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A Prospective Randomized Controlled Study of Fixation of Long Oblique and Spiral Shaft Fractures of the Proximal Phalanx: Closed Reduction and Percutaneous Kirschner Wiring Versus Open Reduction and Lag Screw FixationFrom the Department of Trauma and Orthopaedics, University Hospital Queens Medical Centre, Nottingham, UK Correspondence: Prof. T. R. C. Davis, ChM FRCS, Special Professor of Orthopaedic and Trauma Surgery, Department of Trauma and Orthopaedics, Queens Medical Centre, Nottingham NG7 2UH, UK. Tel.: 0115 924 9924 Ext. 44337/44917; Fax: 0115 920 9921; E-mail: t.davis{at}btinternet.com Patients with an isolated spiral or long oblique fracture of the proximal phalanx were randomized into two groups. One was treated by closed reduction and Kirschner wire fixation and the second treated by open reduction and lag screw fixation. An independent observer assessed function, pain, movement, grip strength and intrinsic muscle function. X-rays were assessed for malunion. Thirty-two patients were entered the study and 15 in the Kirschner wire and 13 in the lag screw group were reviewed at a mean follow-up of 40 months. There was no significant difference in the functional recovery rates or in the pain scores for the two groups. X-rays showed similar rates of malunion and there were no statistically significant differences in range of movement or grip strength.
Journal of Hand Surgery (British and European Volume), Vol. 28, No. 1,
5-9 (2003) |
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