Article

Finger fractures are the most common skeletal injuries of the upper limbs. The
purpose of this study was to evaluate the functional outcomes and complications
after surgical management of isolated, closed fractures of the proximal phalanx
(PP) of the hand (thumb excluded). Surgical management was indicated in 87 PP
fractures. Fractures were reduced and fixed with pins, screws or a plate.
Functional outcomes were assessed through the range of motion (ROM) in
flexion-extension, hand and finger strength, and the QuickDASH and PRWHE scores.
Fixation was done with pins in 32 cases, screws in 41 cases, and a plate in 14
cases. Rehabilitation was started an average of 1.7 weeks after surgery. There
was no significant difference in the functional outcomes based on either fracture
type or surgical approach. Nevertheless, the following significant differences
were observed: PRWHE score (P=0.017) by injured finger; proximal interphalangeal
(PIP) ROM (P=0.037) by fixation type; and grip strength (P=0.019), Quick DASH
(P=0.017), and PRWHE (P=0.045) by rehabilitation delay. The most common clinical
complications were minor malrotation and cold intolerance. Radiological
assessment showed complete union in all cases. Surgical management of PP
fractures leads to good functional outcomes, including a satisfactory recovery of
finger ROM. The functional recovery of a fractured digit is dependent on the
right fixation choice, complete bone union, and early rehabilitation. We suggest
using screw fixation to achieve patient satisfaction and optimal functional
recovery of closed, isolated PP fractures of the long fingers.
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Langue : ANGLAIS