Intramedullary Compression Screw Fixation for Middle Phalangeal Fractures

Adam R George; Hagen Abbot; Luke McCarron; David J Graham; Brahman S Sivakumar

doi:10.1016/j.jhsa.2023.12.011

Intramedullary Compression Screw Fixation for Middle Phalangeal Fractures

J Hand Surg Am. 2024 Feb 2:S0363-5023(23)00690-1. doi: 10.1016/j.jhsa.2023.12.011. Online ahead of print.

Authors

Adam R George¹, Hagen Abbot², Luke McCarron³, David J Graham⁴, Brahman S Sivakumar⁵

Affiliations

¹ Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Camperdown, NSW, Australia. Electronic address: adamrgeorge@protonmail.com.
² Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Camperdown, NSW, Australia.
³ Department of Musculoskeletal Services, Gold Coast University Hospital, Southport, QLD, Australia.
⁴ Department of Musculoskeletal Services, Gold Coast University Hospital, Southport, QLD, Australia; Griffith University School of Medicine and Dentistry, Southport, QLD, Australia; Department of Orthopaedic Surgery, Queensland Children's Hospital, South Brisbane, QLD, Australia; Australian Research Collaboration on Hands (ARCH), Mudgeeraba, QLD, Australia; School of Medicine, University of Queensland, Herston, QLD, Australia.
⁵ Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Camperdown, NSW, Australia; Department of Hand & Peripheral Nerve Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia; Australian Research Collaboration on Hands (ARCH), Mudgeeraba, QLD, Australia; Department of Orthopaedic Surgery, Hornsby Ku-ring-gai Hospital, Hornsby, NSW, Australia; Department of Orthopaedic Surgery, Nepean Hospital, Kingswood, NSW, Australia.

PMID: 38310510
DOI: 10.1016/j.jhsa.2023.12.011

Abstract

Purpose: This study aimed to evaluate short- and medium-term clinical and patient-reported outcomes of intramedullary compression screw fixation for extra-articular middle phalangeal fractures.

Methods: A retrospective study was performed on a series of 20 patients (with a total of 23 fractured digits) who underwent fixation of middle phalangeal fractures between January 2020 and March 2023. The results from this cohort were compared against those for plate and K-wire fixation in the literature.

Results: Total active motion was 246°; Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score was 4.9; verbal numerical pain score was 1.1 of 10; mean time for return to work was 62.5 days; and a single complication was noted in the entire cohort.

Conclusion: Intramedullary screw fixation is a viable option in the treatment of extra-articular middle phalangeal fractures. It offers a favorable postoperative range of motion, good duration for return to function, excellent rates of complication, and low pain scores.

Type of study/level of evidence: Therapeutic IV.

Keywords: Fracture; intramedullary; middle; phalangeal; screw.