Treatment of open fracture of the distal phalanx with syringe needle and nail template

Abstract

Objective To report the feasibility and efficacy of the treatment of open fracture of the distal phalanx with nail bed injury. Methods From June 2016 to August 2018, 28 patients with open fracture of the distal phalanx of 34 fingers with nail bed injury admitted to the emergency department of our hospital were treated. After thorough debridement, one or two No.7 syringe needles were used to screw from the bottom or side of nail bed through the fingertip, and the fracture end was fixed by intramedullary fixation under direct vision. After nail bed reduction in situ without suture, nail template was made with 5 ml syringe barrel (if the original nail was intact, it could be trimmed and replanted) and covered the surface of the nail bed. The nail template was removed 3 weeks after operation, and the syringe needle was removed 4 to 6 weeks after operation to observe fracture healing and nail growth. Results All the patients were follow-up for 3 to 18 months, and all wounds achieved primary healing. No infection or nonunion occurred. The nail regeneration was evaluated as excellent in 25 fingers, good in 6 fingers, fair in 2 fingers, and poor in 1 finger, with the excellent and good rate being 91.2%. The finger flexion and extension function was rated as excellent in 26 fingers, good in 4 fingers, fair in 3 fingers, and poor in 1 finger, with the excellent and good rate being 88.2%. Conclusion The method of fixing the fracture of the distal phalanx with syringe needle is reliable. The nail template made by syringe needle barrel covering the lacerated nail bed is simple and effective in preventing nail deformity after operation. Key words: Finger phalanges; Fractures,bone; Nail bed; Syringe needle; Nail template