Double X Configuration Screw Fixation for Middle Phalanx Fracture - A Case Report.

Abstract

Introduction: Techniques for treating phalangeal fractures are evolving. Intramedullary screws are a trendy surgical choice that leads to optimal results. Metacarpals and proximal phalanges could tolerate two screws. We want to demonstrate that middle phalanx fractures could also be treated with double-cannulated screws.

Case report: A 19-year-old patient with a middle phalanx fracture of the 4th left digit was treated with Kirschner wires leading eventually to malunion. We revised the fracture with a redo, recreating the fracture and introducing retrograde crossed-cannulated screws with excellent stability that allowed an immediate range of motion. The patient achieved union with full grip and range of motion.

Conclusion: Middle phalanx fractures could be treated with two screws in a crossed configuration achieving stable fixation and obviating the proximal interphalangeal joint.