title: Treatment of unstable distal phalanx fractures by extra-articular DIP pinning: A series of 12 cases.
abstract: Unstable distal phalanx fractures are typically treated by pinning of the distal phalanx or the distal interphalangeal joint (DIP). Complications include unstable fixation, K-wire migration, septic arthritis and osteoarthritis. To limit these complications, we wanted to explore the benefits of using locked extra-articular DIP pinning. The cohort consisted of 12 patients (mean age 36.3 years) who had an extra-articular (6 cases) or intra-articular distal phalanx fracture (6 cases). All patients were treated surgically with a construct consisting of two connected K-wires: one was placed inside the shaft of the distal phalanx and the other was placed perpendicular to the middle phalanx. The K-wires were removed after 1 month. After an average follow-up of 19.9 weeks, pain was 0.4/10 and the QuickDASH score was 7.41/100 on average. The range of motion was, on average, 30.0° less than the contralateral uninjured side for active flexion, 8.8° less for active extension, 32.0° less for passive flexion and 4.1° less for passive extension. The overall hand strength averaged 85.2% of the contralateral one. One secondary displacement occurred but there were no infections. In all, these findings suggest that locked extra-articular DIP pinning is a simple and reproducible surgical treatment for distal phalanx fractures.
  
  
  
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authors: Hand Surgery Department, SOS main, CCOM, Strasbourg University Hospital, FMTS, Strasbourg University, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France.
authors: G
authors: G
authors: Prunières
authors: Hand Surgery Department, SOS main, CCOM, Strasbourg University Hospital, FMTS, Strasbourg University, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France.
authors: S
authors: S
authors: Gouzou
authors: Hand Surgery Department, SOS main, CCOM, Strasbourg University Hospital, FMTS, Strasbourg University, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France.
authors: S
authors: S
authors: Facca
authors: Hand Surgery Department, SOS main, CCOM, Strasbourg University Hospital, FMTS, Strasbourg University, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France.
authors: A-S
authors: AS
authors: Matheron
authors: Hand Surgery Department, SOS main, CCOM, Strasbourg University Hospital, FMTS, Strasbourg University, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France.
authors: N
authors: N
authors: Maire
authors: Hand Surgery Department, SOS main, CCOM, Strasbourg University Hospital, FMTS, Strasbourg University, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France.
authors: J-J
authors: JJ
authors: Hidalgo Díaz
authors: Hand Surgery Department, SOS main, CCOM, Strasbourg University Hospital, FMTS, Strasbourg University, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France. Electronic address: Philippe.liverneaux@chru-strasbourg.fr.
authors: P
authors: P
authors: Liverneaux
mesh_terms: D000293:Adolescent; D000328:Adult; D001170:Arthritis, Infectious / Q000209:etiology / Q000517:prevention & control*; D001864:Bone Wires; D005260:Female; D050278:Finger Phalanges / Q000293:injuries*; D005593:Fracture Fixation, Internal / Q000379:methods*; D005594:Fracture Fixation, Intramedullary / Q000379:methods; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D057072:Intra-Articular Fractures / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000209:etiology / Q000517:prevention & control*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D016059:Range of Motion, Articular; D016896:Treatment Outcome; D055815:Young Adult
keywords: Articulation interphalangienne distale; Brochage; Distal interphalangeal joint; Distal phalanx fracture; Doigt en maillet; Fracture de la phalange distale; Mallet finger; Pinning