INTRAMEDULLARY NAILING OF PROXIMAL PHALANGEAL FRACTURES

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.