A retrospective review of 25 consecutive patients with 28 proximal pha
langeal fractures was performed. Fractures oi the thumb were excluded.
Twenty-five fractures were closed and three were open. All fractures
were reduced, closed, and fixed using flexible intramedullary fixation
with 0.8-mm prebent nails. Fractures amenable to flexible intramedull
ary fixation include short oblique and transverse fractures. Contraind
ications include long oblique, spiral, and bicortical comminuted fract
ures. The average follow-up time was 10 months (range, 2-20). Five pat
ients with six fractures were lost to follow-up evaluation. All of the
remaining 23 fractures healed and there were no infections. An averag
e of 2 degrees angulation was seen on anteroposterior x-ray films. One
patient showed 4 degrees of angulation on the lateral x-ray film. No
shortening was noted. One fracture showed appreciable malrotation of 1
0 degrees. Flexible intramedullary redding of specific proximal phalan
geal fractures provides excellent results with a low complication rate
. Proper selection of fractures and good surgical technique are necess
ary to avoid complications.