title: Outcomes of closed reduction and periarticular pinning of base and shaft fractures of the proximal phalanx.
abstract: OBJECTIVE
  To review the results of periarticular pinning of extra-articular fractures of the proximal phalanx base and shaft.
  
  
  METHODS
  A retrospective review was performed of the senior author's practice (C.S.M.) from 2006 to 2012. The inclusion criteria were patients older than 18 years of age who underwent periarticular pinning of base or shaft fractures of the proximal phalanx. Age, sex, fracture location, fracture pattern, and time to surgery were recorded. Outcome measures were range of motion, time to healing, and complication rate.
  
  
  RESULTS
  A total of 43 patients with 50 fractures were identified. There were 19 men and 24 women with 16 shaft and 34 base fractures. Five fractures were open. The little finger was involved in 62%, the ring finger in 30%, and the index and middle fingers in 4% each. Most fractures were transverse or oblique, and just over half had comminution and/or impaction. Average follow-up was 17 weeks, and average time to clinical union was 35 days. Nine patients (18%) were lost to follow-up. Twenty-six fingers had excellent results (63%), lacking less than 10° of total motion. Seven patients (17%) had good results, lacking less than 20° of motion; 7 patients had fair results (17%); and 1 patient had a poor result. Three patients (7%) developed stiffness requiring tenolysis. There were 2 pin-site infections, 1 of which resulted in a loss of reduction. Results for shaft and base fractures were not significantly different.
  
  
  CONCLUSIONS
  Percutaneous periarticular pinning is an acceptable option for unstable base and shaft fractures of the proximal phalanx. Most fractures healed within 4 weeks. The majority of patients had excellent or good results.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA; Hand Surgery Service, Massachusetts General Hospital, Boston, MA.
authors.forename: Kyle R
authors.initials: KR
authors.lastname: Eberlin
authors.affiliation: Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA; Hand Surgery Service, Massachusetts General Hospital, Boston, MA.
authors.forename: Anna
authors.initials: A
authors.lastname: Babushkina
authors.affiliation: Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA; Hand Surgery Service, Massachusetts General Hospital, Boston, MA.
authors.forename: Juliana Rojas
authors.initials: JR
authors.lastname: Neira
authors.affiliation: Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA; Hand Surgery Service, Massachusetts General Hospital, Boston, MA. Electronic address: cmudgal@partners.org.
authors.forename: Chaitanya S
authors.initials: CS
authors.lastname: Mudgal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D050278:Finger Phalanges / Q000293:injuries* / Q000601:surgery; D005592:Fracture Fixation; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Base; percutaneous pinning; proximal phalanx; shaft