Surgical Technique|Articles in Press

Reverse Instrumentation for Headless Compression Screw Fixation of Basal Proximal Phalangeal Fractures

  • Brahman Sivakumar
    Corresponding author: Brahman Sivakumar, MBBS, BSci (Med), MS, MSc, Australian Research Collaboration on Hands (ARCH), 4/75 Railway St; Mudgeeraba QLD 4213, Australia.
    Department of Hand and Peripheral Nerve Surgery, Royal North Shore Hospital, St. Leonards NSW, Australia

    Australian Research Collaboration on Hands (ARCH), 4/75 Railway St, Mudgeeraba QLD, Australia

    Department of Surgery, Faculty of Medicine, University of Sydney, Camperdown NSW, Australia

    Department of Orthopaedic Surgery, Hornsby Ku-ring-gai Hospital, Hornsby NSW, Australia

    Department of Orthopaedic Surgery, Nepean Hospital, Kingswood, NSW, Australia
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  • David J. Graham
    Australian Research Collaboration on Hands (ARCH), 4/75 Railway St, Mudgeeraba QLD, Australia

    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
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Published:February 23, 2023DOI:
      Intramedullary headless compression screw fixation of proximal phalangeal fractures permits semirigid stabilization through a minimally invasive approach with negligible tendon disturbance, allowing early mobilization and rehabilitation. Antegrade insertion is preferred for basal fractures, but various concerns and technical difficulties have been identified with both intra- and transarticular instrumentation. We describe a technical tip to facilitate easier guidewire insertion and instrumentation with a screw via an intra-articular approach.

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