Adhesions as an Uncommon Complication of K-Wiring in Paediatric Phalangeal Fractures
- Author:
NANCHAPPAN S
1
Author Information
1. Hand and Microsurgery Unit, Department of Orthopaedics and Traumatology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.
- Collective Name:NANCHAPPAN S; PARMINDER GS; NUR AZUATUL AK; TAN JA, AHMAD SUPARNO B; JAMARI S; SHALIMAR A
- Publication Type:Journal Article
- Keywords:
adhesions;
flexor tendon;
fracture;
percutaneous K–wire;
phalanx;
proxima
- From:Medicine and Health
2019;14(1):203-208
- CountryMalaysia
- Language:English
-
Abstract:
Paediatric hand fractures are common and prompt management is mandatory to
achieve a good functional outcome. However many fail to realize that treating a
fracture does not only involve bones but the soft tissues, as well. K-wiring itself
can be difficult with multiple attempts inadvertently injuring the flexor or extensor
tendons and resulting in adhesions. We highlight this possible complication of
K-wiring which we believe is under reported due to the perception that K-wiring
is a simple procedure. We present a case of a 9-year-old child, who sustained a
closed displaced fracture of the base of the proximal phalanx (Salter Harris type 2)
of the left index finger. He underwent percutaneous K-wiring but was complicated
with severe adhesions of the flexor digitorum profundus (FDP) and flexor digitorum
superficialis tendons (FDS). He was unable to flex the proximal and distal
interphalangeal joints of the affected finger. We subsequently performed tendon
adhesiolysis twice together with A2 pulley reconstruction, to restore movement
of the finger. K-wiring of the fingers are not just simple bony procedures but also
involve soft tissue components which can be prone to adhesions
- Full text:12.2019my0104.pdf