title: Open proximal phalangeal shaft fractures of the hand treated by theta fixation.
abstract: BACKGROUND
  Many implants and techniques are used for the treatment of open phalangeal fractures with varying grades of stability. The ubiquitous and simple Kirschner (K) wiring does not provide adequate stability to allow early mobilization of fingers. Lister described a combination of coronal interosseous wire and oblique K-wire technique for phalangeal fracture fixation with a stable construct that allowed early mobilization. Due to the fancied resemblance of this construct to the Greek alphabet θ (theta), we have referred to this as the theta fixation.
  
  
  METHODS
  Ten patients with open proximal phalangeal shaft (transverse) fractures were treated with theta fixation between January and June 2010. Outcome was analysed in terms of stability, early mobilization, fracture healing and function of hand. They were graded according to the Belsky score.
  
  
  RESULTS
  90% patients were graded excellent and 10% good, with none having fair or poor results. All fractures allowed the mobilization at a mean of 2.9 days and all healed at an average of 6.1 weeks. No loss of stability was seen on followup X-rays. All patients returned to their old profession.
  
  
  CONCLUSIONS
  The theta fixation technique is a safe, simple and effective method for open transverse phalangeal fractures with results comparable to other techniques. This method gives superior fracture stability to allow early mobilization of joints and thus early return of function. It is also a cost effective way of management for the developing world.
authors.affiliation: Dr. Paul Brand Centre for Hand Surgery, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
authors.forename: Binu Prathap
authors.initials: BP
authors.lastname: Thomas
authors.affiliation: Dr. Paul Brand Centre for Hand Surgery, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
authors.forename: R
authors.initials: R
authors.lastname: Sreekanth
authors.affiliation: Dr. Paul Brand Centre for Hand Surgery, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
authors.forename: Samuel C Raj
authors.initials: SC
authors.lastname: Pallapati
keywords: Hand; Hand fracture; Lister fixation; finger; fracture; fracture fixation; interosseous wiring; phalanx fracture; theta fixation