Adolescent ; Adult ; Aged ; External Fixators ; Female ; Finger Injuries ; surgery ; Finger Phalanges ; injuries ; Fracture Fixation ; methods ; Humans ; Male ; Middle Aged

Osteochondroma is the most common benign bone tumor around the metaphysis. Usually, it is originated from the peripheral area of metaphysis-physis junction due to mutation of physeal chondrocyte. This 1-year and 3-month-old boy presented with a mallet deformity. Radiographs showed an abnormal mass on the distal part of the middle phalanx. It was connected to the articular cartilage which was not associated with the physis. Operative and pathologic findings showed typical osteochondroma. After excision of the osteochondroma with sparing of the extensor tendon and immobilization for 6 weeks with a full extension splint, the pseudomallet deformity disappeared.
Cartilage, Articular ; Chondrocytes ; Congenital Abnormalities ; Finger Phalanges ; Fingers ; Humans ; Immobilization ; Infant ; Osteochondroma ; Splints ; Tendons

Adequate debridement and flap operations are effective treatment methods for chronic osteomyelitis. Several flap operations have been described for treating chronic osteomyelitis in various regions. We performed anterolateral thigh fasciocutaneous free flap and iliac bone graft for treating posttraumatic chronic osteomyelitis in hand. The result was successful with satisfactory control of osteomyelitis and avoiding amputation of fingers.
Amputation ; Bone Transplantation ; Debridement ; Finger Phalanges ; Fingers ; Free Tissue Flaps* ; Hand* ; Osteomyelitis* ; Thigh* ; Transplants*

Phalangeal neck fractures occur almost exclusively in children. We present the case of a 49 years old man with a dislocated fracture of the neck of the middle phalanx with the distal fragment rotated at 180? due to a traumatic circular saw injury to the left index, which was solved by anatomical reduction and bone fixation with two 1.5 mm Synthes screws and a temporary transarticular K-wire at the distal interphalangeal joint. Zone I flexor digitorum profundus repair was performed using a modification of the Kessler 4-strands core suture and a full-thickness skin graft from the hypothenar eminence was taken to cover the skin gap. At 6-month follow-up the patient was pain-free and with a total active movement equivalent to 190? No radiological signs of avascular necrosis of the head of the middle phalanx or nonunion of the distal fragment was detectable with recovery to the previous manual work. Owing to the position of the phalangeal head maintained in position by the collateral ligaments an anatomic reduction from dorsal approach is difficult to be performed and a longitudinal traction can render the reduction harder too. The volar approach permits an easier reduction of the fracture through a derotation of the distal fragment facing palmar.
Finger Phalanges ; diagnostic imaging ; injuries ; surgery ; Fractures, Bone ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Radiography

OBJECTIVETo explore therapeutic effects of minor external fixator for open comminuted phalangeal fractures with non-transarticular.

METHODSFrom January 2013 to December 2014,13 patients with open comminuted phalangeal fractures were treated by minor external fixator with non-transarticular, including 9 males and 4 females aged from 18 to 56 years old with an average of 35 years old. According to Gustilo classification, 8 cases were type II, and 5 cases were type III. The time from injury to operation ranged from 2 to 7 h averaged 5 h. Seven patients were diagnosed as phalangeal fracture, 6 patients were involved with joint surface of phalangeal, which 1 case combined with inherent nerve damage and 1 case combined with soft tissue defect repaired at stage II. The patients were fixed by plaster for 2 weeks and removal external fixtor from 6 to 8 weeks after operation and received functional exercise.

RESULTSAll patients were followed up from 3 to 12 months with an average of 7 months. One case occurred metacarpophalangeal joints stiffness. No screw breakage, inflammation occurred. Skin soft tissue recovered well and obtained bone healing, the average time of bone healing was (4.6 ± 1.0) weeks. According to TAM scoring system used by Hand Surery Association of Chinese Medical Association, 7 cases got excellent results, 4 good, 1 moderate and 1 poor.

CONCLUSIONMinor external fixator for open comminuted phalangeal fractures with non-transarticular has advantages of simple operation, good stability, and could adjust at the later stage, less damage for soft tissue periosteum, low inflammatory rate, earlier functional exercise. It is worth to be popularized and applied.

Adolescent ; Adult ; External Fixators ; Female ; Finger Phalanges ; injuries ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged

We report an innovative approach to reconstructing the defect after excision of giant tumor cell (GCT) involving the entire first metacarpal. Reconstruction was performed using non-vascularized fibular autograft fused at the metacarpo-phalangeal (MP) joint and soft tissue arthroplasty using ligament reconstruction and tendon interposition (LRTI) at the carpo-metacarpal (CMC) joint of the thumb.

Two years after the procedure, the CMC joint had functional pain-free motion and radiographs showed fusion of the MP joint. The patient did not present with any major complication and was satisfied with the outcome of the procedure.

