title: Treatment of atrophic nonunion of middle phalanx in a nine-year-old boy with external distraction and bone grafting.
abstract: Nonunion of phalangeal fractures is uncommon and even rarer in the paediatric age group. There is paucity of literature relating to the treatment of atrophic non-union of phalangeal fractures in the paediatric age group. We present a case of five years old atrophic non-union of the middle phalanx of the index finger of the dominant hand in a nine-year-old male child, managed with a staged treatment protocol of initial fracture site distraction with a threaded external fixator followed by delayed bone grafting. This treatment was successful in attaining length and bony union in case of atrophic non-union of the middle phalanx with a good pinch strength and gaining a good range of motion at the proximal interphalangeal joint with little soft tissue dissection.
authors.affiliation: Patankar's Hand and Limb Reconstruction Clinic, 204, Garodia Market, Plot No. 8-A, D.K. Sandu Marg, Chembur, Mumbai-400071, Maharashtra, India.
authors.forename: Anoop C
authors.initials: AC
authors.lastname: Dhamangaonkar
authors.forename: Hemant S
authors.initials: HS
authors.lastname: Patankar
mesh_terms: D016025:Bone Transplantation; D002648:Child; D016267:External Fixators; D050278:Finger Phalanges / Q000293:injuries*; D005592:Fracture Fixation; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D019857:Osteogenesis, Distraction / Q000379:methods*; D011859:Radiography
keywords: Atrophic Nonunion; Bone Grafting; External Fixator; Fracture Phalanx