title: Percutaneous Cannulated Compression Screw Osteosynthesis in Phalanx Fractures: The Surgical Technique, the Indications, and the Results.
abstract: Objective:Fractures of metacarpals and phalanges are very common fractures, and there are a lot of treatment modalities. The purpose of the study was to describe the technique of percutaneous fixation of phalangeal fractures using a cannulated compression screw fixation system and its results.Methods:We conducted a prospective clinical study on 43 patients with different types of phalangeal fractures undergoing a percutaneous cannulated compression screw osteosynthesis. Parameters such as average operation time and clinical outcome were evaluated postoperatively.Results:Forty-three patients were treated using a percutaneous cannulated compression screw fixation system for phalanx fractures of the proximal (n = 26), middle phalanx (n = 16), or distal phalanx (n = 1). All fractures healed after 6 to 8 weeks except in 1 patient with secondary loss of reduction occurring 2.5 weeks after surgery. No infections were observed. The mean total active motion values were 247.56° ±16.16° and 244.35° ± 11.61° for the intra-articular fracture and 251.25° ± 19.86° for the shaft fractures; the mean Disabilities of the Arm, Shoulder, and Hand (DASH) score 3 months after the surgery was 1.67 ± 2.74.Conclusions:The advantages of this technique are the avoidance of an open procedure requiring extensive soft-tissue dissection with the risks of tendon adhesions and the achievement of interfragmentary compression. Because of the interfragmentary compression, it is superior to simple K-wires. With regard to indications, our primary focus was on unicondylar proximal interphalangeal joint fractures, shaft fractures, and simple oblique 2-fragment fractures.
authors.affiliation: Department of Plastic Surgery, Hand Surgery and Burn Care Unit, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
authors.forename: Eirini
authors.initials: E
authors.lastname: Liodaki
authors.affiliation: Department of Plastic Surgery, Hand Surgery and Burn Care Unit, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Kisch
authors.affiliation: Department of Plastic Surgery, Hand Surgery and Burn Care Unit, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
authors.forename: Eike
authors.initials: E
authors.lastname: Wenzel
authors.affiliation: Department of Plastic Surgery, Hand Surgery and Burn Care Unit, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Mailänder
authors.affiliation: Department of Plastic Surgery, Hand Surgery and Burn Care Unit, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Stang
keywords: cannulated screw; compression screw; hand fracture; percutaneous screw fixation; phalanx fracture