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KMID : 0386420080210020140
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Journal of the Korean Fracture Society
2008 Volume.21 No. 2 p.140 ~ p.144
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The Results of Surgical Treatment for Nonunion of Phalanges in the Hand
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Kim Hee-Dong
Kim Yoon-Hong
Choi Yong-Soo
Jung Heun-Guyn
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Abstract
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Purpose: To evaluate the results of internal fixation and autogenous bone graft for the phalangeal nonunion in the hand.
Materials and Methods: From Feb. 2000 until May 2006, thirteen cases that had been treated for non-union of phalanges in the hand were investigated retrospectively. Seven cases were treated with mini-plate fixation and autogenous cancellous graft and six cases with Kirschner wire fixation and autogenous cancellous graft. We analyzed bony union period radiographically and clinical results according to Belsky’s score.
Results: Thirteen cases obtained bony union. Seven cases of mini-plate fixation and bone graft, and six cases of K-wire fixation and bone graft achieved the bony union postoperatively on average 7.9 weeks and 6.3 weeks, respectively. Clinical results were "good" in four cases and "poor" in nine cases according to the Belsky’s score. Only one of ten cases with associated injuries, such as tendon, nerve, arterial injuries and other finger fractures in the injured hand, had the good clinical result, but all three cases without associated injuries had the good one.
Conclusion: Internal fixation and autogenous bone graft can be a successful treatment of phalangeal nonunion. However, more careful choice of surgical treatment methods and preoperative explanation of poor post-operative results or complications should be made for phalangeal nonunion with associated injuries in the finger because of poor outcome in those cases.
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KEYWORD
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Phalanx, Nonunion, Surgical treatment
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