Minimally invasive surgical treatment for unstable fractures of the proximal phalanx: intramedullary screw

Aita, Marcio Aurélio; Mos, Paulo Augusto Castro; Leite, Gisele de Paula Cardoso Marques; Alves, Rafael Saleme; Credídio, Marcos Vinicius; Costa, Eduardo Fernandes da

doi:10.1016/j.rboe.2015.12.005

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Original Articles • Rev. bras. ortop. 51 (1) • jan-feb 2016 • https://doi.org/10.1016/j.rboe.2015.12.005 copy

Minimally invasive surgical treatment for unstable fractures of the proximal phalanx: intramedullary screw^{^☆} ☆ Work performed in the Discipline of Orthopedics and Hand Surgery, Faculdade de Medicina do ABC (FMABC), Santo André, SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE:

To analyze the clinical-functional parameters and quality of life of patients undergoing minimally invasive surgical treatment for extra-articular fractures of the proximal phalanx, using an intramedullary screw (Acutrak^(r)).

METHODS:

Between January 2011 and September 2014, a prospective study was conducted on 41 patients (48 fingers) with unstable extra-articular fractures of the proximal phalanx, who underwent minimally invasive surgical treatment using an intramedullary screw (Acutrak^(r)). These patients were evaluated 12 months after the surgery by means of the DASH quality-of-life questionnaire, VAS pain scale, measurement of range of motion (ROM, in degrees) and radiographic assessment.

RESULTS:

All the patients achieved adequate reduction and consolidation of their fractures. There were statistically significant improvements in quality of life on the DASH scale, pain on the VAS scale and range of motion.

CONCLUSION:

The minimally invasive technique for treating unstable extra-articular fractures of the proximal phalanx using an intramedullary screw (Acutrak^(r)) is effective and safe, and it presents satisfactory clinical-functional results.

Keywords:
Fracture fixation; Internal facture fixation; Fractures of the proximal phalanx

Number	Age (years)	Finger affected	Follow-up (months)	Return to work	Complications
1	36	2nd right	12	Before 6 months	No
2	36	3rd right	12	Same occupation	No
3	48	4th right	12	Same occupation	No
4	26	2nd right	12	Other occupation	Yes
5	23	4th left	12	Other occupation	No
6	19	4th left	12	Same occupation	No
7	29	5th right	12	Same occupation	No
8	36	1st left	12	Other occupation	No
9	21	3rd right	12	Same occupation	No
10	24	2nd right	12	Other occupation	Yes
11	24	3rd right	12	Other occupation	No
12	36	4th left	12	Same occupation	No
13	48	2nd left	12	Other occupation	No
14	41	3rd right	12	Same occupation	No
15	21	5th right	12	Same occupation	Yes
16	30	2nd right	21	Same occupation	No
17	32	3rd right	20	Other occupation	No
18	25	3rd right	20	Same occupation	No
19	28	5th right	20	Same occupation	No
20	19	3rd right	18	Same occupation	No
21	23	1st right	18	Other occupation	No
22	25	2nd left	17	Same occupation	No
23	25	3rd left	17	Same occupation	No
24	29	5th left	17	Same occupation	No
25	32	5th left	17	Other occupation	No
26	30	5th left	17	Same occupation	No
27	25	2nd right	15	Same occupation	No
28	47	4th right	16	Same occupation	No
29	19	5th right	12	Same occupation	No
30	28	5th right	12	Same occupation	No
31	28	4th right	12	Same occupation	No
32	23	5th right	12	Other occupation	Yes
33	28	3rd right	12	Other occupation	No
34	28	4th right	12	Other occupation	No
35	28	5th right	12	Other occupation	No
36	25	3rd right	33	Same occupation	No
37	29	5th right	32	Same occupation	No
38	46	1st right	32	Same occupation	No
39	29	4th left	32	Same occupation	No
40	51	5th right	31	Same occupation	No
41	38	1st left	31	Same occupation	No
42	29	2nd right	23	Same occupation	No
43	29	3rd right	23	Same occupation	No
44	36	5th right	20	Same occupation	No
45	42	5th right	20	Same occupation	No
46	21	3rd left	19	Same occupation	No
47	36	5th left	19	Same occupation	No
48	19	2nd right	19	Same occupation	No

Pair of variables	n	Mean	Standard deviation	Minimum	Maximum	25th percentile	50th percentile (median)	75th percentile	Significance (p)
Normal ROM	48	100.0	0.00	100.0	100.0	100.0	100.0	100.0	0.002
ROM after 1 year	48	97.02	7.02	65.0	100.0	96.25	100.0	100.0
Normal DASH	48	1.00	0.00	1.00	1.00	1.00	1.00	1.00	0.002
DASH after 1 year	48	3.56	7.00	1.00	45.0	1.00	1.00	4.00
Normal VAS	48	1.00	0.00	1.00	1.00	1.00	1.00	1.00	0.002
VAS after 1 year	48	1.52	1.11	1.00	6.00	1.00	1.00	1.75

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] * Corresponding author. E-mail:eduardo.fcosta42@gmail.com (E.F. da Costa).

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Minimally invasive surgical treatment for unstable fractures of the proximal phalanx: intramedullary screw☆ ☆ Work performed in the Discipline of Orthopedics and Hand Surgery, Faculdade de Medicina do ABC (FMABC), Santo André, SP, Brazil.

ABSTRACT

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSION:

Minimally invasive surgical treatment for unstable fractures of the proximal phalanx: intramedullary screw^{^☆} ☆ Work performed in the Discipline of Orthopedics and Hand Surgery, Faculdade de Medicina do ABC (FMABC), Santo André, SP, Brazil.