bone