Compression fixation with cross-locking Kirschner wires for bicondylar fractures of the phalangeal neck in fingers (toes)
10.3760/cma.j.cn115530-20240714-00294
- VernacularTitle:加压交叉锁定克氏针固定法治疗指（趾）骨颈双髁骨折的疗效分析
- Author:
Jiguo YANG
1
;
Shilin GU
1
;
Chong LIU
1
Author Information
1. 浙江省台州医院手足外科，台州 318050
- Publication Type:Journal Article
- Keywords:
Finger phalanges;
Toe phalanges;
Fracture fixation, internal;
Kirschner wires;
Cross-locking
- From:
Chinese Journal of Orthopaedic Trauma
2025;27(1):84-87
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy of compression fixation with cross-locking Kirschner wires in the treatment of bicondylar fractures of the phalangeal neck in fingers (toes).Methods:A retrospective study was conducted to analyze the clinical data of 15 patients with bicondylar fractures of the phalangeal neck in fingers (toes) who had been treated from February 2019 to August 2023 at Department of Hand and Foot Surgery, Taizhou Hospital. The patients were all treated by compression fixation with cross-locking Kirschner wires. They were 13 males and 2 females with an age of (43.4±11.0) years and with 9 hands and 6 feet involved. In 2 of them, the fracture line of the bone block was completely located far from the insertion point of the lateral collateral ligament (condylar lateral recess). After surgery, no additional external fixation was used for all but 2 patients whose bone fold line was fixed with plaster for 3 to 4 weeks at a distance from the lateral collateral ligament insertion point. Follow-up records included fracture healing time, visual analogue scale (VAS) pain score at postoperative 3 months, total active motion (TAM) of the finger for hand patients at the final follow-up, and surgical complications.Results:All patients were followed up for (5.4±3.0) months. The VAS pain score for all patients was 0 (0, 0) point at postoperative 3 months. Only 2 patients reported mild pain in the hand at 3 months postoperatively (their VAS pain score was 1 or 2 respectively). At 12-month follow-up, 1 foot patient reported mild pain (1 point of VAS) and the other 5 foot patients experienced no pain while they were carrying weights and walking normally. X-ray evaluations at postoperative 4, 6, and 8 weeks showed nonunion of a middle phalanx intra-articular fracture of the ring finger in 1 case, complicated by bone resorption and joint stiffness which were not further treated. The other cases achieved bony union after an average healing time of (7.1±1.9) weeks. Of the 8 hand patients whose total active motion was measured at the final follow-up using the TAM scoring system, 6 were rated as excellent and 2 as good. No fracture displacement, loosening or withdrawal of Kirschner wires, or no needle tunnel infection occurred.Conclusion:In the treatment of bicondylar fractures of the phalangeal neck in fingers (toes), compression fixation with cross-locking Kirschner wires offers advantages of simplicity in operation, minimal invasiveness, good stability, and facilitation of early postoperative rehabilitation.
