Low-velocity gunshot wounds of the proximal phalanx: treatment by early stable fixation

The Journal of Hand Surgery
M H GonzalezRobert F Hall

Abstract

Twenty-eight proximal phalangeal fractures secondary to low-velocity gunshot wounds in 27 patients treated by stable fixation were retrospectively reviewed. Definitive fixation was performed within 1 week of injury. Fractures were stabilized with either a plate, intramedullary spacer, or a combination of both. When necessary, supplemental fixation was achieved with cerclage wires or interfragmentary screws. Twenty fractures with bone loss or comminution were primarily supplemented with iliac crest bone graft. After surgery, the fingers were splinted in 90 degrees of metacarpophalangeal (MP) flexion. An aggressive supervised therapy program was initiated within 24 hours of surgery. The average length of follow-up care was 9 months (range, 3-29 months). Primary union was achieved in all fractures. The average range of motion was 83 degrees for the MP joint and 66 degrees for the proximal interphalangeal joint. The average total active motion (TAM) for the involved digits was 200 degrees (range, 65 degrees-250 degrees). Fractures without intra-articular extension had a significantly better average TAM (213 degrees) than did those with intra-articular extension (169 degrees; p = .05). Primary bone grafting did not adversely effect ...Continue Reading

References

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Citations

Mar 21, 2007·International Orthopaedics·Mahmut KömürcüMustafa Basbozkurt
Dec 22, 2005·The Journal of Hand Surgery : Journal of the British Society for Surgery of the Hand·Michel Saint-CyrAmit Gupta
May 21, 2003·Journal of Hand Therapy : Official Journal of the American Society of Hand Therapists·Alan E FreelandShannon Singletary
Dec 3, 2013·Hand : Official Journal of the American Association for Hand Surgery·Anna Babushkina, Scott Edwards
Sep 18, 2013·The Journal of Hand Surgery·David Ruta, Kagan Ozer
Oct 22, 2008·The Journal of Hand Surgery·O Alton BarronBenjamin Chia
Jul 18, 2006·Hand Clinics·Michel Saint-Cyr, Amit Gupta
Apr 10, 2003·Hand Clinics·Alan E FreelandSheila G Lindley
Jan 25, 2006·Annals of Plastic Surgery·Robert L RodriguesKevin C Chung
Jun 7, 2015·Current Reviews in Musculoskeletal Medicine·Vasanth SathiyakumarManish K Sethi
Oct 8, 2005·Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery·Frederik J T Van OosteromSteven E R Hovius
Oct 4, 2008·The Journal of the American Academy of Orthopaedic Surgeons·Mark H Henry
Mar 5, 2003·Clinical Orthopaedics and Related Research·Robert H Wilson
Jul 20, 2017·Hand : Official Journal of the American Association for Hand Surgery·Paul A GhareebDiane Payne
Jun 11, 2021·Hand : Official Journal of the American Association for Hand Surgery·Brian W StarrDavid M Megee

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