Human ; Female ; Young Adult ; Thumb ; Metacarpal Bones ; Autografts ; Metacarpophalangeal Joint ; Arthroplasty ; Tendons ; Finger Phalanges ; Ligaments ; Pain

Hand fractures are the second most common fracture in the upper extremities after the distal radius, and patients with these injuries may be experienced in hand surgery clinics. On the other hand, during the treatment of hand fractures, complications can occur due to complex functions of the hand and small-sized injuries to the bone and soft tissues. This review focused on the principles of management of these fractures, including injury mechanism, evaluations and recent treatment options. Minimally invasive surgery in various types of hand fractures, including the phalanx and metacarpal bone, is preferred because early mobilization after surgery has been emphasized to reduce complications, such as stiffness.
Early Ambulation ; Finger Phalanges ; Hand ; Humans ; Metacarpal Bones ; Minimally Invasive Surgical Procedures ; Radius ; Upper Extremity

Binder syndrome is a maxillonasal dysostosis characterized by midface and nasal hypoplasia. It is sometimes associated with short terminal phalanges of fingers and toes and transient radiological features of chondrodysplasia punctata. It is associated with vitamin K deficiency during pregnancy. We describe here a baby with Binder syndrome who was born from mother with cholelithiasis during pregnancy.
Cholelithiasis ; Chondrodysplasia Punctata ; Dysostoses ; Finger Phalanges ; Humans ; Infant ; Maxilla ; Maxillofacial Abnormalities ; Mothers ; Nose ; Pregnancy ; Toes ; Vitamin K ; Vitamin K Deficiency

PURPOSE: Hand fractures can be treated conservatively in many cases, but rotation malalignment is one of the important indications for surgical treatment because of dysfunction. We performed open reduction and internal fixation in these malalignment fractures and report clinical and radiological results. METHODS: This study included 28 patients (18 male, 10 female) who had metacarpal and phalangeal fractures with rotational malalignment of finger on initial examination. Patients with combined injuries including open soft tissue damage or multiple fractures were excluded. Mean age was 36.1 years and average follow-up period was 14.6 months. Perioperative extent of rotation and correction during the follow-up, union on the radiographs, Range of motion, disability of the arm, shoulder and hand (DASH) score, and pinch power at the last follow-up were evaluated. RESULTS: Average corrected angulation of rotation was 11.9° and no patient showed scissoring appearance of fingers at the last follow-up. All patients showed solid bony union on the radiographs during the follow-up. The average of total active motion of the injured fingers were average 254°, average DASH score was 3.2 and average pinch power was 3.0 kg at the last follow-up. CONCLUSION: Clinical and radiologically satisfactory results were obtained in all patients. Care should be taken not to overlook the rotational misalignment after fracture of the hand, and surgical treatment should be considered to ensure correct reduction and fixation.
Arm ; Finger Phalanges ; Fingers ; Follow-Up Studies ; Fractures, Multiple ; Hand ; Humans ; Male ; Metacarpal Bones ; Range of Motion, Articular ; Shoulder

PURPOSE:The cone-shaped epiphyses mid-5 (CSE-5) and brachymesophalagia-5 (BMP-5) are common osseous anomalies. Those are thought to be normal variants. We evaluated the frequency of CSE-5 and BMP-5 and the influence of them on adult height in Korean children with normal short stature. METHODS:We retrospectively reviewed medical records of 322 normal short stature children. Lengths of the fourth (MP-4) and fifth middle phalanx (MP-5) and widths of MP-5 of all children were measured. Two indicies for BMP-5 were used. Index 1 was based upon the ratio of the width to the length of the MP-5. Index 2 was based upon the ratio of the lengths of MP-5 to MP-4. CSE-5 was assessed by visual inspection only. We assessed several clinical parameters as follows; advanced skeletal maturation, z-scores of height, target height (THz) and predicted adult height (PAHz) according to CSE-5 and/or BMP-5. Results:Of the 322 children, 23.6% had BMP-5 (male 19.5%, female 27.4%), 23.6% had CSE-5 (male 13.0%, female 33.3%). The children with CSE-5 and/or BMP-5 were more advanced skeletal maturation than normal fifth finger (0.07+/-1.09 yrs vs -0.23+/-1.34 yrs, P=0.049), lower PAHz (-1.13+/-1.09 vs -0.71+/-1.28, P=0.008), lower PAHz- THz (-0.53+/-1.07 vs -0.14+/-1.30, P=0.013). In male subjects, the PAHz had weak correlation with index 1 (r=-0.26, P=0.001) and index 2 (r=0.27, P=0.001). CONCLUSION:This study suggests that BMP-5 and CSE-5 in Korean children with short stature are one contributable factor for adult height.
Adult ; Body Height ; Bone Development ; Bone Morphogenetic Protein 5 ; Child ; Epiphyses ; Female ; Finger Phalanges ; Fingers ; Humans ; Male ; Medical Records ; Retrospective Studies