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Surgical Technique|Articles in Press

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

  • Brahman Sivakumar
    Correspondence
    Corresponding author: Brahman Sivakumar, MBBS, BSci (Med), MS, MSc, Australian Research Collaboration on Hands (ARCH), 4/75 Railway St; Mudgeeraba QLD 4213, Australia.
    Affiliations
    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
    Affiliations
    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:https://doi.org/10.1016/j.jhsa.2022.12.012
      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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      References

        • Sivakumar B.S.
        • An V.V.G.
        • Phan K.
        • et al.
        Range of motion following extensor tendon splitting vs. tendon sparing approaches for plate osteosynthesis of proximal phalangeal fractures - a systematic review and meta-analysis.
        J Hand Surg Asian Pac Vol. 2020; 25: 462-468
        • del Piñal F.
        • Moraleda E.
        • Rúas J.S.
        • de Piero G.H.
        • Cerezal L.
        Minimally invasive fixation of fractures of the phalanges and metacarpals with intramedullary cannulated headless compression screws.
        J Hand Surg Am. 2015; 40: 692-700
        • Sivakumar B.S.
        • An V.V.G.
        • Graham D.J.
        • Ledgard J.
        • Lawson R.D.
        • Furniss D.
        Intramedullary compression screw fixation of proximal phalangeal fractures: a systematic literature review.
        Hand (N Y). 2020; 17: 595-601
        • Geurts G.
        • van Riet R.
        • Meermans G.
        • Verstreken F.
        Incidence of scaphotrapezial arthritis following volar percutaneous fixation of nondisplaced scaphoid waist fractures using a transtrapezial approach.
        J Hand Surg Am. 2011; 36: 1753-1758
        • Yoshida R.
        • House H.O.
        • Patterson R.M.
        • Shah M.A.
        • Viegas S.F.
        Motion and morphology of the thumb metacarpophalangeal joint.
        J Hand Surg Am. 2003; 28: 753-757
        • Marshall T.G.
        • Sivakumar B.S.
        • Smith B.J.
        • Hile M.S.
        Mechanics of metacarpophalangeal joint extension.
        J Hand Surg Am. 2018; 43: 681.e1-681.e5
        • Leibovic S.J.
        • Bowers W.H.
        Anatomy of the proximal interphalangeal joint.
        Hand Clin. 1994; 10: 169-178
        • Ibanez D.S.
        • Rodrgues F.L.
        • Salviani R.S.
        • Roberto F.A.R.
        • Pengo Jr., J.R.
        • Aita M.A.
        Experimental trial on surgical treatment for transverse fractures of the proximal phalanx: technique using intramedullary conical compression screw versus lateral compression plate.
        Rev Bras Ortop. 2015; 50: 509-514
        • Borbas P.
        • Dreu M.
        • Poggetti A.
        • Calcagni M.
        • Giesen T.
        Treatment of proximal phalangeal fractures with an antegrade intramedullary screw: a cadaver study. J.
        Hand Surg Eur Vol. 2016; 41: 683-687
        • Vegas M.J.R.
        • Diez M.E.E.
        • Nunez P.M.
        • Veganzones R.A.
        Use of intramedullary cannulated headless screws in the treatment of hand fractures–an anatomical study on long fingers.
        Rev Iberam Cir Mano. 2017; 45: 94-103